For OBFC@ the haplotype carrying both rare alleles ( rs@G and rs@C , haplotype frequency @ ) was associated with lower CHD prevalence ( OR : @ ; @ % CI : @-@ @ ; P = @ ) .


The TERC haplotype GTC ( rs@G , rs@T and rs@C , haplotype frequency @ ) was associated with lower risk for both CHD ( OR : @ ; @ % CI : @-@ @ ; P = @ ) and T@D ( OR : @ ; @ % CI : @-@ @ ; P = @ ) , with no effect on LTL .


Only the last association remained after adjusting for multiple testing .


Of reported associations , only that between the OBFC@ rs@ SNP and LTL was confirmed , although our study has a limited power to detect modest effects .


A @-SNP OBFC@ haplotype was associated with higher risk of CHD , and a @-SNP TERC haplotype was associated with both higher risk of CHD and T@D .


Further work is required to confirm these results and explore the mechanisms of these effects .


To examine whether older adults with vision impairment differentially benefit from cognitive speed of processing training ( SPT ) relative to healthy older adults .


Secondary data analyses were conducted from a randomised trial on the effects of SPT among older adults .


The effects of vision impairment as indicated by ( @ ) near visual acuity , ( @ ) contrast sensitivity , ( @ ) self-reported cataracts and ( @ ) self-reported other eye conditions ( e.g. , glaucoma , macular degeneration , diabetic retinopathy , optic neuritis , and retinopathy ) among participants randomised to either SPT or a social - and computer-contact control group was assessed .


The primary outcome was Useful Field of View Test ( UFOV ) performance .


Mixed repeated-measures ancovas demonstrated that those randomized to SPT experienced greater baseline to post-test improvements in UFOV performance relative to controls ( p 's < @ ) , regardless of impairments in near visual acuity , contrast sensitivity or presence of cataracts .


Those with other eye conditions significantly benefitted from training ( p = @ ) , but to a lesser degree than those without such conditions .


Covariates included age and baseline measures of balance and depressive symptoms , which were significantly correlated with baseline UFOV performance .


Among a community-based sample of older adults with and without visual impairment and eye disease , the SPT intervention was effective in enhancing participants ' UFOV performance .


The analyses presented here indicate the potential for SPT to enhance UFOV performance among a community-based sample of older adults with visual impairment and potentially for some with self-reported eye disease ; further research to explore this area is warranted , particularly to determine the effects of eye diseases on SPT benefits .


Flu-like symptoms ( FLS ) are commonly experienced by patients receiving interferon gamma-@b which may cause discontinuation or disruption of dosing during initial therapy or on re-initiation following a break in therapy .


In contrast to Type I interferons , the impact of dose-titration on FLS has not been reported and is not a practice described or included in the approved prescribing information for interferon gamma-@b .


The objective of this study was to assess the effect of a @ week titration regimen on the severity of FLS during the initial @ weeks of therapy with three times weekly subcutaneous injections of interferon gamma-@b .


Healthy men and women were randomized into a double-blind , two-period , crossover study .


Each study period was @ weeks in duration and there was a minimum @ day washout between treatment periods .


Two treatment regimens were compared : No Titration dosing ( full @mcg/m ( @ ) subcutaneously -LSB- s.c. -RSB- three times weekly for @ weeks ) and Titration ( @mcg/m ( @ ) s.c. three times weekly during week @ , @mcg/m ( @ ) s.c. three times weekly during week @ followed by the full dose of @mcg/m ( @ ) s.c. three times weekly during week @ ) .


Subjects remained in the clinic for at least @ hours following each injection .


FLS was based on a composite score for fever , chills , tiredness and muscle aches assessed at baseline and @ , @ and @ hours following each injection .


Acetaminophen was allowed at the discretion of the PI .


The primary endpoint was the change from baseline in FLS severity at @ hours averaged over the @ weeks of treatment .


Additional endpoints included FLS at @ and @ hours , individual flu-like symptoms , rates of discontinuation , incidence of FLS and acetaminophen use .


NCT @ .


Of the @ subjects randomized , there were @ ( @ % ) discontinuations .


Titration resulted in a significant reduction in FLS severity at @ hours ( p = @ ) averaged over the @ week treatment period .


The difference in @ week FLS severity reflects differences during week @ treatment , indicating an early peak in FLS severity during the No Titration treatment and subsequent development of tolerance .


In contrast , titration results in near baseline severity scores throughout the treatment period .


Similar trends were seen for @ and @ hour FLS severity scores .


Of the individual FLS , difference in fever severity was most marked .


Safety profiles for both regimens were consistent with the approved prescribing information for interferon gamma-@b .


Study limitations included the use of healthy subjects rather than disease subjects , the lack of a validated assessment tool for evaluating FLS and the relatively high discontinuation rate .


A short @ week , dose-titration regimen reduces FLS severity following interferon gamma-@b treatment initiation in normal subjects .


Little is known about variables associated with overdrainage complications and neurofunctional and health-related quality of life outcomes in idiopathic normal-pressure hydrocephalus ( iNPH ) patients after shunt surgery .


To identify candidate demographic and disease-specific predictors of overdrainage and patient-related outcomes , allowing for more personalized care of patients with iNPH .


This was a secondary analysis of the dataset of the SVASONA study , a multicenter randomized trial comparing gravitational and conventional gravitational valves for treating iNPH .


We evaluated the association between baseline items and the incidence of overdrainage , using different endpoint definitions .


We identified only a few variables associated with a possible increased risk of overdrainage .


Apart from using conventional rather than gravitational valves , longer duration of surgery and female sex were associated with a higher risk of clinical signs and symptoms suggestive of overdrainage ( hazard ratio : @ , @ % confidence interval : @-@ @ and @ , @ % confidence interval : @-@ @ ) .


The occurrence of clinical symptoms of overdrainage , and the need for exchanging a programmable by a gravitational valve may adversely affect disease-specific outcomes like the Kiefer score .


Few , if any , baseline and treatment characteristics may be helpful in estimating the individual risk of complications and clinical outcomes after shunt surgery for iNPH .


Patients should be informed that longer surgery for any reason may increase the risk of later overdrainage .


Also , women should be counseled about a sex-associated increased risk of the development of clinical symptoms of overdrainage , although the latter can not be distinguished from a generally higher prevalence of headaches in the female population .


Soluble urokinase-type plasminogen activator receptor ( suPAR ) could be a causative factor in idiopathic focal segmental glomerulosclerosis ( FSGS ) .


It is currently unknown to what extent suPAR levels could be affected by treatment with immunosuppressive drugs such as cyclosporin A ( CsA ) and mycophenolate mofetil ( MMF ) .


Treatment with CsA , but not MMF , is accompanied by nephrotoxicity , and since suPAR levels correlate with glomerular filtration rate ( GFR ) , treatment with these drugs could indirectly modulate suPAR levels by their effect on renal function .


We measured suPAR levels in a recent prospective multicenter crossover trial comparing the efficacy of MMF and CsA in pediatric patients with minimal change disease ( MCD ) and frequently relapsing steroid-sensitive nephrotic syndrome ( FR-SSNS ) .


All patients had biopsy-proven MCD and normal renal function ; they were treated with each drug for @ year in a crossover study design .


Serum suPAR levels were measured before and after @ year of therapy with MMF ( n = @ ) and CsA ( n = @ ) .


The suPAR levels decreased after @ year of treatment with MMF ( p < @ ) .


Conversely , suPAR levels increased after @ year of treatment with CsA in the same patients ( p = @ ) .


These changes in suPAR levels were not correlated to the estimated glomerular filtration rate ( eGFR ) or changes in the GFR .


Data from this prospective randomized trial suggest that treatment with MMF and CsA is associated with different effects on suPAR levels in children with MCD and that these are independent of their effects on GFR .


To analyze choroidal thickness ( CT ) in eyes with geographic atrophy ( GA ) secondary to age-related macular degeneration ( AMD ) .


A total of @ eyes of @ patients ( mean age , @ @ years ) with GA and @ eyes of @ healthy controls ( @ @ years ) were examined by confocal scanning laser ophthalmoscopy and enhanced depth imaging ( EDI ) spectral-domain optical coherence tomography .


Choroidal thickness was measured at @ defined points in horizontal and vertical scans .


Geographic atrophy size was determined in fundus autofluorescence ( FAF ) images and GA subtypes were classified based on abnormal FAF in the perilesional zone .


In GA , subfoveal CT ( fCT ) was significantly thinner compared to controls ( @ @ vs. @ @ m , P < @ ) .


Analysis of averaged measurements of all @ points obtained per patient ( mCT ) revealed similar results ( @ @ vs. @ @ m , P < @ ) .


Spatial differences in CT between both groups were largest superior to the fovea .


Addressing `` diffuse-trickling '' ( n = @ ) and `` non-diffuse-trickling '' ( n = @ ) GA independently , fCT was @ @ and @ @ m , respectively ( P = @ ) , with both groups being significantly thinner than controls ( P < @ for `` diffuse-trickling '' and P < @ for '' ?


non-diffuse-trickling '' ) .


Similar results were obtained for mCT , which was @ @ m in `` diffuse-trickling , '' @ @ m in '' ?


non-diffuse-trickling '' and @ @ m in controls .


Differences were significant with P = @ between both GA groups and P @ toward controls for each GA group .


The results indicate that the choroid in eyes with GA is thinner compared to normal eyes of similar age .


Hereby , the extent of thinning is most pronounced in a specific subtype of GA identified by FAF imaging ( `` diffuse trickling '' ) .


Such GA subtype-related differences in choroidal thickness may reflect heterogeneity in the pathogenesis of disease .


( ClinicalTrials.gov number , NCT@ . )


Because of the high prevalence of overweight and obesity , there is a need to identify cost-effective approaches for weight loss in primary care and community settings .


To evaluate the long-term cost effectiveness of a commercial weight loss programme ( Weight Watchers ) ( CP ) compared with standard care ( SC ) , as defined by national guidelines .


A Markov model was developed to calculate the incremental cost-effectiveness ratio ( ICER ) , expressed as the cost per quality-adjusted life year ( QALY ) over the lifetime .


The probabilities and quality-of-life utilities of outcomes were extrapolated from trial data using estimates from the published literature .


A health sector perspective was adopted .


Over a patient 's lifetime , the CP resulted in an incremental cost saving of AUD @ per patient , and an incremental @ QALYs gained per patient .


As such , the CP was found to be the dominant treatment , being more effective and less costly than SC ( @ % confidence interval : dominant to @ per QALY ) .


Despite the CP delaying the onset of diabetes by @ months , there was no significant difference in the incidence of type @ diabetes , with the CP achieving < @ % fewer cases than SC over the lifetime .


The modelled results suggest that referral to community-based interventions may provide a highly cost-effective approach for those at high risk of weight-related comorbidities .


This study investigates the effectiveness of Lokomat + conventional therapy in recovering walking ability in non-ambulatory subacute stroke subjects involved in inpatient rehabilitation .


Thirty first-ever stroke patients completed @ weeks of intervention .


One group ( n = @ ) received Lokomat therapy twice a week , combined with three times @min a week of conventional overground therapy .


The second group ( n = @ ) received conventional assisted overground therapy only , during a similar amount of time ( @ h a week ) .


The intervention was part of the normal rehabilitation program .


Primary outcome measure was walking speed .


Secondary outcome measures assessed other walking - and mobility-related tests , lower-limb strength and quality of life measures .


All outcome measures were assessed before and after the intervention and at wk @ and wk @ after start of the intervention .


Patients showed significant ( p < @ ) gains in walking speed , other walking - and mobility related tests , and strength of the paretic knee extensors relative to baseline at all assessments .


However , there were no significant differences in improvements in any of the variables between groups at any time during the study .


These results indicate that substituting Lokomat therapy for some of conventional therapy is as effective in recovering walking ability in non-ambulatory stroke patients as conventional therapy alone .


Implications for Rehabilitation Recovery of walking after stroke is important .


Robot-assisted therapy is currently receiving much attention in research and rehabilitation practice as devices such as the Lokomat seem to be promising assistive devices .


Technical developments , sub-optimal study designs in literature and new therapy insights warrant new effectiveness studies .


RESULTS of a financially and practically feasible study indicate that substituting Lokomat therapy for some of conventional therapy is as effective in recovering walking ability in non-ambulatory stroke patients as compared to conventional overground therapy alone .


Huntington 's disease ( HD ) is a complex , single-gene inherited neurodegenerative condition resulting in symptoms that occur across a wide range of neurological domains , including cognitive , behavioral and motor .


The benefits of regular physical activity for people with HD are widely recognized .


However , a number of factors can prohibit sustained exercise and activity .


The purpose of this trial is to explore the feasibility , acceptability and effectiveness of a physical activity intervention program targeted for people with early - to mid-stage HD .


The proposed trial is a single blind , multisite , exploratory , randomized controlled feasibility trial of a physical activity intervention .


A total of @ participants with genetically confirmed HD will be recruited .


Each participant will be involved in the trial for @weeks .


Participants will be randomized immediately following the baseline assessment into either a physical activity intervention or a social contact control intervention .


The physical activity intervention is framed around self-determination theory placed within a broader behaviour change wheel framework .


An HD-specific workbook and individual goal setting will be utilized over six @:@ sessions , with interim telephone calls .


All participants will be reassessed at @weeks following the baseline assessment , and then again at a final follow-up assessment @weeks later .


At the end of the study , all participants will be offered a brief version of the alternative intervention , with one home visit and one follow-up telephone call .


Engaging and supporting people with HD in a regular physical activity program raises a number of challenges .


The physical activity intervention and the comparator social interaction intervention have been developed following consultation with people with HD and their families .


Each are individually tailored and determined on individual needs and goals .


The results from this trial will provide guidance for the development of definitive trials .


Braces used to treat ( PF ) osteoarthritis ( OA ) may reduce contact stress across the PF joint .


We hypothesised that in PF OA , braces would decrease knee pain and shrink PF bone marrow lesions ( BMLs ) .


Eligible subjects had painful PF OA .


Subjects were randomly allocated to brace or no brace for @weeks .


Knee MRIs were acquired at baseline and @weeks .


We measured BMLs on post-contrast fat suppressed sagittal and proton density weighted axial images .


The primary symptom outcome was change in pain at @weeks during a preselected painful activity , and the primary structural outcome was BML volume change in the PF joint .


Analyses used multiple linear regression .


We randomised @ subjects aged @-@years ( mean age @ years ; @ females ( @ % ) ) .


Mean nominated visual analogue scale ( @-@cm ) pain score at baseline was @ cm .


@ knees ( @ % ) had PF BMLs at baseline .


Subjects wore the brace for a mean of @ h/day .


@ subjects withdrew during the trial .


After accounting for baseline values , the brace group had lower knee pain than the control group at @weeks ( difference between groups -@ cm , @ % CI -@ to -@ ; p < @ ) and reduced PF BML volume ( difference -@ mm ( @ ) , @ % CI -@ to -@ ; p = @ ) but not tibiofemoral volume ( difference -@ mm ( @ ) , @ % CI -@ to @ ; p = @ ) .


A PF brace reduces BML volume in the targeted compartment of the knee , and relieves knee pain .


Adjunctive psychosocial interventions are efficacious in bipolar disorder , but their incorporation into routine management plans are often confounded by cost and access constraints .


We report here a comparative evaluation of two online programs hosted on a single website ( www.moodswings.net.au ) .


A basic version , called MoodSwings ( MS ) , contains psychoeducation material and asynchronous discussion boards ; and a more interactive program , MoodSwings Plus ( MS-Plus ) , combined the basic psychoeducation material and discussion boards with elements of Cognitive Behavioral Therapy .


These programs were evaluated in a head-to-head study design .


Participants with Bipolar I or II disorder ( n = @ ) were randomized to receive either MoodSwings or MoodSwings-Plus .


Outcomes included mood symptoms , the occurrence of relapse , functionality , Locus of Control , social support , quality of life and medication adherence .


Participants in both groups showed baseline to endpoint reductions in mood symptoms and improvements in functionality , quality of life and medication adherence .


The MoodSwings-Plus group showed a greater number of within-group changes on symptoms and functioning in depression and mania , quality of life and social support , across both poles of the illness .


MoodSwings-Plus was superior to MoodSwings in improvement on symptoms of mania scores at @ months ( p = @ ) but not on the incidence of recurrence .


The study did not have an attention control group and therefore could not demonstrate efficacy of the two active arms .


There was notable ( @ % ) attrition by @ months from baseline .


This study suggests that both CBT and psychoeducation delivered online may have utility in the management of bipolar disorder .


They are feasible , readily accepted , and associated with improvement .


To characterize change through @-year follow-up , associated with training , booster , adherence , and other characteristics .


Sample included all individuals randomly assigned to reasoning training ( N = @ ) .


Piecewise latent growth modeling was used to examine trajectory of performance on outcome measures .


Training resulted in improved reasoning performance through Year @ .


A significant third annual booster effect was one-half the size of the training effect .


Training adherence resulted in greater training effects .


Higher education , Mini-Mental State Exam ( MMSE ) , better health , and younger age related to higher baseline performance .


Higher MMSE was related to larger training effects , larger linear slopes , and smaller booster effects .


Significant functional outcomes included a training effect for complex reaction time ( CRT ) , and first annual booster effects for the CRT and observed tasks of daily living .


Initial training gain was comparable with magnitude of age-related cognitive decline over @ years with no training .


Neither age nor gender predicted training or booster effects , indicating the generality of training effects across age ( @-@ years ) .


Epidemiological studies show that vascular risk factors are the same across the world but their effect vary between different race-ethnic groups .


However , few studies have evaluated differences in recurrent stroke rates in various race-ethnicities .


In > @ patients spanning @ countries encompassing most race-ethnicities , we evaluated the incidence of ischemic and hemorrhagic strokes and myocardial infarction in patients within the context of the largest secondary stroke prevention trial ( Prevention Regimen for Effectively Avoiding Secondary Strokes ) to identify any significant differences .


There were @ patients with a recent ischemic stroke randomized in a factorial design to receive the antiplatelet agent clopidogrel vs. aspirin plus extended-release dipyridamole , and @mg of the anthypertensive telmisartan vs. placebo .


The primary outcome for the trial was the time to any recurrent stroke .


Statistical analysis was used to detect race-ethnic differences in recurrent vascular events .


Mean patient age was @ ( @ ) years and @ % were women .


The study included @ % European/Caucasian , @ % Asians , @ % Latin/Hispanic , and @ % Black African .


There were @ % of patients that were hypertensive , and average systolic and diastolic blood pressure was @/@mmHg .


There was at least one significant difference in the overall test of all race-ethnic groups in myocardial infarction and symptomatic intracerebral hemorrhage occurrence .


In the Kaplan-Meier hemorrhage and stroke-free survival curves , Asians showed a significantly higher recurrence of ischemic stroke risk in the @-@mmHg and greater than @mm Hg blood pressure groups , and a greater risk of hemorrhage recurrence in the greater than @mmHg blood pressure group .


We found a significant difference in myocardial infarction and symptomatic intracerebral hemorrhage recurrence among different race-ethnic groups .


The risk of recurrent ischemic and hemorrhagic stroke was greater in Asians with high blood pressure .


Whether an insulin infusion should be used for tight control of hyperglycemia in critically ill children remains unclear .


We randomly assigned children ( @ years of age ) who were admitted to the pediatric intensive care unit ( ICU ) and were expected to require mechanical ventilation and vasoactive drugs for at least @ hours to either tight glycemic control , with a target blood glucose range of @ to @ mg per deciliter ( @ to @ mmol per liter ) , or conventional glycemic control , with a target level below @ mg per deciliter ( @ mmol per liter ) .


The primary outcome was the number of days alive and free from mechanical ventilation at @ days after randomization .


The main prespecified subgroup analysis compared children who had undergone cardiac surgery with those who had not .


We also assessed costs of hospital and community health services .


A total of @ patients at @ centers in England underwent randomization : @ to tight glycemic control and @ to conventional glycemic control ; @ % had undergone cardiac surgery .


The mean between-group difference in the number of days alive and free from mechanical ventilation at @ days was @ days ( @ % confidence interval -LSB- CI -RSB- , -@ to @ ) ; the effects did not differ according to subgroup .


Severe hypoglycemia ( blood glucose , < @ mg per deciliter -LSB- @ mmol per liter -RSB- ) occurred in a higher proportion of children in the tight-glycemic-control group than in the conventional-glycemic-control group ( @ % vs. @ % , P < @ ) .


Overall , the mean @-month costs were lower in the tight-glycemic-control group than in the conventional-glycemic-control group .


The mean @-month costs were similar in the two groups in the cardiac-surgery subgroup , but in the subgroup that had not undergone cardiac surgery , the mean cost was significantly lower in the tight-glycemic-control group than in the conventional-glycemic-control group : - $ @,@ ( @ % CI , - $ @,@ to - $ @,@ ) .


This multicenter , randomized trial showed that tight glycemic control in critically ill children had no significant effect on major clinical outcomes , although the incidence of hypoglycemia was higher with tight glucose control than with conventional glucose control .


( Funded by the National Institute for Health Research , Health Technology Assessment Program , U.K. National Health Service ; CHiP Current Controlled Trials number , ISRCTN@ . )


Cognitive-behavioural therapy ( CBT ) is an effective treatment for body dysmorphic disorder ( BDD ) .


However , most sufferers do not have access to this treatment .


One way to increase access to CBT is to administer treatment remotely via the Internet .


This study piloted a novel therapist-supported , Internet-based CBT program for BDD ( BDD-NET ) .


Uncontrolled clinical trial .


Patients ( N = @ ) were recruited through self-referral and assessed face to face at a clinic specialising in obsessive-compulsive and related disorders .


Suitable patients were offered secure access to BDD-NET .


BDD-NET is a @-week treatment program based on current psychological models of BDD that includes psychoeducation , functional analysis , cognitive restructuring , exposure and response prevention , and relapse prevention modules .


A dedicated therapist provides active guidance and feedback throughout the entire process .


The clinician-administered Yale-Brown Obsessive Compulsive Scale for BDD ( BDD-YBOCS ) .


Symptom severity was assessed pretreatment , post-treatment and at the @-month follow-up .


BDD-NET was deemed highly acceptable by patients and led to significant improvements on the BDD-YBOCS ( p = < @ ) with a large within-group effect size ( Cohen 's d = @ , @ % CI @ to @ ) .


At post-treatment , @ % of the patients were classified as responders ( defined as@ % improvement on the BDD-YBOCS ) .


These gains were maintained at the @-month follow-up .


Secondary outcome measures of depression , global functioning and quality of life also showed significant improvements with moderate to large effect sizes .


On average , therapists spent @ min per patient per week providing support .


The results suggest that BDD-NET has the potential to greatly increase access to CBT , at least for low-risk individuals with moderately severe BDD symptoms and reasonably good insight .


A randomised controlled trial of BDD-NET is warranted .


To compare the plaque removal efficacy of a water flosser to string floss combined with a manual toothbrush after a single use .


Seventy adult subjects participated in this randomized , single-use , single-blind , parallel clinical study .


Subjects were assigned to one of two groups ; Waterpik Water Flosser plus a manual toothbrush ( WF ) or waxed string floss plus a manual toothbrush ( SF ) .


Each participant brushed for two minutes using the Bass technique .


The WF group added @ ml of warm water to the reservoir and followed the manufacturer 's instructions , and the SF group used waxed string floss between each tooth , cleaning the mesial and distal surfaces as instructed .


Subjects were observed to ensure they covered all areas and followed instructions .


Scores were recorded for whole mouth , marginal , approximal , facial , and lingual regions for each subject using the Rustogi Modification of the Navy Plaque Index .


The WF group had a @ % reduction in whole mouth plaque and @ % for approximal plaque compared to @ % and @ % for the SF group , respectively ( p < @ ) .


The differences between the groups showed the water flosser was @ % more effective than string floss for overall plaque removal and approximal surfaces specifically ( p < @ ) .


The WF group was more effective in removing plaque from the marginal , lingual , and facial regions ; @ % , @ % , and @ % , respectively ( p < @ ) .


The Waterpik Water Flosser and manual toothbrush is significantly more effective than a manual brush and string floss in removing plaque from tooth surfaces .


Test the hypotheses that tremor amplitude in musicians with task-specific dystonia is higher at the affected finger ( dystonic tremor , DT ) or the adjacent finger ( tremor associated with dystonia , TAD ) than ( @ ) in matched fingers of healthy musicians and non-musicians and ( @ ) within patients in the unaffected and non-adjacent fingers of the affected side within patients .


We measured @ patients , @ healthy musicians and @ non-musicians .


Participants exerted a flexion-extension movement .


Instantaneous frequency and amplitude values were obtained with empirical mode decomposition and a Hilbert-transform , allowing to compare tremor amplitudes throughout the movement at various frequency ranges .


We did not find a significant difference in tremor amplitude between patients and controls for either DT or TAD .


Neither differed tremor amplitude in the within-patient comparisons .


Both hypotheses were rejected and apparently neither DT nor TAD occur in musician 's dystonia of the fingers .


This is the first study assessing DT and TAD in musician 's dystonia .


Our finding suggests that even though MD is an excellent model for malplasticity due to excessive practice , it does not seem to provide a good model for DT .


Rather it seems that musician 's dystonia may manifest itself either as dystonic cramping without tremor or as task-specific tremor without overt dystonic cramping .


To evaluate whether the efficacy and safety of menatetrenone for the treatment of osteoporosis is noninferior to alfacalcidol in Chinese postmenopausal women .


This multicenter , randomized , double-blinded , double-dummy , noninferiority , positive drug-controlled clinical trial was conducted in five Chinese sites .


Eligible Chinese women with postmenopausal osteoporosis ( N = @ ) were randomized to Group M or Group A and received menatetrenone @ mg/day or alfacalcidol @ g/day , respectively , for @ year .


Additionally , all patients received calcium @ mg/day .


Posttreatment bone mineral density ( BMD ) , new fracture onsets , and serum osteocalcin ( OC ) and undercarboxylated OC ( ucOC ) levels were compared with the baseline value in patients of both groups .


A total of @ patients ( @ % ) completed the study .


After @ year of treatment , BMD among patients in Group M significantly increased from baseline by @ % and @ % at the lumbar spine and trochanter , respectively ( P < @ ) ; and the percentage increase of BMD in Group A was @ % and @ % , respectively ( P < @ ) .


No difference was observed between groups .


There were no changes in femoral neck BMD in both groups .


Two patients ( @ % , @/@ ) in Group M and four patients ( @ % , @/@ ) in Group A had new fracture onsets ( P > @ ) .


In Group M , OC and ucOC decreased from baseline by @ % and @ % , respectively ( P < @ ) .


In Group A , OC and ucOC decreased by @ % and @ % , respectively ( P < @ ) .


Decreases in serum OC and ucOC were more obvious in Group M than in Group A ( P < @ ) .


The safety profile of menatetrenone was similar to alfacalcidol .


Menatetrenone is an effective and safe choice in the treatment of postmenopausal osteoporosis in Chinese women .


We explored the effectiveness of mirror therapy ( MT ) in the treatment of unilateral neglect in stroke patients .


This is an open , blinded endpoint , randomized controlled trial carried out from January @ to August @ .


We included stroke patients with thalamic and parietal lobe lesions with unilateral neglect @ hours after stroke .


Patients were randomized to the MT group or the control group ( sham MT ) , and both the groups received limb activation .


Patients received treatment for @-@ hours a day @ days a week for @ weeks .


The primary outcome was unilateral neglect assessed by a blinded assessor using the star cancellation test , the line bisection test , and a picture identification task at @ , @ , and @ months .


This study was registered at http://clinicaltrials.gov ( NCT @ ) .


Forty-eight patients were randomized to MT ( n = @ ) or the control group ( n = @ ) .


Improvement in scores on the star cancellation test over @ months was greater in the MT group ( mean difference @ , @ % confidence interval -LSB- CI -RSB- @-@ ; p < @ ) .


Similarly , improvement in the MT group was observed in the scores on the picture identification task ( mean difference @ , @ % CI @-@ @ ; p < @ ) and line bisection test ( mean difference @ , @ % CI @-@ @ ; p = @ ) .


In patients with stroke , MT is a simple treatment that improves unilateral neglect .


This study provides Class I evidence that for patients with neglect from thalamic and parietal lobe strokes , MT improves neglect .


In Huntington disease ( HD ) patients receiving rivastigmine treatment improvement of behavioral symptoms and of cognitive function ( assessed with screening diagnostic instruments ) has been reported .


The aim of the present study was to verify such improvement in cognitive function by cognitive function assessment with a detailed neuropsychological battery covering all relevant cognitive systems expected to be impaired in early phase HD .


Eighteen ( @ ) HD patients entered the study and were randomly allocated to the rivastigmine and placebo group .


All subjects underwent neuropsychological assessment at baseline .


Follow-up neuropsychological assessment was applied after @ months of rivastigmine or placebo treatment .


Eighteen ( @ ) healthy controls entered the study to control for practice effect and underwent neuropsychological assessment at baseline and after @ months , without treatment .


The neuropsychological battery consisted of assessment tools that are sensitive to cognitive impairment seen in early phase HD : CTMT , SDMT , Stroop ( attention and information control ) , RFFT , TOL , Verbal fluency ( executive functioning ) , CVLT-II , RCFT ( learning and memory ) .


Effect of rivastigmine and possible effect of practice was assessed using the mixed ANOVA model .


No statistically significant effect of rivastigmine treatment on cognitive function in HD patients was detected .


There was no evidence for practice or placebo effect .


Detailed neuropsychological assessment did not confirm previously reported effect of rivastigmine treatment on cognitive function in HD patients .


The limitations of our study are , in particular , small sample size and the lack of a single measure of relevant cognitive functioning in HD patients .


Instead of focusing solely on statistical significance , a clinical relevance study is proposed to clarify the issue of rivastigmine effects in HD .


Smoking is the main preventable cause of morbidity and mortality in our region , it being the main causative agent of chronic obstructive pulmonary disease .


There still is no consensus on the use of spirometry as a strategy for smoking cessation , given that there is insufficient scientific evidence from high quality studies to recommend the use of this technique .


This is to be a randomized , multicentre , open-label clinical trial .


A total of @ smokers over @ years of age will be recruited by @ general practitioners from @ health centers .


Primary objective of this study is to assess the effectiveness of spirometry together with information regarding the test for smoking cessation after @ year in smokers over @ years of age with a more than @ pack-year history and no previous diagnosis of chronic obstructive pulmonary disease .


Groups of @ patients who smoke will be randomly selected from the lists of the participating doctors .


The names will be sent to the corresponding doctors who will contact candidate patients and assess whether they meet the selection criteria .


Patients who meet these criteria will be randomly allocated to an intervention or control group .


For patients in both groups , a nurse will conduct an interview and perform a spirometry test to measure forced vital capacity .


Then , all patients will be referred for an appointment with their doctor for brief anti-smoking intervention , patients from the intervention group additionally being informed about the result of the spirometry test .


After @ year , smoking status will be assessed and , in those who report that they have quit smoking , abstinence will be confirmed by co-oximetry .


Data will be analyzed on an intention-to-treat basis using the chi-squared test for outcomes and binary logistic regression if it is considered to be necessary to adjust for confounding variables .


Performing a spirometry test and providing information on pulmonary function may increase awareness of the effect of smoking among smokers who are asymptomatic or have few symptoms and make them decide to quit .


Specifically , in patients with chronic obstructive pulmonary disease it might increase levels of motivation to quit smoking in early stages of the disease .


If this strategy were to be effective , it could be included in the health promotion activities offered in primary care .


Research is needed on initial smoking abstinence and relapse risk .


This study aims to investigate the effects of different durations of initial abstinence on sensitivity to smoking-related stimuli and response inhibition in the context of a larger battery of outcome measures .


Smokers were randomly assigned to receive payment contingent on smoking abstinence across all @ study days ( @C ) or just the final @days ( @C ) .


Smoking status and subject ratings were assessed daily .


Participants completed fMRI sessions at baseline and day @ during which they completed craving ratings after exposure to smoking-related and neutral stimuli and performed a response inhibition task .


On day @ , participants completed a smoking preference session involving @ exclusive choices between smoking and money .


The payment contingencies were effective in producing greater smoking abstinence in the @C vs. @C conditions .


Ratings of withdrawal decreased , while ratings of ease and confidence in abstaining increased in the @C vs. @C conditions across the @-day study .


@C participants were less likely to choose the smoking option in the preference session .


@C participants reported greater reductions in craving compared to the @C participants in the presence of smoking-related and neutral stimuli ( i.e. , decreases in generalized craving ) , but no differences were noted in cue reactivity per se or in response inhibition .


Results systematically replicate prior observations that a period @weeks of initial abstinence decreases the relative reinforcing effects of smoking and improves other outcomes associated with relapse risk compared to the initial day or two of a cessation effort , and extends them by underscoring the importance of generalized rather than cue-induced craving in relation to relapse risk during the initial weeks of smoking cessation .


The aim of this study was to evaluate the clinical results of non surgical knee distraction in patients with severe knee osteoarthritis .


forty female patients with severe knee osteoarthritis were randomly divided in two groups .


A standard physiotherapy treatment was applied to both groups and in one group it was accompanied with @ min knee joint distraction .


The patients were treated for @ sessions .


Clinical examination consisted of functional examination , completion of a quality of life questionnaire , pain scale , and assessment of joint mobility and joint edema .


The standard physiotherapy treatment accompanied by knee distraction resulted in significantly higher improvement in pain ( P = @ ) , functional ability ( P = @ ) , quality of life ( P = @ ) and knee flexion range of motion ( p = @ ) compared to the standard physiotherapy treatment alone post treatment and after @ month follow up .


Adding knee distraction to standard physiotherapy treatment can result in further improvement in pain relief , increased functional ability and better quality of life in patients with severe knee osteoarthritis .


To compare the efficacy of the erlotinib versus gefitinib in the first-line treatment of patients with advanced EGFR mutation-positive NSCLC .


Fifty patients with untreated advanced EGFR mutation - positive NSCLC were randomly divided into gefitinib group ( n = @ ) and erlotinib group ( n = @ ) .


The progression-free survival , objective response rate and disease control rate were evaluated to compare the efficacy of gefitinib and erlotinib .


There were no significant differences in the objective response rate ( P = @ ) and disease control rate ( P = @ ) between the two groups .


The progression-free survival of gefitinib group and erlotinib group was @ months and @ months , respectively .


The efficacy of the two drugs was similar ( P = @ ) .


There is no significant differences between gefitinib and erlotinib in the first-line treatment of patients with advanced EGFR mutation-positive NSCLC .


Recent research shows that advance care planning ( ACP ) for patients with chronic obstructive pulmonary disease ( COPD ) is uncommon and poorly carried out .


The aim of the present study was to explore whether and to what extent structured ACP by a trained nurse , in collaboration with the chest physician , can improve outcomes in Dutch patients with COPD and their family .


A multicentre cluster randomised controlled trial in patients with COPD who are recently discharged after an exacerbation has been designed .


Patients will be recruited from three Dutch hospitals and will be assigned to an intervention or control group , depending on the randomisation of their chest physician .


Patients will be assessed at baseline and after @ and @ months .


The intervention group will receive a structured ACP session by a trained nurse .


The primary outcomes are quality of communication about end-of-life care , symptoms of anxiety and depression , quality of end-of-life care and quality of dying .


Secondary outcomes include concordance between patient 's preferences for end-of-life care and received end-of-life care , and psychological distress in bereaved family members of deceased patients .


Intervention and control groups will be compared using univariate analyses and clustered regression analysis .


To compare the use of intralesional triamcinolone acetonide and its combination with @ flourouracil in the treatment of keloid and hypertrophic scars in terms of reduction in initial height of the scar .


The randomised controlled trial was conducted at the Department of Plastic Surgery , King Edward Medical University , Lahore , from March @ to December @ .


It comprised patients of both genders having keloids or hypertrophic scars ( @ cm to @ cm in size ) having no history of treatment for the scars in preceding @ months .


Those who were pregnant , planning pregnancy or lactating were excluded .


The subjects were divided into two groups : Group A received intralesional triamcinolone acetonide alone ; and Group B received triamcinolone acetonide + @ flourouracil .


Eight injections were given at weekly interval .


Scars were assessed @ weeks after the completion of treatment on a five-point scale .


SPSS @ was used for statistical analysis .


The @ subjects in the study were divided into two equal groups of @ ( @ % ) each .


Good to excellent results were seen in @ ( @ % ) cases in Group A compared to @ ( @ % ) in Group B. Frequency of complications was @ ( @ % ) and @ ( @ % ) in Group A and Group B respectively .


Combination of triamcinolone acetonide and @ flourouracil is superior to triamcinolone acetonide therapy in the treatment of keloids and hypertrophic scars .


It is believed that local anesthetic injected to obtain circumferential spread around nerves produces a more rapid onset and successful blockade after some ultrasound-guided peripheral nerve blocks .


However , evidence demonstrating this point is limited only to the popliteal sciatic nerve block , which is relatively easy to perform by via a high-frequency linear transducer .


In the present study , we tested the hypothesis that multiple injections of local anesthetic to make circumferential spread would improve the rate of sensory and motor blocks compared with a single-injection technique for ultrasound-guided subgluteal sciatic nerve block , which is considered a relatively difficult block conducted with a low-frequency , curved-array transducer .


Ninety patients undergoing knee surgery were divided randomly into @ groups to receive the ultrasound-guided subgluteal approach to sciatic nerve block with @ mL of @ % mepivacaine with epinephrine .


For group M ( the multiple-injection technique ) , the local anesthetic was injected to create circumferential spread around the sciatic nerve without limitation on the number of needle passes .


For group S ( the single-injection technique ) , the number of needle passes was limited to @ , and the local anesthetic was injected to create spread along the dorsal surface of the sciatic nerve , during which no adjustment of the needle tip was made .


Sensory and motor blockade were assessed in double-blind fashion for @ minutes after completion of the block .


The primary outcome was sensory blockade of all sciatic components tested , including tibial , superficial peroneal , and sural nerves at @ minutes after injection .


Data from @ patients ( @ in each group ) were analyzed .


Block execution took more time for group M than group S.


The proportion of patients with complete sensory blockade of all sciatic components at @ minutes after injection was significantly larger for group M than group S ( @ % vs @ % , P = @ ) .


Complete motor blockade of foot and toes extension also was observed more frequently in group M than in group S ( @ % vs @ % , P = @ and @ % vs @ % , P = @ , respectively ) .


When ultrasound-guided subgluteal sciatic nerve block is conducted , multiple injections of local anesthetic to make a circumferential spread around the sciatic nerve improve the rate of sensory and motor blocks compared with a single injection .


Progressive loss of muscle and strength with age is often coincident with increases in adiposity , leading to a condition called sarcopenic obesity .


Studies have shown sarcopenic obese adults to be at higher risk for declines in physical function .


Despite this rising public health concern , no intervention studies currently exist in this population .


A total of @ sarcopenic obese adults , @ years or older , were randomized into two groups , strength/hypertrophy ( SH , n = @ ) and high-speed circuit ( HSC , n = @ ) and were trained for @ weeks .


The primary outcome was the SPPB modified as a measure of physical function , assessed by assessors blinded to randomization .


Secondary outcomes were lower body and upper body power and strength , instrumental activities of daily living ( IADL ) , ratings of perceived exertion ( RPE ) , body fat % ( BF % ) , skeletal muscle index ( SMI ) , and grip strength ( GRP ) .


For the SPPB results favored HSC over SH ( @ , @ % CI ( -@ to @ ) , p = @ ) and showed a moderate effect size ( Hedge g = @ , @ % CI ( -@ , @ ) ) .


For secondary outcomes , lower body power ( mean difference = @ W , @ % CI ( @ , @ ) ; p = @ ) and RPE ( mean difference = -@ , @ % CI ( -@ , -@ ) ; p = @ ) also favored HSC .


IADL , SMI , BF % , upper and lower body strength and upper body power , showed no statistically significant differences between groups .


Considering the moderate effect size , the large treatment effect shown by the upper limit of the @ % CI , the low perceived exertion , and no adverse effects , HSC training should be further investigated with a larger sample size in sarcopenic obese adults .


Septal body hypertrophy , like inferior turbinate hypertrophy , can result in changes to the nasal cross-sectional area and resistance to airflow .


The aim of this study is to evaluate the efficacy of septal body volume reduction ( SBVR ) for the treatment of septal body hypertrophy in patients with nasal obstruction .


Prospective randomized study .


The study was conducted on two groups ( @ patients ) with symptoms and signs of nasal obstruction associated with septal body and inferior turbinate hypertrophy that were refractory to medical therapy .


In the turbinoplasty only ( ITR ) group ( n = @ ) , conventional turbinoplasty was only performed on the inferior turbinate .


In the septal body reduction ( SBR ) group ( n = @ ) , concurrent bilateral microdebrider-assisted SBVR was performed during the turbinate surgery .


The nasal symptoms , including nasal obstruction , rhinorrhea , itching , and sneezing , had significantly improved at @ months after treatment in both groups ( P < @ ) .


Improvement of nasal obstruction in the SBR group was greater than that in the ITR group at @ months ( P < @ ) .


Acoustic rhinometry demonstrated a significant increase in the cross-sectional area and nasal volume in both groups @ months after surgery .


The postoperative change in nasal volume was higher in the SBR group ( P < @ ) .


No adverse reactions such as bleeding , infection , adhesions , or olfactory changes were encountered in the SBR group .


Combined SBVR and turbinoplasty appears to be more effective than turbinoplasty alone for the treatment of nasal obstruction in patients with inferior turbinate and septal body hypertrophy .


Since sugar-sweetened beverages ( SSB ) may contribute to the development of overweight in children , effective interventions to reduce their consumption are needed .


Here we evaluated the effect of a combined school - and community-based intervention aimed at reducing children 's SSB consumption by promoting the intake of water .


Favourable intervention effects on children 's SSB consumption were hypothesized .


In @-@ , a controlled trial was conducted among four primary schools , comprising @ children aged @-@ years who lived in multi-ethnic , socially deprived neighbourhoods in Rotterdam , the Netherlands .


Intervention schools adopted the ` water campaign ' , an intervention developed using social marketing .


Control schools continued with their regular health promotion programme .


Primary outcome was children 's SSB consumption , measured using parent and child questionnaires and through observations at school , both at baseline and after one year of intervention .


Significant positive intervention effects were found for average SSB consumption ( B -@ litres , @ % CI -@ ; -@ ; parent report ) , average SSB servings ( B -@ servings , @ % CI -@ ; -@ ; parent report ) and bringing SSB to school ( OR @ , @ % CI @ ; @ ; observation report ) .


This study supports the effectiveness of the water campaign intervention in reducing children 's SSB consumption .


Further studies are needed to replicate our findings .


Many children who lost parents in the @ earthquake in Sichuan Province , China , experienced symptoms of posttraumatic stress disorder ( PTSD ) and depression .


This randomized controlled study compared the treatment effectiveness of short-term cognitive-behavioral therapy ( CBT ) with a general supportive intervention and with a control group of nontreatment .


METHODS ; Thirty-two Chinese adolescents were randomly assigned to three treatment groups .


Participants were compared for psychological resilience ( Connor-Davidson Resilience Scale ) , symptoms of PTSD ( Children 's Revised Impact of Events Scale ) , and depression ( Center for Epidemiologic Studies Depression Scale ) at baseline , after treatment , and three-month follow-up .


CBT was effective in reducing PTSD and depressive symptoms and improved psychological resilience .


General support was more effective than no intervention in improving psychological resilience .


Short-term CBT group intervention seems to be a robust intervention for natural disaster victims .


Short-term CBT group intervention was more effective than the general supportive intervention and the no-treatment group in enhancing psychological resilience and reducing PTSD and depression among adolescents who had lost parents in the earthquake .


The general supportive intervention was effective only in improving psychological resilience .


To assess whether bipolar transurethral resection of the prostate using the TURis ( Olympus , Tokyo , Japan ) system demonstrates comparable efficacy and safety reporting @months of follow-up findings .


The trial was registered at University hospital Medical Information Network Clinical Trials Registry in Japan ( trial number UMIN @ ) .


Patients were randomly selected to undergo transurethral resection of the prostate using either the TURis or the conventional monopolar technique .


Primary end points were safety according to operation time , decline of sodium and hemoglobin levels , clot retention , and catheterization time .


Secondary end points were efficacy findings for patients after @months of follow-up .


A total of @ patients were enrolled .


Mean operation times were significantly prolonged in the TURis group ( @ and @ minutes for monopolar and TURis groups , respectively ; P = @ ) .


Nosignificant differences in the decline of hemoglobin , hematocrit , and perioperative transfusion rates between groups were seen , whereas clot retention ( grade @ ) after the treatment seemed to occur more often in the monopolar group ( @ of @ -LSB- @ % -RSB- in monopolar group vs @ of @ -LSB- @/@ % -RSB- in TURis group ; P = @ ) .


No case presented symptomatic transurethral resection syndrome in either groups .


Continued efficacy at @months after the treatment could be confirmed for the first time in TURis system , which also seems to be preferable as they produced more clinically favorable outcomes .


Nevertheless , the TURis system required significantly more resection time , which might not entirely be a panacea for the treatment of benign prostatic obstruction , especially for patients having larger prostatic volumes .


Acupuncture has been commonly used for preventing migraine attacks and relieving pain during a migraine , although there is limited knowledge on the physiological mechanism behind this method .


The objectives of this study were to compare the differences in brain activities evoked by active acupoints and inactive acupoints and to investigate the possible correlation between clinical variables and brain responses .


A randomized controlled trial and resting-state functional magnetic resonance imaging ( fMRI ) were conducted .


A total of eighty migraineurs without aura were enrolled to receive either active acupoint acupuncture or inactive acupoint acupuncture treatment for @ weeks , and twenty patients in each group were randomly selected for the fMRI scan at the end of baseline and at the end of treatment .


The neuroimaging data indicated that long-term active acupoint therapy elicited a more extensive and remarkable cerebral response compared with acupuncture at inactive acupoints .


Most of the regions were involved in the pain matrix , lateral pain system , medial pain system , default mode network , and cognitive components of pain processing .


Correlation analysis showed that the decrease in the visual analogue scale ( VAS ) was significantly related to the increased average Regional homogeneity ( ReHo ) values in the anterior cingulate cortex in the two groups .


Moreover , the decrease in the VAS was associated with increased average ReHo values in the insula which could be detected in the active acupoint group .


Long-term active acupoint therapy and inactive acupoint therapy have different brain activities .


We postulate that acupuncture at the active acupoint might have the potential effect of regulating some disease-affected key regions and the pain circuitry for migraine , and promote establishing psychophysical pain homeostasis .


Vegetables and fruits are rich in vitamins , minerals and , dietary fiber and contribute to the prevention and improvement of obesity and metabolic syndrome .


However , inadequate intake of vegetable and fruit is a concern in Japan.We therefore produced a juice mixture of fresh fruit and komatsuna ( Brassica rapa L. var .


perviridis : B. rapa ) with the aim to investigate the effects of this juice mixture on anthropometric data , blood parameters , and dietary intake differences .


This study was performed as a single blind and randomized controlled trial .


Subjects were @ men ( mean age , @ years ) , and they were divided into two groups ( control group and intervention group ) .


The intervention group consumed the juice mixture of fresh fruit and B. rapa .


The control group consumed commercial vegetable juice .


Subjects consumed juice twice a day throughout the weekday , for @weeks .


We prepared both juices with an equivalent energy balance .


Weight and body mass index ( BMI ) of the control group after @weeks were significantly increased compared with baseline values .


Serum total cholesterol ( T-Chol ) and low-density lipoprotein cholesterol ( LDL-Chol ) of the intervention group after @weeks were significantly reduced compared with baseline values .


Furthermore , intake of total vegetables and fruits were significantly increased compared with baseline values in both groups .


Both vegetable juices contributed to improved intake of total vegetables and fruit .


Compared with the intake of commercial vegetable juice , the intake of fresh fruit and B. rapa juice is highly effective in reducing serum cholesterol .


Short-term intake of fresh fruit and B. rapa juice was shown to enhance cholesterol metabolism .


Sleep deprivation from extended duty hours is a common complaint for many occupations .


Caffeine is one of the most common countermeasures used to combat fatigue .


However , the benefits of caffeine decline over time and with chronic use .


Our objective was to evaluate the efficacy of anodal transcranial direct current stimulation ( tDCS ) applied to the pre-frontal cortex at @ mA for @ min to remediate the effects of sleep deprivation and to compare the behavioral effects of tDCS with those of caffeine .


Three groups of @ participants each received either active tDCS with placebo gum , caffeine gum with sham tDCS , or sham tDCS with placebo gum during @ h of extended wakefulness .


Our results show that tDCS prevented a decrement in vigilance and led to better subjective ratings for fatigue , drowsiness , energy , and composite mood compared to caffeine and control in sleep-deprived individuals .


Both the tDCS and caffeine produced similar improvements in latencies on a short-term memory task and faster reaction times in a psychomotor task when compared to the placebo group .


Interestingly , changes in accuracy for the tDCS group were not correlated to changes in mood ; whereas , there was a relationship for the caffeine and sham groups .


Our data suggest that tDCS could be a useful fatigue countermeasure and may be more beneficial than caffeine since boosts in performance and mood last several hours .


Colonic fermentation in patients with UC in remission was compared with that in matched healthy subjects on habitual diets and when dietary fibre was increased .


Fibre intake , faecal output of fibre ( measured as non-starch polysaccharide ( NSP ) ) , starch , microbiota and fermentation products , and whole gut transit time ( WGTT ) were assessed in association with habitual diet and when dietary intake of wheat bran ( WB ) - associated fibre and high amylose-associated resistant starch ( RS ) was increased in an @-week , randomised , single-blind , cross-over study .


Despite a tendency to lower habitual fibre intake in UC patients , faecal NSP and starch concentrations were threefold higher than in controls , whereas concentrations of phenols and short-chain fatty acids , pH and WGTT were similar .


Increasing RS/WB intake was well tolerated .


In controls ( n = @ ) , it more than doubled faecal NSP and starch excretion ( p = @ for both ) , had no effect on NSP usage and reduced WGTT ( p = @ ) .


In UC patients ( n = @ ) , high intake of RS/WB tended to normalise gut transit , but did not increase the proportion of NSP fermented .


Increasing intake of RS/WB had little effect on faecal fermentation patterns or the structure of the microbiota .


However , faeces from the UC cohort had lower proportions of Akkermansia muciniphila and increased diversity within Clostridium cluster XIVa compared to controls .


Gut fermentation of NSP and starch is diminished in patients with UC .


This can not be explained by abnormal gut transit and was not corrected by increasing RS/WB intake , and may be due to abnormal functioning of the gut microbiota .


There have been few randomized control trials comparing the incidence of stent fracture and primary patency among different self-expanding nitinol stents to date .


The SMART CONTROL stent ( Cordis Corp , Miami Lakes , Florida , United States ) has a peak-to-valley bridge and inline interconnection , whereas the COMPLETE-SE stent ( Medtronic Vascular , Santa Rosa , California , United States ) crowns have been configured to minimize crown-to-crown interaction , increasing the stent 's flexibility without compromising radial strength .


Further , the @ ESC ( European society of cardiology ) guidelines recommend that dual antiplatelet therapy with aspirin and a thienopyridine such as clopidogrel should be administered for at least one month after infrainguinal bare metal stent implantation .


Cilostazol has been reported to reduce intimal hyperplasia and subsequent repeat revascularization .


To date , there has been no randomized study comparing the safety and efficacy of two different antiplatelet regimens , clopidogrel and cilostazol , following successful femoropopliteal stenting .


The primary purpose of our study is to examine the incidence of stent fracture and primary patency between two different major representative self-expanding nitinol stents ( SMART CONTROL versus COMPLETE-SE ) in stenotic or occlusive femoropopliteal arterial lesion .


The secondary purpose is to examine whether there is any difference in efficacy and safety between aspirin plus clopidogrel versus aspirin plus cilostazol for one month following stent implantation in femoropopliteal lesions .


This is a prospective , randomized , multicenter trial to assess the efficacy of the COMPLETE-SE versus SMART CONTROL stent for provisional stenting after balloon angioplasty in femoropopliteal arterial lesions .


The study design is a @x@ randomization design and a total of @ patients will be enrolled .


The primary endpoint of this study is the rate of binary restenosis in the treated segment at @ months after intervention as determined by catheter angiography or duplex ultrasound .


This trial will provide powerful insight into whether the design of the COMPLETE-SE stent is more fracture-resistant or effective in preventing restenosis compared with the SMART CONTROL stent .


Also , it will determine the efficacy and safety of aspirin plus clopidogrel versus aspirin plus cilostazol in patients undergoing stent implantation in femoropopliteal lesions .


Entonox is a @:@ combination of nitrous oxide and oxygen , which may be used to manage pain during colonoscopy .


The optimal mode of Entonox administration is unknown .


The aim of this study was therefore to compare continuous and as-required Entonox use .


Patients attending for screening colonoscopy at a single centre were randomized to continuous or as-required Entonox use .


The primary outcome measure was the patient 's overall pain rating at the time of discharge ( verbally administered numerical ratings scale , @ = no pain and @ = extreme pain ) .


Secondary outcome measures included the patients ' experience of pain during the colonoscopy ( rated every @min ) , side effects and the need for rescue intravenous medications .


A total of @ patients were randomized , and @ completed the study ( @ continuous , @ as required ) .


The overall pain scores at discharge did not differ between those who used Entonox continuously and as required ( mean = @ vs. @ , P = @ ) .


There were also no differences in the experience of pain during colonoscopy ( mean = @ vs. @ , P = @ ; peak = @ vs. @ , P = @ ; and area under curve = @ vs. @ , P = @ ) .


Patients with high anxiety had greater overall pain scores ( mean = @ vs. @ , P = @ ) .


Light headedness occurred more often with continuous Entonox use ( @ vs. @ % , P = @ ) .


Among patients attending for screening colonoscopy , comfort ratings were similar in those using Entonox continuously and as required , but light headedness was more common with continuous use ( NCT identifier : @ ) .


To assess which is the optimal protocol in terms of endometrial preparation prior to frozen-thawed embryo transfer ( FET ) in women with polycystic ovarian syndrome ( PCOS ) and to explore the effect in stimulated cycle with the addition of vaginal @ - oestradiol .


Five hundred and seventy-six patients with PCOS were prepared for FET using artificial cycle induced with oestradiol and progesterone supplementation ( n = @ ) and stimulated cycle induced by human menopausal gonadotrophin ( HMG ) within or without the addition of vaginal @ - oestradiol ( n = @ ) .


Then the FET was performed in a receptive endometrium .


Endometrial thickness was similar ( @ @ vs. @ @ , P > @ ) in artificial and stimulated cycle .


The two protocols resulted in clinical pregnancy rate ( @ % vs. @ % , P > @ ) , ongoing pregnancy rate ( @ % vs. @ % , P > @ ) , live birth rate ( @ % vs. @ % , P > @ ) , which were not statistically different .


Nevertheless , the cancelled cycle rate made a significant difference ( @ % vs. @ % , P < @ ) .


There is no significant difference in the clinical pregnancy rate in HMG , HMG added with vaginal oestradiol and HMG switch to vaginal oestradiol group ( @ % , @ % , and @ % , respectively ) .


The mean endometrial thickness , clinical pregnancy rate , ongoing pregnancy rate , live birth rate and implantation rate were similar in artificial and stimulated cycle for endometrial preparation prior to FET in PCOS .


It was fine to add vaginal @ - oestradiol to stimulated cycle when necessary .


However , stimulated cycles had a significantly higher cancelled cycle rate .


We should follow the principles of individualization , securitization and optimization in endometrial preparation of the FET in patients with PCOS .


The aim of the study was to compare infants ' gastrointestinal tolerance of formulas supplemented with @ different levels of galacto-oligosaccharides ( GOS ) versus a control formula ( CF ) or human milk .


Healthy , full-term infants ( n = @ ) were enrolled in this @-group controlled , double-blind , multicenter study , and a concurrently enrolled , nonrandomized human milk-fed group ( HM ) by @ days of age .


Infants were randomized to be fed formula supplemented with either @ g ( EF@ ) or @ g ( EF@ ) GOS/L or a CF until day of life ( DOL ) @ .


Infants were to be seen at DOL @ , @ , @ , @ , and @ .


Parents were to record detailed @-hour information about intake , tolerance to feedings , and stool patterns and consistency each day from enrollment to DOL @ , and for @ days before DOL @ , @ , and @ .


Stool consistency was scored on a @-point scale as watery ( @ ) , loose/mushy , soft , formed , or hard ( @ ) .


The mean stool consistency score was higher in the CF group throughout the study ( CF > EF@ and CF > HM for all study periods and CF > EF@ from DOL @ to @ , P < @ ) .


There was a significantly higher percentage of watery stools in the EF@ versus the CF group from study day @ ( SD @ ) to DOL @ ( P < @ ) , but no differences between the groups in number of stools per day .


The percentage of feedings with spit up and/or vomiting within @ hour after feeding was significantly lower for HM versus EF@ and CF from SD @ to DOL @ ( P < @ ) .


In this clinical study , milk-based term infant formula ( Similac Advance ) with @ g GOS/L was well-tolerated in terms of stool consistency and additional measures of gastrointestinal tolerance by newborn infants through the first @ months of life .


Methylphenidate is a psychostimulant that has been used to relieve depressive symptoms in advanced cancer patients .


No studies compare its efficacy against placebo in this group of patients .


To explore the efficacy of methylphenidate compared with placebo in the relief of depressive symptoms in advanced cancer patients .


A multicentre , double-blind , randomised placebo-controlled clinical trial was undertaken comparing the efficacy of methylphenidate and placebo in depressive symptoms .


Advanced stage cancer patients were eligible if they scored at least two points on the Two Question Screening Survey for depression .


A reduction of at least two points on the Edmonton Symptom Assessment Scale for depression ( @-@ ) was considered as a response .


Sixty-nine patients were included ( methylphenidate : n = @ , placebo : n = @ ) ; median daily dose of methylphenidate was @ mg .


Fifty-eight patients ( @ % ) who completed the first week of treatment were considered suitable for evaluation .


In the intention to treat analysis , there were @/@ ( @ % ) responses with methylphenidate and @/@ ( @ % ) responses with placebo ( difference : @ % ; @ % CI : @ % to @ % ; p = @ ) .


With the Hospital Anxiety and Depression Scale , @/@ ( @ % ) patients with methylphenidate and @/@ ( @ % ) with placebo improved from a score compatible with depression in the first @ days ( difference @ % ; @ % CI @ % to @ % ; p = @ ) .


The proportion of patients indicating adverse effects was similar for both cohorts ( p = @ ) .


Compared with the placebo , methylphenidate demonstrated a positive trend in the incidence of response for depressive symptoms in advanced cancer patients .


Depressive disorders are highly prevalent in the working population and are associated with excessive costs .


The evidence for effective worker-directed interventions for employees with depressive symptoms is limited .


Treating employees with depressive symptoms via the Internet before they report sick from work could be beneficial and cost saving .


In this study , we tested the effectiveness over the period of @ year of a Web-based guided self-help intervention , called Happy@Work, for employees with depressive symptoms who were not on sick leave .


A two-arm randomized controlled trial comparing a worker-directed , Web-based , guided self-help intervention to care as usual ( CAU ) was carried out .


We recruited employees from @ companies via the company 's Intranet and by putting up posters .


The inclusion criteria were elevated depressive symptoms as measured by a score @ on the Center for Epidemiologic Studies Depression scale ( CES-D ) and not being on sick leave .


The intervention contained @ lessons and consisted of problem-solving treatment and cognitive therapy .


Participants were asked to submit weekly assignments via the website after completion of a lesson and they received feedback from a coach via the website .


Self-report questionnaires on depressive symptoms ( CES-D ; primary outcome ) , burnout ( Maslach Burnout Inventory , MBI ) , work performance ( Health and Work Performance Questionnaire , HPQ ) , duration of absenteeism , and anxiety ( Hospital Anxiety and Depression Scale , HADS ; secondary outcomes ) , were completed at baseline , posttreatment , and at @ - , and @-month follow-up .


Several subgroup and per-protocol analyses were performed .


A total of @ employees were randomized to either the intervention group ( n = @ ) or to CAU ( n = @ ) .


Completion of assessments varied between @ % -@ % .


Improvement in depressive symptoms between baseline and posttreatment was shown in all participants and these effects sustained over time .


However , there were no differences between the @ groups ( adjusted regression coefficient = @ , @ % CI -@ to @ , P = @ ; Cohen 's d = @ ) .


Differences between groups were also not significant for the secondary outcomes .


No subgroups were identified to show differences between the groups , nor did we find a between-group effect in the per-protocol analyses .


This study showed that a worker-directed , Web-based , guided self-help intervention was not more effective than CAU in reducing depressive symptoms among employees with depressive symptoms who were not on sick leave over the period of @ year .


An intervention for this specific target group might not be necessary because the recovery in the CAU group was comparable to the intervention group and sustained over a @-month period .


To evaluate the safety and efficacy of corneal collagen crosslinking ( CXL ) using a transepithelial technique to treat keratoconus .


Cornea and refractive surgery subspecialty practice .


Prospective clinical trial .


Transepithelial CXL was performed in eyes with keratoconus using proparacaine with benzalkonium chloride ( BAK ) @ % to facilitate riboflavin absorption and riboflavin @ % without dextran .


Eyes were randomized to receive ultraviolet-A treatment ( @ nm , @ mW/cm ( @ ) ) with concurrent administration of riboflavin randomized to every @ minute or every @ minutes for @ minutes .


The principal outcomes included uncorrected ( UDVA ) and corrected ( CDVA ) distance visual acuities and topography-derived maximum keratometry ( K ) values .


Patients were followed for @ months .


Thirty eyes of @ patients were treated .


The mean maximum K value flattened by @ diopter ( D ) ( baseline @ D ; @ months @ D ) ( P = @ ) .


The maximum K worsened by @ D or more in @ patient .


The mean CDVA improved by @ Snellen lines ( P = @ ) .


One patient lost @ lines of CDVA .


There were no differences in the UDVA , CDVA , or keratometry outcomes between the @-minute instillation subgroup and the @-minute instillation subgroup .


Transepithelial CXL resulted in a statistically significant improvement in maximum K values and CDVA at the @-month follow-up .


Further follow-up is necessary to ascertain the ability of transepithelial CXL to achieve long-term stabilization of the cornea in eyes with keratoconus .


Inactivity is a primary factor related to childhood obesity , yet aerobic exercise has been shown to prevent weight gain and improve fitness in adolescents .


Moreover , children become less active during their summer break from school .


This study compared the effects of @ and @ weeks of supervised summer activity versus an unsupervised summer break on metabolic function and fitness in adolescents .


Twenty-two adolescents were divided into @-week ( n = @ , weight @ kg , body fat @ % ) and @-week exercise groups ( n = @ , weight @ kg , body fat @ % ) , that performed supervised , play-based physical activity , versus an age-matched @ week control group that maintained their typical summer break ( n = @ , weight @ kg , body fat @ % ) .


Anthropometrics , resting energy expenditure ( REE ) , resting heart rate ( RHR ) and peak aerobic capacity ( VO ( @peak ) ) were evaluated before and after the intervention ( @ or @ weeks ) .


REE showed group differences in posttraining conditions ( the @-week group vs. the control group , @ vs. @ kcal/die , and the @-week group vs. the control group , @ vs. @ kcal/die , P = @ ) , but RHR decreased ( pre-program vs. post program : @ vs. @ beat/min , P = @ ) and VO ( @peak ) significantly increased ( pre-program vs. post program : @ vs. @ mL/kg/min , P = @ ) in the @-week group compared to the control group .


Eight weeks of supervised play-based activity increased REE and VO ( @peak ) in adolescents with concomitant decreases in RHR .


These data suggest that this novel model of exercise prescription could be considered world-wide by clinicians to improve fitness base in adolescents and help to combat the growing epidemic of childhood obesity .


The aim of this study was to determine the relationship of high daily monosodium glutamate ( MSG ) consumption with glutamate concentrations in jaw muscle , saliva , and serum , and muscle pain sensitivity in healthy participants .


A randomized , double-blinded , placebo-controlled study was conducted to investigate the effect of repetitive consumption of high-dose MSG on glutamate concentration in the masseter muscles measured by microdialysis and muscle pain sensitivity .


In five contiguous experimental daily sessions , @ healthy participants drank MSG ( @mg/kg ) or NaCl ( @mg/kg ) diluted with a @mL soda .


The concentrations of glutamate before and after the ingestion were assessed in dialysate and plasma samples on the first and last days .


Saliva glutamate concentration was assessed every day .


Pressure pain threshold , pressure pain tolerance , autonomic parameters ( heart rate , systolic and diastolic blood pressures ) and reported side effects also were assessed .


No significant change was noted in the baseline concentration of glutamate in the masseter muscle , blood , or saliva , but the peak concentration in the masseter muscle increased significantly between day @ and @ .


A statistically significant increase in systolic and diastolic blood pressures after MSG administration was observed , as well as a significantly higher frequency of reports of nausea and headache in the MSG group .


No robust effect of MSG on muscle sensitivity was found .


Interstitial glutamate concentration in the masseter muscle is not highly disturbed by excessive repetitive intake of MSG in healthy man .


Inflammatory mediators are involved in the pathophysiology of neutrophilic bronchial disorders presenting with chronic productive cough .


Accumulating evidence indicates that prostanoids are key elements in the pathophysiology of these disorders .


However , little is known about the role of prostacyclin in neutrophilic bronchial inflammation .


The effect of beraprost , a chemically and biologically stable analog of prostacyclin , on cough response to inhaled capsaicin was examined in @ patients with chronic bronchitis , a neutrophilic bronchial disorder , in a randomized , placebo-controlled crossover study .


Capsaicin cough threshold , defined as the lowest concentration of capsaicin eliciting five or more coughs , was measured as an index of the airway cough reflex sensitivity .


After a @-week treatment with beraprost ( @ g twice a day orally ) , the cough threshold was significantly ( P < @ ) decreased as compared with placebo -LSB- @ ( geometric standard error of the mean -LSB- GSEM -RSB- @ ) M vs. @ ( GSEM @ ) -RSB- .


These findings indicate that prostacyclin is involved in the pathophysiology of cough reflex sensitivity in patients with chronic bronchitis , a frequently encountered neutrophilic bronchial disorder presenting with chronic productive cough .


The aim of this study was to compare the accuracy of placental - microglobulin-@ ( PAMG-@ ) , insulin-like growth factor binding protein-@ ( IGFBP-@ ) and nitrazine test to diagnose premature rupture of membranes .


A total of @ pregnant women between @ and @ weeks with signs/symptoms of membrane rupture were eligible for our study .


These women were evaluated with the PAMG-@ , IGFBP-@ , and nitrazine tests .


In the @ women , the sensitivity , specificity , positive predictive value , and negative predictive value of PAMG-@ , IGFBP-@ and nitrazine test were @ % , @ % , @ % , and @ % , @ % , @ % , @ % and @ % , and @ % , @ % , @ % , and @ % , respectively .


In a comparison of the PAMG-@ test and the nitrazine test , positive coincidence rate was @ % , negative coincidence rate was @ % , total coincidence rate was @ % , and kappa value was @ .


In a comparison of the PAMG-@ test and the IGFBP-@ test , the positive coincidence rate , negative coincidence rate and total coincidence rate were @ % , @ % , and @ % , and kappa value was @ .


PAMG-@ assay was the most accurate method to diagnose premature rupture of membranes with the highest sensitivity , specificity , positive predictive value and negative predictive value .


To evaluate the effectiveness of orally administered maropitant citrate in preventing vomiting after hydromorphone hydrochloride administration in dogs .


Randomized , blinded , prospective clinical study .


@ dogs with American Society of Anesthesiologists status of I or II , > @ months of age , and weighing between @ and @ kg ( @ and @ lb ) .


Dogs were randomly selected to receive maropitant ( @ to @ mg/kg -LSB- @ to @ mg/lb -RSB- ) or placebo ( lactose monohydrate ) orally @ hours prior to receiving hydromorphone ( @ mg/kg -LSB- @ mg/lb -RSB- , IM ) .


A blinded observer recorded the occurrence of vomiting or signs of nausea ( eg , salivation or lip-licking ) during a @-minute period after hydromorphone administration .


Two-tailed Fisher exact tests were used to compare the incidences of vomiting and signs of nausea with or without vomiting between treatment groups .


Results-Of the @ dogs receiving maropitant , none vomited but @ ( @ % ) developed signs of nausea .


Of the @ dogs receiving placebo , @ ( @ % ) vomited and @ ( @ % ) developed signs of nausea ; overall , @ of @ ( @ % ) dogs in the placebo treatment group vomited or developed signs of nausea .


Compared with the effects of placebo , maropitant significantly decreased the incidence of vomiting but not signs of nausea in dogs administered hydromorphone .


Among the @ study dogs , the incidence of vomiting associated with hydromorphone administration was @ % .


Oral administration of maropitant prevented vomiting but not signs of nausea associated with hydromorphone administration in dogs .


Whether heart failure ( HF ) increases the risk of venous thromboembolism ( VTE ) is not well established .


In the phase III MAGELLAN ( Multicenter , rAndomized , parallel Group Efficacy and safety study for the prevention of venous thromboembolism in hospitalized medically iLL patients comparing rivaroxabAN with enoxaparin ) trial , extended-duration rivaroxaban was compared with standard-duration enoxaparin followed by placebo for VTE prevention in @ hospitalized acutely ill patients with or without HF .


The aim of this analysis was to evaluate the relationship between HF severity and the risk of VTE in MAGELLAN patients .


Hospitalized patients diagnosed with HF were included according to New York Heart Association class III or IV at admission ( n = @ ) .


HF severity was determined by N-terminal probrain natriuretic peptide ( NT-proBNP ) plasma concentrations ( median @ pg/mL ) .


Baseline plasma D-dimer concentrations ranged from @ to @ g/L for the less and more severe HF subgroups .


Patients with more severe HF had a greater incidence of VTE versus patients with less severe HF , with a significant trend up to Day @ ( @ % versus @ % ; P = @ ) and Day @ ( @ % versus @ % ; P = @ ) .


Multivariable analysis confirmed that NT-proBNP concentration was associated with VTE risk up to Day @ ( P = @ ) and D-dimer concentration with VTE risk up to Day @ ( P = @ ) .


The association between VTE risk and HF severity that was observed in the enoxaparin/placebo group was not seen in the extended-duration rivaroxaban group .


Patients with more severe HF , as defined by high NT-proBNP plasma concentration , were at increased risk of VTE .


NT-proBNP may be useful to identify high short-term risk , whereas elevated D-dimer may be suggestive of high midterm risk .


Aromatase inhibitor ( AI ) therapy results in substantial survival benefits for patients with hormone receptor-positive breast cancer .


The rates of poor adherence and discontinuation of AI therapy are high , primarily because of treatment-related toxicities like musculoskeletal pain .


Although pain-related symptoms may worsen during AI therapy , the authors hypothesized that nonpersistence with AI therapy was associated with symptoms that were present before treatment initiation .


Postmenopausal women initiating AI therapy who were enrolled in a prospective clinical trial completed questionnaires at baseline to assess sleep , fatigue , mood , and pain .


Reasons for treatment discontinuation during the first year of treatment were recorded .


Associations between baseline patient-reported symptoms and treatment discontinuation because of toxicity were identified using logistic regression .


Four hundred forty-nine patients were evaluable .


The odds of treatment discontinuation were higher in patients who reported a greater number of symptoms before AI initiation .


Baseline poor sleep quality was associated with early treatment discontinuation , with an odds ratio ( OR ) of @ ( @ % confidence interval -LSB- CI -RSB- , @-@ @ ; P = @ ) .


Baseline presence of tired feeling and forgetfulness had similar ORs for discontinuation ( tired feeling : OR , @ ; @ % CI , @-@ @ ; P = @ ; forgetfulness : OR , @ ; @ % CI , @-@ @ ; P = @ ) .


An increasing total number of baseline symptoms was associated with an increased likelihood of treatment discontinuation , with an OR of @ ( @ % CI , @-@ @ ; P = @ ) for @ to @ symptoms versus @ to @ symptoms .


Symptom clusters in breast cancer survivors that are present before the initiation of adjuvant AI therapy may have a negative impact on a patient 's persistence with therapy .


Interventions to manage these symptoms may improve breast cancer outcomes and quality of life .


Hereditary hemorrhagic telangiectasia ( HHT ) is a genetic disorder associated with abnormal angiogenesis and disabling epistaxis .


Tranexamic acid ( TA ) has been widely used in the treatment of these severe bleeds but with no properly designed trial .


To demonstrate the efficacy of TA in epistaxis in HHT patients and to explore its safety of use .


A randomized , placebo-controlled , double-blind , cross-over trial was conducted .


Participants were randomized to receive TA ( @g a day ) then placebo or the opposite sequence .


The main analysis compared intra-individual mean duration of epistaxis under TA vs. placebo on a log scale .


The primary outcome was the mean duration of epistaxis per month , assessed with specific grids to be completed by participants .


The number of epistaxis episodes was recorded as a secondary outcome .


A total of @ randomized patients contributed to the statistical analysis .


The mean duration of epistaxis per month was significantly shorter with TA than placebo ( @ on the log scale ; SD = @ ; P = @ ) , corresponding to a decrease of @ % ( @ min ) in the duration of epistaxis per month ( CI @ % , @-@ @ ) .


The median number of epistaxis episodes per month was @ episodes in the placebo arm vs. @ episodes in the TA arm .


No thrombophlebitis was observed .


In the ATERO study , we demonstrated a significant decrease in the duration of epistaxis in HHT patients taking TA .


No safety issues were recorded in our cohort of patients .


It has been proposed that royal jelly has antioxidant properties and may improve oxidative stress and glycemic control .


Therefore , we investigated the effects of royal jelly supplementation in diabetic females .


In this pilot , parallel design randomized clinical trial , @ female volunteers with type @ diabetes were randomly allocated to the supplemented ( @ , cases ) and placebo ( @ , cases ) groups , based on random block procedure produced by Random Allocation Software , given a daily dose of @,@ mg royal jelly soft gel or placebo , respectively , for @ weeks .


Before and after intervention , glycemic control indices , antioxidant and oxidative stress factors were measured .


After royal jelly supplementation , the mean fasting blood glucose decreased remarkably ( @ mg/dL vs. @ mg/dL ) .


Royal jelly supplementation resulted in significant reduction in the mean serum glycosylated hemoglobin levels ( @ % @ % vs. @ % @ % , P = @ ) and significant elevation in the mean insulin concentration ( @ pmol/L vs. @ pmol/L , P = @ ) .


Supplementation significantly increased erythrocyte superoxidase dismutase and glutathione peroxidase activities and decreased malondialdehyde levels ( P < @ ) .


At the end of study , the mean total antioxidant capacity elevated insignificantly in both groups .


On the basis of our findings , it seems that royal jelly supplementation may be beneficial in controlling diabetes outcomes .


Further studies with larger sample size are warranted .


Evidence is scarce for the effectiveness of therapies for oesophageal cancer progressing after chemotherapy , and no randomised trials have been reported .


We aimed to compare gefitinib with placebo in previously treated advanced oesophageal cancer .


For this phase @ , parallel , randomised , placebo-controlled trial , eligible patients were adults with advanced oesophageal cancer or type I/II Siewert junctional tumours , histologically confirmed squamous-cell carcinoma or adenocarcinoma , who had progressed after chemotherapy , with WHO performance status @-@ , and with measurable or evaluable disease on CT scan .


Participants were recruited from @ UK centres and randomly assigned ( @:@ ) to gefitinib ( @ mg ) or matching placebo by simple randomisation with no stratification factors .


Patients , clinicians , and trial office staff were masked to treatment allocation .


Treatment continued until disease progression , unacceptable toxicity , or patient choice .


The primary outcome was overall survival , analysed by intention to treat .


This trial is registered , number ISRCTN@ .


Between March @ , @ , and Nov @ , @ , @ patients were randomly assigned to treatment groups ( one patient withdrew consent ; @ patients allocated gefitinib and @ allocated placebo included in analyses ) .


Overall survival did not differ between groups ( median @ months , @ % CI @-@ , for gefitinib vs @ months , @ % CI @-@ , for placebo ; hazard ratio -LSB- HR -RSB- @ , @ % CI @-@ , p = @ ) .


Among the prespecified patient-reported outcomes ( @ patients on gefitinib and @ on placebo completed both baseline and @ week questionnaires and were included in analyses ) , odynophagia was significantly better in the gefitinib group ( adjusted mean difference -@ , @ % CI -@ to -@ ; n = @ ; p = @ ) , whereas the other outcomes were not significantly improved compared with placebo : global quality of life ( @ , @ % CI -@ to @ , n = @ , p = @ ) , dysphagia ( -@ , @ % CI -@ to @ , n = @ , p = @ ) , and eating ( -@ , @ % CI -@ to @ , n = @ , p = @ ) .


Median progression-free survival was marginally longer with gefitinib than it was with placebo ( @ months , @ % CI @-@ in the gefitinib group vs @ months , @ % CI @-@ in the placebo group ; HR @ , @ % CI @-@ , p = @ ) .


The most common toxicities were diarrhoea ( @ -LSB- @ % -RSB- of @ patients on gefitinib vs six -LSB- @ % -RSB- of @ on placebo ) and skin toxicity ( @ -LSB- @ % -RSB- vs two -LSB- @ % -RSB- ) , both mostly grade @ .


The commonest grade @-@ toxicities were fatigue ( @ -LSB- @ % -RSB- vs @ -LSB- @ % -RSB- patients ) and diarrhoea ( @ -LSB- @ % -RSB- vs two -LSB- @ % -RSB- ) .


Serious adverse events were reported in @ ( @ % ) of @ patients assigned to gefitinib and @ ( @ % ) of @ on placebo .


@ ( @ % ) of patients in the gefitinib group achieved disease control at @ weeks , as did @ ( @ % ) of patients on placebo ( p = @ ) .


The use of gefitinib as a second-line treatment in oesophageal cancer in unselected patients does not improve overall survival , but has palliative benefits in a subgroup of these difficult-to-treat patients with short life expectancy .


Future research should focus on identification of predictive biomarkers to identify this subgroup of benefiting patients .


To explore the feasibility and safety on lung resection surgery with the combined method of microinjection acupuncture ( MIA ) and intravenous anesthesia instead of compound traditional acupuncture and drug anesthesia ( ADA ) .


Ninety cases of lung resection surgery were randomized into a general anesthesia group , a MIA group and a ADA group , @ cases in each one .


In the general anesthesia group , before surgery , the intramuscular injection of atropine @ mg was used ; during surgery , the anesthesia induction was followed with intravenous injection of fentanyl citrate , propofol and rocuronium bromide and the dosage was increased accordingly ; after surgery , the analgesia pump was applied .


In the MIA group , on the basis of general anesthesia , before anesthesia induction , the acupoint catgut embedding was applied to Jiaji ( EX-B @ ) of T@ , T@ and T , , Feishui ( BL @ ) , Xinshu ( BL @ ) and Geshu ( BL @ ) on the affected side and bilateral Quchi ( LI @ ) and Zusanli ( ST @ ) ; after surgery , the analgesia pump was applied .


In the ADA group , on the basis of general anesthesia , before !


anesthesia induction , electroacupuncture ( EA ) was applied to Hegu ( LI @ ) , Neiguan ( PC @ ) , Houxi ( SI @ ) and Zhigou ( TE @ ) for @ min ; during surgery , EA and intravenous medication were combined at the same acupoints as those before surgery ; after surgery , moxibustion and the analgesia pump were applied in combination for analgesia .


In each group , the biological indices were monitored during surgery at @ time points named T. ( before anesthesia I induction ) , T@ ( intubation in general anesthesia induction ) , T@ ( skin incision ) , T@ ( rib exposure in muscular incision ) T. ( chest open ) , T , ( lung removal ) , T@ ( drainage tube implantation ) , T@ ( chest closure ) , T ( muscular stitching ) , T , ( skin stitching ) and T@ ( extubation ) .


The actual dosage of anesthetics during surgery and the , dosage of fentanyl citrate in analgesia pump were quantified after surgery .


Results ( @ ) In the MIA group and ADA group , the increased dosage of fentanyl citrate was less than that in the general anesthesia group -LSB- ( @ ) g .


kg-@ .


h-@ vs ( @ g. kg-@ .


h-@ , ( @ g .


h-@ , both P < @ -RSB- .


The increased dosage of propofol and rocuronium bromide was not different during surgery among the groups ( all P > @ ) .


( @ ) In the MIA group and ADA group , after surgery , the increased dosage of fentanyl citrate was less than that in the general anesthesia group -LSB- ( @ ) g/kg vs ( @ g/kg , ( @ g/kg vs ( @ g/kg , both P < @ -RSB- , reducing by @ % in comparison .


( @ ) The differences in heart rate and blood pressure at @ time points during surgery were not significant among the three groups ( all P > @ ) .


n The combined method of MIA and intravenous anesthesia significantly reduces the dosage of intravenous anesthetics during and after lung resection surgery as compared with ADA , presenting the similar analgesic effect as simple intravenous medication and the good safety .


The combined method of MIA and intravenous anesthesia is much


A limited amount of data exists regarding the effect of lipoic acid ( LA ) , an oral antioxidant supplement , on cytokine profiles among multiple sclerosis ( MS ) patients .


We aimed to assess the effect of daily consumption of LA on the cytokine profiles in MS patients .


In this double-blind , placebo-controlled , randomized clinical trial , @ relapsing-remitting MS patients with an age range of @-@ years were recruited into @ groups : LA consumption ( @,@ mg/day ) or placebo .


Patients followed their prescribed supplements for @ weeks .


Fasting blood samples for cytokine profile measurement were collected at baseline and after the intervention .


Anthropometric parameters were measured based on the standard guidelines .


INF - , ICAM-@ , TGF - and IL-@ were significantly reduced in the LA group compared to the placebo group -LSB- ( INF - : @ @ vs. @ @ pg/ml , p < @ ) , ( ICAM-@ : @ @ vs. @ @ ng/ml , p = @ ) , ( TGF - : @ @ vs. @ @ ng/ml , p < @ ) and ( IL-@ : @ @ vs. @ @ ng/ml , p = @ ) -RSB- .


No significant changes in TNF - , IL-@ , EDSS and MMP-@ were found between the LA and placebo groups ( p = @ , p = @ , p = @ and p = @ , respectively ) .


The results suggested that consumption of @,@ mg LA per day beneficially affects several inflammatory cytokines including INF - , ICAM-@ TGF - and IL-@ .


Further investigations are needed to verify the beneficial role of LA on other cytokine profiles among MS patients .


Evidence demonstrates that physical exercise and psychological wellbeing are closely interlinked , particularly in older-aged women .


However , research investigating how different forms of exercise influence mental health in older-aged women is underdeveloped .


A randomized controlled trial ( N = @ ) will assess the relative effectiveness of two different exercise programs ( whole-body vibration and Multicomponent Training ) for improving psychological wellbeing in older-aged women .


The following outcomes will be assessed at three time points ( that is , pre , post , and follow-up ) : psychological wellbeing , proactive attitude , quality of life , and happiness .


Results will have important implications for preventing psychological and physiological disease in older-aged women and for managing health-related costs for this population group .


Targeted interventions to reduce the risk and increase the early detection of melanoma have the potential to save lives .


We aimed to assess the effect of such an intervention on patient prevention behavior .


We conducted a pilot clustered randomized controlled trial , comparing a targeted screening and education intervention with a conventional information-based campaign in @ private surgeries in western France .


In the intervention group , @ general practitioners identified patients at elevated risk for melanoma with a validated assessment tool , the Self-Assessment Melanoma Risk Score ( SAMScore ) , examined their skin , and counseled them using information leaflets .


In the control group , @ general practitioners displayed a poster and the leaflets in their waiting room and examined patients ' skin at their own discretion .


The main outcome measures were sunbathing and skin self-examinations among patients at elevated risk , assessed @ months later with a questionnaire .


Analyses were based on @ patients .


Compared with control patients , intervention patients were more likely to remember the campaign ( @ % vs @ % , P = @ ) and to correctly identify their elevated risk of melanoma ( @ % vs @ % , P = @ ) .