Azithromycin was detectable in both the umbilical cord plasma and amniotic fluid after the single preoperative dose .


Azithromycin concentrations in breast milk were high and were sustained up to @ hours after the single dose .


Simulations demonstrated accumulation in breast milk after multiple doses .


A single dose of azithromycin achieves effective plasma and tissue concentrations and is transported rapidly across the placenta .


The tissue concentrations that are achieved in the myometrium exceed the MIC@ for Ureaplasma spp .


To determine the immunologic effects of oropharyngeal colostrum administration in extremely premature infants .


We conducted a double-blind , randomized , placebo-controlled trial involving @ preterm infants born before @ weeks ' gestation .


Subjects received @ mL of their mother 's colostrum or sterile water via oropharyngeal route every @ hours for @ days beginning at @ to @ hours of life .


To measure concentrations of secretory immunoglobulin A , lactoferrin , and several immune substances , urine and saliva were obtained during the first @ hours of life and at @ and @ days .


Clinical data during hospitalization were collected .


Urinary levels of secretory immunoglobulin A at @ week ( @ vs @ ng/g creatinine , P = @ ) and @ weeks ( @ vs @ ng/g creatinine , P = @ ) , and lactoferrin at @ week ( @ vs @ g/g creatinine , P = @ ) were significantly higher in colostrum group .


Urine interleukin-@ level was significantly lower in colostrum group at @ weeks ( @ vs @ g/g creatinine , P = @ ) .


Salivary transforming growth factor-@ ( @ vs @ g/mL , P = @ ) and interleukin-@ ( @ vs @ ng/mL , P = @ ) were significantly lower at @ weeks in colostrum group .


A significant reduction in the incidence of clinical sepsis was noted in colostrum group ( @ % vs @ % , P = @ ) .


This study suggests that oropharyngeal administration of colostrum may decrease clinical sepsis , inhibit secretion of pro-inflammatory cytokines , and increase levels of circulating immune-protective factors in extremely premature infants .


Larger studies to confirm these findings are warranted .


Aortic-root dissection is the leading cause of death in Marfan 's syndrome .


Studies suggest that with regard to slowing aortic-root enlargement , losartan may be more effective than beta-blockers , the current standard therapy in most centers .


We conducted a randomized trial comparing losartan with atenolol in children and young adults with Marfan 's syndrome .


The primary outcome was the rate of aortic-root enlargement , expressed as the change in the maximum aortic-root-diameter z score indexed to body-surface area ( hereafter , aortic-root z score ) over a @-year period .


Secondary outcomes included the rate of change in the absolute diameter of the aortic root ; the rate of change in aortic regurgitation ; the time to aortic dissection , aortic-root surgery , or death ; somatic growth ; and the incidence of adverse events .


From January @ through February @ , a total of @ clinical centers enrolled @ participants , @ months to @ years of age ( mean -LSB- SD -RSB- age , @ years in the atenolol group and @ years in the losartan group ) , who had an aortic-root z score greater than @ .


The baseline-adjusted rate of change in the mean ( SE ) aortic-root z score did not differ significantly between the atenolol group and the losartan group ( -@ and -@ standard-deviation units per year , respectively ; P = @ ) .


Both slopes were significantly less than zero , indicating a decrease in the aortic-root diameter relative to body-surface area with either treatment .


The @-year rates of aortic-root surgery , aortic dissection , death , and a composite of these events did not differ significantly between the two treatment groups .


Among children and young adults with Marfan 's syndrome who were randomly assigned to losartan or atenolol , we found no significant difference in the rate of aortic-root dilatation between the two treatment groups over a @-year period .


( Funded by the National Heart , Lung , and Blood Institute and others ; ClinicalTrials.gov number , NCT@ . )


To investigate the efficacy and safety of aerobic training ( AT ) in patients with cancer with medically stable heart failure ( HF ) .


A retrospective analysis of @ patients with cancer who have HF and who were randomly assigned to AT ( n = @ ) or guideline-based usual care ( UC ; n = @ ) was performed .


AT consisted of three supervised sessions per week at @ to @ minutes per session at @ % to @ % of heart rate reserve for @ weeks followed by home-based sessions for @ to @ months .


The primary end point was all-cause mortality and hospitalization .


Secondary end points were other clinical events , safety , and change in exercise capacity ( VO ( @peak ) ) and health-related quality of life ( HRQOL ) .


Median follow-up was @ months .


In intention-to-treat ( ITT ) analyses , all-cause mortality or hospitalization at @ years was @ % in the AT group compared with @ % in the UC group ( adjusted hazard ratio -LSB- HR -RSB- , @ ; @ % CI , @ to @ ; P = @ ) .


The incidence of cardiovascular mortality or cardiovascular hospitalization was significantly higher in the AT group compared with the UC group ( @ % v @ % ; adjusted HR , @ ; @ % CI , @ to @ ; P = @ ) .


There were no differences in any VO ( @peak ) or HRQOL end points .


In post hoc analyses based on adherence to AT , all-cause mortality and hospitalization was @ % in adherent patients ( @ minutes per week ) compared with @ % in nonadherent patients ( < @ minutes per week ) .


In ITT analyses , AT did not improve clinical outcomes in patients with cancer who had HF .


Post hoc analyses suggested that patients not capable of adhering to the planned AT prescription may be at increased risk of clinical events .


To determine whether droxidopa , an oral norepinephrine precursor , improves symptomatic neurogenic orthostatic hypotension ( nOH ) .


Patients with symptomatic nOH due to Parkinson disease , multiple system atrophy , pure autonomic failure , or nondiabetic autonomic neuropathy underwent open-label droxidopa dose optimization ( @-@ mg @ times daily ) , followed , in responders , by @-day washout and then a @-day double-blind trial of droxidopa vs placebo .


Outcome measures included patient self-ratings on the Orthostatic Hypotension Questionnaire ( OHQ ) , a validated , nOH-specific tool that assesses symptom severity and symptom impact on daily activities .


From randomization to endpoint ( n = @ ) , improvement in mean OHQ composite score favored droxidopa over placebo by @ units ( p = @ ) .


Improvement in OHQ symptom subscore favored droxidopa by @ units ( p = @ ) , with maximum change in `` dizziness/lightheadedness . ''


Improvement in symptom-impact subscore favored droxidopa by @ units ( p = @ ) , with maximum change for `` standing a long time . ''


Mean standing systolic blood pressure ( BP ) increased by @ vs @ mm Hg ( p < @ ) , and mean supine systolic BP by @ vs @ mm Hg ( p < @ ) .


At endpoint , supine systolic BP > @ mm Hg was observed in @ % of droxidopa and @ % of placebo recipients .


Adverse events reported in @ % of double-blind droxidopa recipients were headache ( @ % ) and dizziness ( @ % ) .


No patients discontinued double-blind treatment because of adverse events .


In patients with symptomatic nOH , droxidopa improved symptoms and symptom impact on daily activities , with an associated increase in standing systolic BP , and was generally well tolerated .


This study provides Class I evidence that in patients with symptomatic nOH who respond to open-label droxidopa , droxidopa improves subjective and objective manifestation of nOH at @ days .


Midazolam comedication with morphine is a routine practice in pre and postoperative patients but has not been evaluated in prehospital setting .


We aimed to evaluate the comedication effect of midazolam in the prehospital traumatic adults .


A prehospital prospective randomized double-blind placebo-controlled trial of intravenous morphine @ mg/kg and midazolam @ mg/kg vs morphine @ mg/kg and placebo .


Pain assessment was done using a validated numeric rating scale ( NRS ) .


The primary end point was to achieve an efficient analgesic effect ( NRS@ ) @ minutes after the baseline .


The secondary end points were treatment safety , total morphine dose required until obtaining NRS@ , and efficient analgesic effect @ minutes after the baseline .


Ninety-one patients were randomized into midazolam ( n = @ ) and placebo ( n = @ ) groups .


No significant difference in proportion of patients with a pain score@ was observed between midazolam ( @ % ) and placebo ( @ % ) after @ minutes ( P = @ ) .


Secondary end points were similar in regard with proportion of patients with a pain score@ at T@ , the side effects and adverse events except for drowsiness in midazolam vs placebo , @ % vs @ % ( P < @ ) .


No significant difference in total morphine dose was observed , that is , midazolam ( @ mg@ @ ) vs placebo ( @ mg@ @ ) ( P = @ ) .


According to our study , midazolam does not enhance pain control as an adjunctive to morphine regimen in the management of trauma-induced pain in prehospital setting .


However , such midazolam use seems to be associated with an increase in drowsiness .


Recent initiatives to target the personal , social and clinical needs of people with long-term health conditions have had limited impact within primary care .


Evidence of the importance of social networks to support people with long-term conditions points to the need for self-management approaches which align personal circumstances with valued activities .


The Patient-Led Assessment for Network Support ( PLANS ) intervention is a needs-led assessment for patients to prioritise their health and social needs and provide access to local community services and activities .


Exploring the work and practices of patients and telephone workers are important for understanding and evaluating the workability and implementation of new interventions .


Qualitative methods ( interviews , focus group , observations ) were used to explore the experience of PLANS from the perspectives of participants and the telephone support workers who delivered it ( as part of an RCT ) and the reasons why the intervention worked or not .


Normalisation Process Theory ( NPT ) was used as a sensitising tool to evaluate : the relevance of PLANS to patients ( coherence ) ; the processes of engagement ( cognitive participation ) ; the work done for PLANS to happen ( collective action ) ; the perceived benefits and costs of PLANS ( reflexive monitoring ) .


@ patients in the intervention arm of a clinical trial were interviewed and their telephone support calls were recorded and a focus group with @ telephone support workers was conducted .


Analysis of the interviews , support calls and focus group identified three themes in relation to the delivery and experience of PLANS .


These are : formulation of ` health ' in the context of everyday life ; trajectories and tipping points : disrupting everyday routines ; precarious trust in networks .


The relevance of these themes are considered using NPT constructs in terms of the work that is entailed in engaging with PLANS , taking action , and who is implicated this process .


PLANS gives scope to align long-term condition management to everyday life priorities and valued aspects of life .


This approach can improve engagement with health-relevant practices by situating them within everyday contexts .


This has potential to increase utilisation of local resources with potential cost-saving benefits for the NHS .


To evaluate the effect of acupuncture on hot flushes and other menopause-related symptoms used in an integrated system , including such therapeutic techniques as diet therapy and Tuina self-massage .


Randomized trial .


Outpatient center .


One hundred women in spontaneous menopause with at least three episodes of hot flushes daily were randomly allocated to two treatment groups ( @ per group ) : Women in group A were given diet , self-massage training , and treatment with acupuncture , and women in group B ( the control group ) were given the same diet and self-massage training , but treatment with acupuncture started @ weeks after they were enrolled into the study .


Acupuncture treatments were scheduled twice weekly for @ consecutive weeks .


Mean change in frequency and/or intensity in menopause-related symptoms were estimated by questionnaire after treatment at week @ .


Treatment with acupuncture significantly reduced the occurrence of hot flushes and sudden sweating ( p < @ ) .


Other symptoms ( sleep disorders , tightness in the chest , irritability , bone pain , feeling depressed ) significantly improved .


Acupuncture in an integrated system that includes therapeutic techniques such as diet therapy and Tuina self-massage can be used to treat hot flushes and selected symptoms in postmenopausal women .


Although social anxiety disorder is a common and sometimes disabling condition , there are no approved treatments that can be used on an as-needed basis .


The authors examined the acute use of PH@B , an intranasally administered neurosteroidal aerosol , for the acute management of the symptoms of social anxiety disorder .


The authors conducted a phase @ , multicenter , randomized , double-blind , placebo-controlled , single-dose study of PH@B .


Ninety-one women @-@ years of age with generalized social anxiety disorder received placebo intranasal spray ( single-blind ) @ minutes before laboratory-simulated public speaking and social interaction challenges .


Patients who experienced significant distress during at least one challenge returned @ week later to receive either intranasal PH@B or placebo aerosol spray ( double-blind ) before repeat challenges .


Patients who received PH@B during the second set of challenges had a significantly greater decrease in mean Subjective Units of Distress scores during the public speaking and social interaction challenges compared with the first set of challenges , than did patients who received placebo for both sets of challenges .


A significantly greater proportion of the PH@B group were much or very much improved from the first to the second sets of challenges compared with the placebo group ( @ % and @ % , respectively ) .


The side effects of PH@B were benign .


PH@B may be a novel , effective , and well-tolerated acute treatment for performance and social anxiety in women with social anxiety disorder .


Autologous chondrocyte implantation ( ACI ) aims to restore hyaline cartilage .


Traditionally , ACI rehabilitation is prescribed in a concurrent ( CON ) format .


However , it is well known from studies in asymptomatic populations that CON training produces an interference effect that can attenuate strength gains .


Strength is integral to joint function , so adopting a nonconcurrent ( N-CON ) approach to ACI rehabilitation might improve outcomes .


To assess changes in function and neuromuscular performance during @ wk of CON and N-CON physical rehabilitation after ACI to the knee .


Orthopedic Hospital NHS Foundation Trust .


Randomized control , pilot study .


@ patients ( @ male , @ female ; age @ @ y ; body mass @ @ kg ; time from injury to surgery @ @ mo -LSB- mean SD -RSB- ) randomly allocated to N-CON : CON ( @:@ ) .


Standardized CON and N-CON physiotherapy that involved separation of strength and cardiovascular-endurance conditioning .


Function in the single-leg-hop test , patient-reported outcomes ( Knee injury and Osteoarthritis Outcome Score -LSB- KOOS -RSB- , International Knee Documentation Committee subjective questionnaire -LSB- IKDC -RSB- ) , and neuromuscular outcomes of peak force ( PF ) , rate of force development ( RFD ) , electromechanical delay ( EMD ) , and sensorimotor performance ( force error -LSB- FE -RSB- ) of the knee extensors and flexors of the injured and noninjured legs , measured presurgery and at @ , @ , @ , and @ wk postsurgery .


Factorial ANOVAs with repeated measures of group by leg and by test occasion revealed significantly superior improvements for KOOS , IKDC , PF , EMD , and FE associated with N-CON vs. CON rehabilitation ( F ( @,@ GG ) = @-@ @ , P < @ ) .


These results confirm increased peak effectiveness of N-CON rehabilitation ( ~ @-@ @ % better than CON over @ wk of rehabilitation ) .


N-CON and CON showed similar patterns of improvement for single-leg-hop test and RFD .


Nonconcurrent strength and cardiovascular-endurance conditioning during @ wk of rehabilitation after ACI surgery elicited significantly greater improvements to functional and neuromuscular outcomes than did contemporary concurrent rehabilitation .


Study objective To assess the efficacy of outpatient misoprostol administration versus inpatient misoprostol administration for the treatment of first trimester incomplete miscarriage .


A prospective randomised controlled trial was conducted at a tertiary hospital from May @ to April @ .


A total of @ patients with first trimester incomplete miscarriage were randomised to receive misoprostol either as outpatient or inpatient .


Intra-vaginal misoprostol @ mcg was administered eight hourly to a maximum of three doses .


Complete evacuation is achieved when the cervical os was closed on vaginal examination or ultrasound showed no more retained products of conception evidenced by endometrial thickness of less than @ mm .


Treatment failure was defined as failure in achieving complete evacuation on day seven hence surgical evacuation is offered .


Outpatient administration of misoprostol was as effective as inpatient treatment with success rate of @ and @ % ( p = @ ) .


The side effects were not significantly different between the two groups .


Side effects that occurred were minor and only required symptomatic treatment .


Duration of bleeding was @ days in both groups ( p = @ ) .


Mean reduction in haemoglobin was lesser in the outpatient group ( @ g/dl ) as compared to in the inpatient group ( @ g/dl ) which was statistically significant ( p = @ ) .


Medical evacuation using intra-vaginal misoprostol @ mcg eight hourly for a maximum of three doses in an outpatient setting is as effective as in inpatient setting with tolerable side effects .


The authors examine the pattern of direction errors made during the manipulation of a physical simulation of an underground coal mine bolting machine to assess the directional control-response compatibility relationships associated with the device and to compare these results to data obtained from a virtual simulation of a generic device .


Directional errors during the manual control of underground coal roof bolting equipment are associated with serious injuries .


Directional control-response relationships have previously been examined using a virtual simulation of a generic device ; however , the applicability of these results to a specific physical device may be questioned .


Forty-eight participants randomly assigned to different directional control-response relationships manipulated horizontal or vertical control levers to move a simulated bolter arm in three directions ( elevation , slew , and sump ) as well as to cause a light to become illuminated and raise or lower a stabilizing jack .


Directional errors were recorded during the completion of @ trials by each participant


Directional error rates are increased when the control and response are in opposite directions or if the direction of the control and response are perpendicular.The pattern of direction error rates was consistent with experiments obtained from a generic device in a virtual environment .


Error rates are increased by incompatible directional control-response relationships .


Ensuring that the design of equipment controls maintains compatible directional control-response relationships has potential to reduce the errors made in high-risk situations , such as underground coal mining .


To evaluate the impact of @-@-day intravenous administration of meldonium as part of combination therapy in patients with chronic heart failure in the early post-infarction period on the recovery period , structural and functional parameters , and heart rate variability ( HRV ) .


The investigation enrolled @ patients ( men and women ) aged @ to @ years at weeks @-@ after post-myocardial infarction with symptoms of Functional Class II-III heart failure .


All the patients underwent @-hour electrochocardiography monitoring , cardiac echocardiography , and HRV study .


After dividing the patients into @ groups , Group @ ( a study group ) ( n = @ ) was given intravenous meldonium ( idrinol ) @ mg/day in addition to the basic therapy of coronary heart disease .


The patients in the study and control ( Group @ ; n = @ ) groups were at baseline matched for age , gender , disease severity , and basic therapy pattern .


Following @-@ days of treatment , both groups showed clinical improvement and the favorable changes in cardiac structural and functional parameters and HRV values , which were more pronounced in the patients receiving meldonium .


The patients with CHF using meldonium as part of combination therapy in the early post-infarction period were observed to have clinical improvement , a significant reduction in the rate of angina attacks and in the need for nitrates , a decrease in the number of arrhythmic and ischemic episodes , and favorable changes in cardiac structural and functional parameters and HRV values .


This article illustrates the use of mixed methods in the development and evaluation of the Positive Online Weight Reduction ( POWeR ) programme , an e-health intervention designed to support sustainable weight loss .


The studies outlined also explore how human support might enhance intervention usage and weight loss .


Mixed methods were used to develop and evaluate POWeR .


In the development phase , we drew on both quantitative and qualitative findings to plan and gain feedback on the intervention .


Next , a feasibility trial , with nested qualitative study , explored what level of human support might lead to the most sustainable weight loss .


Finally , a large community-based trial of POWeR , with nested qualitative study , explored whether the addition of brief telephone coaching enhances usage .


Findings suggest that POWeR is acceptable and potentially effective .


Providing human support enhanced usage in our trials , but was not unproblematic .


Interestingly , there were some indications that more basic ( brief ) human support may produce more sustainable weight loss outcomes than more regular support .


Qualitative interviews suggested that more regular support might foster reliance , meaning patients can not sustain their weight losses when support ends .


Qualitative findings in the community trial also suggested explanations for why many people may not take up the opportunity for human support .


Integrating findings from both our qualitative and quantitative studies provided far richer insights than would have been gained using only a single method of inquiry .


Further research should investigate the optimum delivery of human support needed to maximize sustainable weight loss in online interventions .


Statement of contribution What is already known on this subject ?


There is evidence that human support may increase the effectiveness of e-health interventions .


It is unclear what level of human support might be optimal or how human support improves effectiveness .


Triangulation of quantitative and qualitative methods can be used to inform the design and implementation of interventions What does this study add ?


This paper demonstrates the value of a mixed methods approach when developing and evaluating an intervention .


Qualitative methods provided complementary insights into the optimal level of human support .


Brief human support is valued by some and may enhance usage and outcomes of an e-health intervention for weight loss .


This study assessed whether the Venner-PneuX endotracheal tube ( ET ) system , which has sub-glottic suction as well as irrigation ports and continuous cuff-pressure monitoring , is associated with a reduction in ventilator-associated pneumonia ( VAP ) when compared with the standard ET in high-risk patients undergoing cardiac surgery .


This was a single-institution , prospective , randomized control trial .


Patients were categorized as either Group A ( Venner-PneuX ET tube , n = @ ) or Group B ( Standard ET tube , n = @ ) .


Inclusion criteria included patients over the age of @ years and/or impaired left ventricular function ( LVEF < @ % ) undergoing cardiac surgery .


Patients were monitored for VAP for up to @ h post extubation and the diagnosis of VAP was according to the centres for disease control definition .


There were no significant differences in the patients ' demographics .


The mean ( SD ) ages for the two groups were @ ( @ ) and @ ( @ ) years ( P = @ ) , respectively .


The mean EuroSCORE was @ ( @ ) for Group A and @ ( @ ) for Group B ( P = @ ) .


The median intubation times were @ ( @ , @ ) h and @ ( @ , @ ) h , respectively .


VAP incidence was significantly lower in the Venner-PneuX ET group , being @ % when compared with @ % in the standard ET group ( P = @ ) .


There was no significant difference between the two groups in terms of intensive care unit stay ( P = @ ) and in-hospital mortality ( P = @ ) .


A binary logistic regression analysis ( type of ET tube , age , LVEF , history of lung disease , smoking history , surgical procedure , EuroSCORE , cardiopulmonary bypass time , blood transfusion , intubation duration among others ) confirmed that the Venner-PneuX ET tube was associated with significant VAP reduction ( Odds ratio @ , P = @ ) .


The Venner-PneuX VAP prevention system is associated with a significant reduction in VAP .


This can potentially lead to significant cost reductions and should be implemented as part of the VAP reduction bundle .


Treatment of respiratory distress syndrome in premature infants with continuous positive airway pressure ( CPAP ) preserves surfactant and keeps the lung open but is insufficient in severe surfactant deficiency .


Traditional surfactant administration is related to short periods of positive pressure ventilation and implies the risk of lung injury .


CPAP with surfactant but without any positive pressure ventilation may work synergistically .


This randomized trial investigated a less invasive surfactant application protocol ( LISA ) .


To test the hypothesis that LISA increases survival without bronchopulmonary dysplasia ( BPD ) at @ weeks ' gestational age in extremely preterm infants .


The Nonintubated Surfactant Application trial was a multicenter , randomized , clinical , parallel-group study conducted between April @ , @ , and March @ , @ , in @ level III neonatal intensive care units in Germany .


The final follow-up date was June @ , @ .


Participants included @ of @ eligible ( @ % ) spontaneously breathing preterm infants born between @ and @ weeks ' gestational age with signs of respiratory distress syndrome .


In an intention-to-treat design , infants were randomly assigned to receive surfactant either via a thin endotracheal catheter during CPAP-assisted spontaneous breathing ( intervention group ) or after conventional endotracheal intubation during mechanical ventilation ( control group ) .


Analysis was conducted from September @ , @ , to June @ , @ .


LISA via a thin catheter .


Survival without BPD at @ weeks ' gestational age .


Of @ infants who were randomized , @ were randomized to the control group and @ to the LISA group .


Of the infants who received LISA , @ ( @ % ) survived without BPD compared with @ ( @ % ) of those in the control group .


The reduction in absolute risk was @ % ( @ % CI , -@ % to @ % ; P = @ ) .


Intervention group infants were less frequently intubated ( @ infants -LSB- @ % -RSB- vs @ -LSB- @ % -RSB- ; P < @ ) and required fewer days of mechanical ventilation .


Significant reductions were seen in pneumothorax ( @ of @ intervention group infants -LSB- @ % -RSB- vs @ of @ @ % -RSB- ; P = @ ) and severe intraventricular hemorrhage ( @ infants -LSB- @ % -RSB- vs @ -LSB- @ % -RSB- ; P = @ ) , and the combined survival without severe adverse events was increased in the intervention group ( @ infants -LSB- @ % -RSB- vs @ -LSB- @ % -RSB- ; P = @ ; absolute risk reduction , @ ; @ % CI , @ to @ ) .


LISA did not increase survival without BPD but was associated with increased survival without major complications .


Because major complications are related to lifelong disabilities , LISA may be a promising therapy for extremely preterm infants .


Alcohol misuse in England costs around @ billion ( US$ @ billion ) annually from lost productivity and absenteeism .


Delivering brief alcohol interventions to employees as part of a health check may be acceptable , particularly with online delivery which can provide privacy for this stigmatised behaviour .


Research to support this approach is limited and methodologically weak .


The aim was to determine the effectiveness of online screening and personalised feedback on alcohol consumption , delivered in a workplace as part of a health check .


This two-group online individually randomised controlled trial recruited employees from a UK-based private sector organisation ( approx .


@,@ employees ) .


@,@ employees completed the online health check in the three week recruitment period .


Of these , @,@ ( @ % ) scored five or more on the AUDIT-C ( indicating alcohol misuse ) and were randomised to receive personalised feedback on their alcohol intake , alongside feedback on other health behaviours ( n = @ ) , or to receive feedback on all health behaviours except alcohol intake ( n = @ ) .


Participants were mostly male ( @ % ) , with a median age of @ years and half were in managerial positions ( @ % ) .


Median Body Mass Index was @ , @ % were smokers , median time undertaking moderate/vigorous physical activity a week was @ minutes and median fruit and vegetable consumption was three portions a day .


Eighty percent ( n = @,@ ) of participants completed follow-up questionnaires at three months .


An intention to treat analysis found no difference between experimental groups for past week drinking ( primary outcome ) ( @ % increase associated with the intervention ( @ % CI -@ % to @ % ; p = @ ) ) , AUDIT ( measure of alcohol-related harm ) and health utility ( EQ-@D ) .


There was no evidence to support the use of personalised feedback within an online health check for reducing alcohol consumption among employees in this organisation .


Further research is needed on how to engage a larger proportion of employees in screening .


The purposes of this study were to compare the oxygen cost , metabolic parameters and temporalspatial variables between barefoot and shod running in trained mid-forefoot runners .


Experienced runners ( N. = @ ; @ years ; @ men ) performed two separate @ minute treadmill running bouts at ~ @ % of estimated maximal heart rate .


Rate of oxygen consumption ( VO@ ) , energy cost , fuel use and heart rate ( HR ) were collected continuously using a portable gas analyzer .


Three-dimensional motion capture was used to measure temporalspatial parameters .


Participants ran at a mean self-selected speed of @ m/s for both conditions , at intensities corresponding to mean HR values of @ bpm ( shod ) and @ bpm ( barefoot ) .


Steady State VO@ was not different between the shod and barefoot conditions ( @ @ mL/kg * min vs. @ mL/kg * min , respectively ) .


The total energy expended in the shod and barefoot conditions was @ kJ and @ kJ .


The average non-protein respiratory exchange ratios , proportions and amount of fat and carbohydrate used were not different between conditions .


Cadence was @ % higher and center of gravity vertical displacement was @ cm less for the barefoot condition ( P < @ ) .


In trained mid-forefoot runners experienced with barefoot running , there are not significant metabolic differences between shod and barefoot running conditions .


Barefoot running increases cadence and decreases foot contact time and vertical displacement .


Experienced participants were likely able to titrate kinematics to standardize energy output and fuel use for a given running distance and speed irrespective of shoe wear .


Clinical trials yielded conflicting data about the benefit of adding systemic corticosteroids for treatment of community-acquired pneumonia .


We assessed whether short-term corticosteroid treatment reduces time to clinical stability in patients admitted to hospital for community-acquired pneumonia .


In this double-blind , multicentre , randomised , placebo-controlled trial , we recruited patients aged @ years or older with community-acquired pneumonia from seven tertiary care hospitals in Switzerland within @ h of presentation .


Patients were randomly assigned ( @:@ ratio ) to receive either prednisone @ mg daily for @ days or placebo .


The computer-generated randomisation was done with variable block sizes of four to six and stratified by study centre .


The primary endpoint was time to clinical stability defined as time ( days ) until stable vital signs for at least @ h , and analysed by intention to treat .


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


From Dec @ , @ , to May @ , @ , of @ patients assessed for eligibility , @ patients were randomly assigned to either the prednisone group ( n = @ ) or the placebo group ( n = @ ) .


Median time to clinical stability was shorter in the prednisone group ( @ days , IQR @-@ ) than in the placebo group ( @ days , @-@ ; hazard ratio -LSB- HR -RSB- @ , @ % CI @-@ , p < @ ) .


Pneumonia-associated complications until day @ did not differ between groups ( @ -LSB- @ % -RSB- in the prednisone group and @ -LSB- @ % -RSB- in the placebo group ; odds ratio -LSB- OR -RSB- @ -LSB- @ % CI @-@ -RSB- ; p = @ ) .


The prednisone group had a higher incidence of in-hospital hyperglycaemia needing insulin treatment ( @ -LSB- @ % -RSB- vs @ -LSB- @ % -RSB- ; OR @ , @ % CI @-@ , p = @ ) .


Other adverse events compatible with corticosteroid use were rare and similar in both groups .


Prednisone treatment for @ days in patients with community-acquired pneumonia admitted to hospital shortens time to clinical stability without an increase in complications .


This finding is relevant from a patient perspective and an important determinant of hospital costs and efficiency .


The purpose of this study was to investigate the safety and efficacy of two novel light sources for large area and full body application , providing polychromatic , non-thermal photobiomodulation ( PBM ) for improving skin feeling and appearance .


For non-thermal photorejuvenation , laser and LED light sources have been demonstrated to be safe and effective .


However , lasers and LEDs may offer some disadvantages because of dot-shaped ( punctiform ) emission characteristics and their narrow spectral bandwidths .


Because the action spectra for tissue regeneration and repair consist of more than one wavelength , we investigated if it is favorable to apply a polychromatic spectrum covering a broader spectral region for skin rejuvenation and repair .


A total of @ volunteers participated in this prospective , randomized , and controlled study .


Of these volunteers , @ subjects randomly assigned into four treatment groups were treated twice a week with either @-@ or @-@ nm polychromatic light ( normalized to @ J/cm ( @ ) in the range of @-@ nm ) and were compared with controls ( n = @ ) .


Irradiances and treatment durations varied in all treatment groups .


The data collected at baseline and after @ sessions included blinded evaluations of clinical photography , ultrasonographic collagen density measurements , computerized digital profilometry , and an assessment of patient satisfaction .


The treated subjects experienced significantly improved skin complexion and skin feeling , profilometrically assessed skin roughness , and ultrasonographically measured collagen density .


The blinded clinical evaluation of photographs confirmed significant improvement in the intervention groups compared with the control .


Broadband polychromatic PBM showed no advantage over the red-light-only spectrum .


However , both novel light sources that have not been previously used for PBM have demonstrated efficacy and safety for skin rejuvenation and intradermal collagen increase when compared with controls .


Colon cancers deficient in mismatch repair ( MMR ) may exhibit diminished expression of the DNA repair gene , MRE@ , as a consequence of contraction of a T@ mononucleotide tract .


This study investigated MRE@ status and its association with prognosis , survival and drug response in patients with stage III colon cancer .


Cancer and Leukemia Group B @ ( Alliance ) randomly assigned @,@ patients with stage III colon cancer to postoperative weekly adjuvant bolus @-fluorouracil/leucovorin ( FU/LV ) or irinotecan + FU/LV ( IFL ) , with @ year follow-up .


Tumors from these patients were analyzed to determine stability of a T@ tract in the MRE@ gene .


The primary endpoint was overall survival ( OS ) , and a secondary endpoint was disease-free survival ( DFS ) .


Non-proportional hazards were addressed using time-dependent covariates in Cox analyses .


Of @ tumor cases examined , @ ( @ % ) exhibited contraction at the T@ tract in one or both MRE@ alleles and were thus predicted to be deficient in MRE@ ( dMRE@ ) .


In pooled treatment analyses , dMRE@ patients showed initially reduced DFS and OS but improved long-term DFS and OS compared with patients with an intact MRE@ T@ tract .


In the subgroup of dMRE@ patients treated with IFL , an unexplained early increase in mortality but better long-term DFS than IFL-treated pMRE@ patients was observed .


Analysis of this relatively small number of patients and events showed that the dMRE@ marker predicts better prognosis independent of treatment in the long-term .


In subgroup analyses , dMRE@ patients treated with irinotecan exhibited unexplained short-term mortality .


MRE@ status is readily assayed and may therefore prove to be a useful prognostic marker , provided that the results reported here for a relatively small number of patients can be generalized in independent analyses of larger numbers of samples .


The purpose of this study was to investigate the survival effects of inferior vena cava filters in patients with venous thromboembolism ( VTE ) who had a significant bleeding risk .


The effectiveness of inferior vena cava filter use among patients with acute symptomatic VTE and known significant bleeding risk remains unclear .


In this prospective cohort study of patients with acute VTE identified from the RIETE ( Computerized Registry of Patients With Venous Thromboembolism ) , we assessed the association between inferior vena cava filter insertion for known significant bleeding risk and the outcomes of all-cause mortality , pulmonary embolism ( PE ) - related mortality , and VTE rates through @ days after the initiation of VTE treatment .


Propensity score matching was used to adjust for the likelihood of receiving a filter .


Of the @,@ eligible patients who had acute symptomatic VTE , @ underwent filter placement because of known significant bleeding risk .


A total of @ patients treated with a filter were matched with @ patients treated without a filter .


Propensity score-matched pairs showed a nonsignificant trend toward lower risk of all-cause death for filter insertion compared with no insertion ( @ % vs. @ % ; p = @ ) .


The risk-adjusted PE-related mortality rate was lower for filter insertion than no insertion ( @ % vs. @ % ; p = @ ) .


Risk-adjusted recurrent VTE rates were higher for filter insertion than for no insertion ( @ % vs. @ % ; p < @ ) .


In patients presenting with VTE and with a significant bleeding risk , inferior vena cava filter insertion compared with anticoagulant therapy was associated with a lower risk of PE-related death and a higher risk of recurrent VTE .


However , study design limitations do not imply a causal relationship between filter insertion and outcome .


A model for predicting cardiovascular disease in Asian populations is limited .


In total , @ @ consecutive asymptomatic Korean individuals aged @ to @ years without a prior history of cardiovascular disease who underwent a general health examination were enrolled .


Subjects were randomly classified into the train ( n = @ @ ) and validation ( n = @ @ ) cohorts .


Thirty-one possible risk factors were assessed .


The cardiovascular event was a composite of cardiovascular death , myocardial infarction , and stroke .


In the train cohort , the C-index ( @ % confidence interval ) and Akaike Information Criterion were used to develop the best-fitting prediction model .


In the validation cohort , the predicted versus the observed cardiovascular event rates were compared by the C-index and Nam and D'Agostino ( @ ) statistics .


During a median follow-up period of @ ( interquartile range , @-@ @ ) years , @ subjects had @ cardiovascular events .


In the train cohort , the best-fitting model consisted of age , diabetes mellitus , hypertension , current smoking , family history of coronary heart disease , white blood cell , creatinine , glycohemoglobin , atrial fibrillation , blood pressure , and cholesterol ( C-index = @ -LSB- @-@ @ -RSB- and Akaike Information Criterion = @ ) .


When this model was tested in the validation cohort , it performed well in terms of discrimination and calibration abilities ( C-index = @ -LSB- @-@ @ -RSB- and Nam and D'Agostino ( @ ) statistic = @ for @ years ; C-index = @ -LSB- @-@ @ -RSB- and Nam and D'Agostino ( @ ) statistic = @ for @ years ) .


A risk model based on traditional clinical and biomarkers has a feasible model performance in predicting cardiovascular events in an asymptomatic Korean population .


Non-invasive positive pressure ventilation has increasingly been chosen as the primary ventilation mode in respiratory distress syndrome ( RDS ) in preterm infants .


In order to further understand the application of various non-invasive positive pressure ventilation modes , we compared the advantages and disadvantages of three modes as a primary mode of ventilation in premature infants with RDS .


From December @ to March @ , @ preterm infants with RDS who received intubation-pulmonary surfactant ( PS ) - extubation in our NICU were randomly divided ( by means of random number table ) into three groups based on the primary mode of ventilation : nasal continuous positive airway pressure -LSB- NCPAP , n = @ , male/female ratio was @/@ , mean gestational age ( GA ) was ( @ @ ) weeks , mean birth weight ( BW ) was ( @ @ ) g -RSB- , bi-level positive airway pressure -LSB- BiPAP , n = @ , male/female ratio was @/@ , GA was ( @ @ ) weeks , BW was ( @ @ ) g -RSB- , and synchronized bi-level positive airway pressure -LSB- SBiPAP , n = @ , male/female rate was @/@ , GA was ( @ @ ) weeks , BW was ( @ @ ) g -RSB- .


Ventilation settings including FiO ( @ ) were adjusted according to transcutaneous SPO ( @ ) monitoring or blood gas analysis .


Various settings and adverse events were recorded as well .


The main parameter was the FiO ( @ ) at @ h post-positive-pressure ventilation .


Statistical analyses were performed using ( @ ) test , rank sum test , one-way analysis of variance for least-significant difference value , paired-sample t-test , two related sample Wilcoxon signed rank sum test and Logistic regression .


The PaCO ( @ ) ( mmHg , @ mmHg = @ kPa ) , oxygen index ( OI ) at @-@ h , and FiO ( @ ) at @ h post-ventilation in BiPAP and SBiPAP groups were lower than that in NCPAP groups with significant difference ( @ @ and @ @ vs. @ @ , @ @ and @ @ vs. @ @ , @ @ and @ @ vs. @ @ ; F = @ , @ and @ ; P = @ , @ and @ , respectively ) .


There was no significant difference between BiPAP and SBiPAP groups .


There was no significant difference among three groups ( all P > @ ) in the following events : respiratory index ( RI ) at @-@ h post-ventilation , abdominal distension , period of non-invasive ventilation , ratio of intubation for invasive ventilation if failed noninvasive ventilation , air-leak syndrome , neonatal necrotizing enterocolitis , periventricular-intraventricular haemorrhage , bronchopulmonary dysplasia , retinopathy of prematurity , mortality rate after @ h of age or rate of abandon for discharge .


The independent risk factors for failure of non-invasive positive pressure ventilation were gender , gestational age , antepartum steroid at @ h before birth to @ d , and birth weight , with the OR ( @ % confidence interval ) being @ ( @ , @ ) , @ ( @ , @ ) , @ ( @ , @ @ ) , and @ ( @ , @ ) , respectively .


As the primary mode of ventilation in premature infants with RDS , both BiPAP and SBiPAP are more beneficial than NCPAP in improving oxygenation and reducing CO ( @ ) retention without increasing the incidence of adverse events .


The purpose of this study was to reexamine the factor pattern of the @-item Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being Scale ( FACIT-Sp-@ ) using exploratory factor analysis in people newly diagnosed with advanced cancer .


Principal components analysis ( PCA ) and @ common factor analysis methods were used to explore the factor pattern of the FACIT-Sp-@ .


Factorial validity was assessed in association with quality of life ( QOL ) .


Principal factor analysis ( PFA ) , iterative PFA , and maximum likelihood suggested retrieving @ factors : Peace , Meaning , and Faith .


Both Peace and Meaning positively related to QOL , whereas only Peace uniquely contributed to QOL .


This study supported the @-factor model of the FACIT-Sp-@ .


Suggestions for revision of items and further validation of the identified factor pattern were provided .


We examined the impact of a prenatal exercise intervention on physical activity in @ women at risk for gestational diabetes mellitus .


We randomized participants in the Behaviors Affecting Baby and You ( BABY ) Study , which took place from @ to @ , to either a @-week individually tailored , motivationally matched exercise intervention ( n = @ ) or to a comparison health and wellness intervention ( n = @ ) .


We assessed physical activity with the Pregnancy Physical Activity Questionnaire .


We used linear mixed models to evaluate the impact of the interventions on change in physical activity according to intensity and type , total walking , and sedentary behavior .


Compared with the health and wellness arm , the exercise arm had significantly greater increases in sports or exercise activity ( @ vs @ metabolic equivalent of task -LSB- MET -RSB- hours/week ; P < @ ) , and smaller declines in total activity ( -@ vs -@ MET hours/week ; P = @ ) and activities of moderate to vigorous intensity ( -@ vs -@ MET hours/week ; P = @ ) , and was more likely to achieve recommended guidelines for physical activity ( odds ratio = @ ; @ % confidence interval = @ , @ ) .


These findings extend the previous literature by demonstrating the benefits of a clinically feasible exercise intervention in an ethnically and socio-economically diverse population .


Given the increased risk of adverse maternal health outcomes in ethnic minority groups , these findings may have important implications for reducing health disparities .


Selenium is present in the active site of proteins important for thyroid hormone synthesis and metabolism .


The objective of this study is to investigate the effect of selenium supplementation in different doses on thyroid function , under conditions of suboptimal dietary selenium intake .


The Danish PREvention of Cancer by Intervention with SElenium pilot study ( DK-PRECISE ) is a randomized , double-blinded , placebo-controlled trial .


A total of @ males and females aged @-@ years were randomized to @g ( n = @ ) , @g ( n = @ ) , or @g ( n = @ ) selenium-enriched yeast or matching yeast-based placebo tablets ( n = @ ) .


A total of @ participants , equally distributed across treatment groups , completed the @-year intervention period .


Plasma samples were analyzed for selenium and serum samples for TSH , free triiodothyronine ( FT@ ) , and free thyroxine ( FT@ ) at baseline , and after @ months , and @ years of supplementation .


Plasma selenium concentrations increased significantly and dose-dependently in treatment groups receiving selenium ( P < @ ) .


Serum TSH and FT@ concentrations decreased significantly and dose-dependently by @ mIU/l ( P = @ ) and @ pmol/l ( P = @ ) , respectively , per @g/day increase , with insignificant differences between @ months and @ years .


No significant effects were found for FT@ and FT@ : FT@ ratio .


In euthyroid subjects , selenium supplementation minutely and dose-dependently affects thyroid function , when compared with placebo , by decreasing serum TSH and FT@ concentrations .


Based on these findings , selenium supplementation is not warranted under conditions of marginal selenium deficiency .


However , a role for selenium supplementation in the treatment of autoimmune thyroid diseases is still unresolved .


We aimed to compare the effect of repaglinide and metformin monotherapy as an initial therapy in Chinese patients with newly diagnosed type @ diabetes mellitus ( T@DM ) .


In this @-week , open-labelled , parallel-controlled , randomised study , @ Chinese drug-naive patients with newly diagnosed T@DM were randomised ( @:@ ) to receive repaglinide or metformin monotherapy .


Primary endpoint was change in HbA@c from baseline to the end of the trial .


Secondary endpoints included changes in glycaemic variability , insulin sensitivity and - cell function .


Patients in both repaglinide and metformin groups achieved significant reductions in HbA@c ( -@ @ vs -@ @ % ) , FPG ( fasting blood glucose ) ( -@ @ vs -@ @ mmol/l ) and @-hPPG ( post-prandial glucose ) ( -@ @ vs -@ @ mmol/l ) , with no statistical differences between the groups .


Glycaemic variability , glucose infusion rate and - cell function were all significantly improved from baseline in the two groups ( all P < @ ) , without any statistical differences in the improvement between the groups .


Repaglinide and metformin achieved comparable efficacy in improving glycaemic control , reducing glycaemic variability , enhancing insulin sensitivity and ameliorating - cell function .


Therefore , repaglinide is an optional agent for initial therapy in Chinese patients with newly diagnosed T@DM .


Standard bowel cleansing for colon capsule endoscopy ( CCE ) requires a liquid diet and bowel laxatives for at least @ days , which is a major drawback of this procedure and affects tolerance and acceptability .


To compare the quality of colon cleanliness achieved with one-day versus two-day bowel preparation in outpatients undergoing CCE .


Patients were randomly assigned to one of two groups : group I ( one-day schedule , n = @ ) received a fiber-free diet and @ L of polyethylene glycol ( PEG ) on day @ ; group II ( two-day schedule , n = @ ) received a liquid diet and @ L of PEG in the evening of day -@ , and @L of PEG in the early morning of day @ .


In both groups , the patients received @ mg bisacodyl on day -@ and one or two additional sodium phosphate ( NaP ) boosters following capsule ingestion .


Each colon segment was assessed for cleanliness using a four-point grading scale ( excellent = @ , good = @ , fair = @ , and poor = @ ) .


For the final analysis , colon cleanliness was rated as adequate ( good or excellent ) or inadequate ( fair or poor ) .


Overall colon cleanliness was adequate in @ % ( CI @-@ ) of patients in group I versus @ % ( CI @-@ ) in group II ( P = @ ) .


No significant differences were observed in the per-segment quality of colon cleansing between the two groups .


CCE reached the rectum in @ % ( CI @-@ ) of patients in group I versus @ % ( CI @-@ ) in group II ( p = @ ) .


The quality of colon cleanliness achieved with one-day bowel preparation is equivalent to that of the standard two-day schedule in patients undergoing CCE .


To compare the efficacy difference in the treatment of chronic pelvic pain syndrome of Sev-damp-heat stagnation pattern between acupoint catgut embedding therapy and western medication .


enty cases were randomized into a catgut embedding group ( @ cases ) and a western medication group ( @ cases ) at the ratio of @ : @ .


In the catgut embedding group , the catgut embedding therapy was applied to Sanyinjiao ( SP @ ) , Quchi ( LI @ ) , Huiyin ( CV @ ) , Zusanli ( ST @ ) , Zhongji ( CV @ ) , Shenshu ( BL @ ) , etc. .


The treatment was given once every two weeks , the treatment for @ weeks was as one session and totally @ sessions were required .


In the western medication group , tamsulosin hydrochloride capsules @ mg , oral administration , once a day , and Indometacin sustained release tablets , @ mg , once a day , @ tablets each time were prescribed .


The symptom score of TCM , score of NIH Chronic Prostatitis Symptom Index ( NIH-CPSI ) , lecithin body number in prostatic fluid , ( SAS ) score of Self-Rating Anxiety Scale and score of Self-Rating Depression Scale ( SDS ) were compared before and after treatment in the patients of the two groups .


The efficacy was evaluated in the two groups .


( @ ) The total effective rate was @ % ( @/@ ) in the catgutembedding group and was @ % ( @/@ ) in the western medication group .


The efficacy in the catgutembedding group was better than that in the western medication group ( P < @ ) .


( @ ) The symptom score of TCM was all reduced significantly after treatment in the two groups ( both P < @ ) , and the result in the catgut embedding group was superior to the western medication group ( @ + / -@ vs @ + / -@ , P < @ ) .


( @ ) Lecithin body number was increased apparently in the two groups after treatment ( both P < @ ) , and the result in the catgut-embedding group was superior to the western medicine group ( @ + / -@ vs @ + / -@ , P < @ ) .


( @ ) Total score of NIH-CPSI , score of pain , score of SAS and score of SDS were all improved apparently after treatment in the two groups ( all P < @ ) , and the results in the catgut embedding group were superior to the western medication group ( P < @ , P < @ ) .


The acupoint catgut embedding therapy achieves the superior efficacy on chronic pelvic pain syndrome of damp-heat stagnation pattern as compared with conventional western medicine .


This therapy relieves clinical symptoms , improves the states of anxiety and depression and increases lecithin body number obviously .


A recent paper reported the outcomes of a study examining a new self-guided internet-delivered treatment , the Wellbeing Course , for symptoms of anxiety or depression .


This study found the intervention resulted in significant symptom reductions .


It also found that automated emails increased treatment completion and clinical improvements in a subsample with elevated anxiety and depression .


To examine the clinical outcomes and the effect of automated emails at @ months post-treatment .


Participants , who were randomly allocated to a Treatment Plus Automated Emails Group ( TEG ; n = @ ) , a standard Treatment Group ( TG ; n = @ ) or delayed-treatment Waitlist Control Group ( Control ; n = @ ) , were followed up at @ months post-treatment .


Eighty-one percent , @ % and @ % of participants in the TEG , TG and treated Waitlist Control Group provided symptom data at @-month follow-up , respectively .


The primary outcome measures were the Patient Health Questionnaire-@ Item Scale ( PHQ-@ ) and the Generalized Anxiety Disorder-@ Item Scale ( GAD-@ ) .


Significant improvements in symptoms of anxiety and depression were observed over time in both the TEG and TG ( Fs > @ , ps < @ ) these were sustained from post-treatment to @-month follow-up ( ps > @ ) , and were associated with large effect sizes .


No statistically significant differences in symptoms were found between the TEG and TG at post-treatment , @-month or @-month follow-up .


Previously reported symptom differences between TEG and TG participants with comorbid symptoms were no longer present at @-month follow-up ( ps > @ ) .


The overall benefits of the Wellbeing Course were sustained at @-month follow-up .


Although automated emails facilitated Course completion and reductions in symptoms for participants with comorbid anxiety and depression from pre-post treatment , these differences were no longer observed at @-month follow-up .


The results indicate that automated emails promote more rapid treatment response for people with elevated and comorbid symptoms , but may not improve longer term outcomes .


To explore the differential effect of a multifaceted intervention on hospital-based maternal mortality between patients with cesarean and vaginal delivery in low-resource settings .


We reanalyzed the data from a major cluster-randomized controlled trial , QUARITE ( Quality of care , Risk management and technology in obstetrics ) .


These subgroup analyses were not pre-specified and were treated as exploratory .


The intervention consisted of an initial interactive workshop and quarterly educational clinically oriented and evidence-based outreach visits focused on maternal death reviews ( MDR ) and best practices implementation .


The trial originally recruited @,@ patients who delivered in each of the @ participating hospitals in Mali and Senegal , between @ and @ .


The primary endpoint was hospital-based maternal mortality .


Subgroup-specific Odds Ratios ( ORs ) of maternal mortality were computed and tested for differential intervention effect using generalized linear mixed model between two subgroups ( cesarean : @,@ ; and vaginal delivery : @,@ ) .


The test for homogeneity of intervention effects on hospital-based maternal mortality among the two delivery mode subgroups was statistically significant ( p-value : @ ) .


Compared to the control , the adjusted OR of maternal mortality was @ ( @ % CI : @-@ @ , p = @ ) among women with cesarean delivery .


The intervention had no significant effect among women with vaginal delivery ( adjusted OR @ , @ % CI @-@ @ , p = @ ) .


This differential effect was particularly marked for district hospitals .


Maternal deaths reviews and on-site training on emergency obstetric care may be more effective in reducing maternal mortality among high-risk women who need a cesarean section than among low-risk women with vaginal delivery .


Tuberculosis is a public health problem in Cameroon , just like in many other countries in the world .


The National Tuberculosis Control Programme ( PNLT ) put in place by the state , aims to fight tuberculosis through the implementation of international directives ( Directly Observed Treatment Short , DOTS ) .


Despite the deployment of this strategy across the world , its implementation is difficult in the context of low-resource countries .


Some expected results are not achieved .


In Cameroon , the cure rate for patients with sputum positive pulmonary tuberculosis ( TPM + ) after @ months is only about @ % , @ % below the target .


This is mainly due to poor patient adherence to treatment .


By relying on the potential of mobile Health , the objective of this study is to evaluate the effect of SMS reminders on the cure rate of TPM + patients , measured using @-month bacilloscopy .


This is a blinded , randomised controlled multicentre study carried out in Cameroon .


The research hypothesis is that sending daily SMS messages to remind patients to take their prescribed tuberculosis medication , together with the standard DOTS strategy , will increase the cure rate from @ % ( control group : DOTS , no SMS intervention ) to @ % ( intervention group : DOTS , with SMS intervention ) in a group of new TPM + patients .


In accordance with each treatment centre , the participants will be randomly allocated into the two groups using a computer program : the intervention group and the control group .


A member of the research team will send daily SMS messages .


Study data will be collected by health professionals involved in the care of patients .


Data analysis will be done by the intention-to-treat method .


The achieving of expected outcomes by the PNLT through implementation of DOTS requires several challenges .


Although it has been demonstrated that the DOTS strategy is effective in the fight against tuberculosis , its application remains difficult in developing countries .


This study explores the potential of mHealth to support DOTS strategy .


It will gather new evidence on the effectiveness of mHealth-based interventions and SMS reminders in the improvement of treatment adherence and the cure rate of tuberculosis patients , especially in a low-resource country such as Cameroon .


Depression is common in nursing home ( NH ) patients with dementia , and often clustered with anxiety and other mood symptoms .


An association between pain and depressive symptoms has been reported , but the impact of pain management on depression and other mood symptoms has not been investigated .


Secondary analyses of a cluster randomized clinical trial examine the response of dementia-related mood symptoms to a Stepwise Protocol of Treating Pain .


Three-hundred fifty-two patients with moderate and severe dementia and significant behavioural disturbances , related to @ clusters ( i.e. clusters defined as single independent NH units ) in @ NHs of Western Norway , were included .


All patients in the intervention group received individual daily pain treatment with paracetamol , extended release morphine , buprenorphine transdermal patch or pregabaline for @weeks , with additional follow-up assessment @weeks after completion of the intervention .


Clusters randomized to control received usual treatment .


A mood cluster consisting of depression , anxiety , sleep disorders , apathy and appetite items from the Neuropsychiatric Inventory-Nursing Home ( NPI-NH ) was the primary outcome .


Analysed by Mann-Whitney U-tests , Stepwise Protocol of Treating Pain conferred significant benefit in treatment of the NPI-NH mood cluster ( F = @ , df = @ ; @ , p < @ ) and depression ( F = @ , df = @ ; @ , p = @ ) .


Further analyses highlighted improvements in apathy ( F = @ , df = @ ; @ , p = @ ) , night-time behaviours ( F = @ , df = @ ; @ , p = @ ) , and appetite items ( F = @ , df = @ ; @ , p = @ ) , but not irritability ( p = @ ) and anxiety ( p = @ ) .


Mood symptoms including depression significantly improved with pain treatment , emphasizing the importance of more rigorous treatment of pain in agitated people with dementia .


Findings have potentially immediate clinical relevance .


Specific computer-based auditory training may be a useful completion in the rehabilitation process for cochlear implant ( CI ) listeners to achieve sufficient speech intelligibility .


This study evaluated the effectiveness of a computerized , phoneme-discrimination training programme .


The study employed a pretest-post-test design ; participants were randomly assigned to the training or control group .


Over a period of three weeks , the training group was instructed to train in phoneme discrimination via computer , twice a week .


Sentence recognition in different noise conditions ( moderate to difficult ) was tested pre - and post-training , and six months after the training was completed .


The control group was tested and retested within one month .


Twenty-seven adult CI listeners who had been using cochlear implants for more than two years participated in the programme ; @ adults in the training group , @ adults in the control group .


Besides significant improvements for the trained phoneme-identification task , a generalized training effect was noted via significantly improved sentence recognition in moderate noise .


No significant changes were noted in the difficult noise conditions .


Improved performance was maintained over an extended period .


Phoneme-discrimination training improves experienced CI listeners ' speech perception in noise .


Additional research is needed to optimize auditory training for individual benefit .


In clinical trials where participants are likely to be able to distinguish between true and sham interventions , informing participants that they may receive a sham intervention increases the likelihood of participants ` breaking the blind ' and invalidating trial findings .


The present study explored participants ' perceptions of the consent process in a sham controlled acupressure trial which did not explicitly indicate participants may receive a sham intervention .


Nested qualitative study within a randomised sham controlled trial of acupressure wristbands for chemotherapy-related nausea .


Convenience sample of @ patients participated in semi-structured interviews .


Interviews were audio-recorded and transcribed verbatim .


Transcripts analysed thematically using framework analysis .


Study conducted within three geographical sites in the UK : Manchester , Liverpool , and Plymouth .


All participants indicated that they believed they were fully informed when providing written consent to participate in the trial .


Participants ' perceived it was acceptable to employ a sham intervention within the trial of acupressure wristbands without informing potential participants that they may receive a sham treatment .


Despite the fact that participants were not informed that one of the treatment arms was a sham intervention the majority indicated they assumed one of the treatment arms would be placebo .


Many trials of acupuncture and acupressure do not inform participants they may receive a sham intervention .


The current study indicates patients ' perceive this approach to the consent process as acceptable .


However , the fact participants assume one treatment may be placebo threatens the methodological basis for utilising this approach to the consent process .


Bipolar disorder ( BD ) and borderline personality disorder ( BPD ) both are severe and chronic psychiatric disorders .


Both disorders have overlapping symptoms , and current research shows that the presence of a BPD has an adverse effect on the course of BD .


The limited research available shows an unfavorable illness course , a worse prognosis and response to medication , longer treatment duration , more frequent psychiatric admissions , higher drop-out , increased risk of substance abuse , increased risk of suicide , and more impairment of social and occupational functioning .


However , there is no research available on the effect of specific psychotherapeutic treatment for this patients .


This paper presents the protocol of a RCT to investigate the presence of borderline personality features in patients treated for BD ( study part @ ) and the effectiveness of STEPPS ( Systems Training for Emotional Predictability and Problem Solving ) added to treatment as usual ( TAU ) for BD compared to TAU in patients with BD and comorbid borderline personality features ( study part @ ) .


STEPPS is a validated and effective intervention for BPD .


The study population consists of patients treated for BD at specialized outpatient clinics for BD in the Netherlands .


At first the prevalence of comorbid borderline personality features in outpatients with BD is investigated .


Inclusion criteria for study part @ is defined as having three or more of the DSM-IV-TR diagnostic criteria of BPD , including impulsivity and anger bursts .


Primary outcomes will be the frequency and severity of manic and depressive recurrences as well as severity , course and burden of borderline personality features .


Secondary outcomes will be quality of life , utilizing mental healthcare and psychopathologic symptoms not primarily related to BD or BPD .


Assessment will be at baseline , at the end of the intervention , and at @ and @ months follow-up .


This will be the first randomized controlled trial of a specific intervention in patients with BD and comorbid BPD or borderline personality features .


There are no recommendations in the guideline of treatment of bipolar disorders for patients with this complex comorbidity .


We expect that a combined treatment aimed at mood disorder and emotion regulation will improve treatment outcomes for these patients .


Although serum under-O-glycosylated IgA@ in IgA nephropathy ( IgAN ) patients may deposit more preferentially in glomeruli than heavily-O-glycosylated IgA@ , the relationship between the glomerular IgA deposition level and the O-glycan profiles of serum IgA@ remains obscure .


Serum total under-O-glycosylated IgA@ levels were quantified in @ IgAN patients by an enzyme-linked immunosorbent assay ( ELISA ) with Helix aspersa ( HAA ) lectin .


Serum under-O-glycosylated polymeric IgA@ ( pIgA@ ) was selectively measured by an original method using mouse Fc / receptor ( mFc/R ) transfectant and flow cytometry ( pIgA@ trap ) .


The percentage area of IgA deposition in the whole glomeruli ( Area-IgA ) was quantified by image analysis on the immunofluorescence of biopsy specimens .


Correlations were assessed between the Area-IgA and data from HAA-ELISA or pIgA@ trap .


The relationships between clinical parameters and data from HAA-ELISA or pIgA@ trap were analyzed by data mining approach .


While the under-O-glycosylated IgA@ levels in IgAN patients were significantly higher than those in healthy controls when measured ( p < @ ) , there was no significant difference in under-O-glycosylated pIgA@ .


There was neither a correlation observed between the data from HAA-ELISA and pIgA@ trap ( r@ = @ ) in the IgAN patients ( r@ = @ ) nor was there a linear correlation between Area-IgA and data from HAA-ELISA or the pIgA@ trap ( r@ = @ , @ , respectively ) .


Contour plots of clinical parameters versus data from HAA-ELISA and the pIgA@ trap revealed that patients with a high score in each clinical parameter concentrated in specific areas , showing that patients with specific O-glycan profiles of IgA@ have similar clinical parameters .


A decision tree analysis suggested that dominant immune complexes in glomeruli were consisted of : @ ) IgA@-IgG and complements , @ ) pIgA@ and complements , and @ ) monomeric IgA@-IgA or aggregated monomeric IgA@ .


Serum under-O-glycosylated IgA@ levels are not correlated with glomerular IgA deposition based upon heterogeneity in the composition of glomerular immune complexes in IgAN patients .


Proton-pump inhibitors are known to be effective in the treatment and prevention of ulcers related to low-dose aspirin ( LDA ) , but few reports address H@ - receptor antagonists ( H@RAs ) and gastroprotective agents ( GPs ) .


This study was intended to compare the therapeutic effects of an H@RA and a GP against gastroduodenal mucosal injuries in patients taking LDA .


The subjects consisted of patients requiring continuous LDA treatment , in whom no peptic ulcer was found on endoscopy at enrollment .


The patients were randomized to either famotidine @mg/day ( group F ) or teprenone @mg/day ( group T ) .


The study medication was administered for @ weeks .


The patients underwent endoscopy after administration of the study medication in order to obtain a Lanza score .


A total of @ patients ( @ in group F , @ in group T ) were included in the efficacy analysis population .


The Lanza score changed as follows : in group F , it improved significantly , from @ ( meanstandard deviation ) before medication to @ after medication ( P = @ ) ; in group T , no significant difference was observed : @ before medication and @ after medication .


Famotidine is better than teprenone in terms of reducing the number of the erosions under use of LDA .


To evaluate the effect of exogenous creatine phosphate ( CP ) on myocardial injury after percutaneous coronary intervention ( PCI ) .


Four hundred patients were divided to receive conventional therapy ( control group ) or @-day intravenous infusion of CP after PCI ( CP group ) .


Levels of creatine kinase MB ( CK-MB ) and troponin I ( TnI ) were measured before and on postprocedural day @ .


Postprocedural CK-MB and TnI in the CP group were significantly increased compared to the control group .


In the CP group , @ % and @ % of patients had an increase in CK-MB @ to @ times and > @ times , respectively , which were significantly lower than that of the control group ( @ % and @ % , respectively ) ; @ % and @ % of patients had an increase in TnI @ to @ times and > @ times , respectively , which were significantly lower than that of the control group ( @ % and @ % , respectively ) .


Exogenous CP was helpful to reduce myocardial injury after PCI .


A relationship between echolucency of carotid plaques and the consequent risk of ipsilateral ischemic stroke has been observed .


An aggressive lipid-lowering therapy may increase the echogenicity of carotid plaque in patients with elevated low-density lipoprotein cholesterol levels .


The aim of this study is to prospectively evaluate the long-term effect of high-dose atorvastatin on carotid plaque morphology in patients with first-ever transient ischemic attack or stroke .


All patients with symptomatic first ischemic atherosclerotic cerebrovascular event occurred within the previous @ days were enrolled .


Carotid Doppler ultrasound of the neck vessels with @-@ MHz probe for the definition of the atherosclerotic carotid framework was performed .


The analysis of the gray-scale median ( GSM ) of each plate was carried out with image processing software .


A total of @ symptomatic plaques were included and divided into @ groups : @ in group A ( atorvastatin @ mg ) , @ in group B ( atorvastatin @ mg ) , and @ to group C ( no atorvastatin ) .


GSM score increases significantly more extensive in group A than in group B ( +@ vs. +@ , P < @ ) and group C ( +@ vs. @ , P = @ ) .


An inverse association between reduction of low-density lipoprotein and the increase in the GSM score ( r = -@ , P = @ ) has been observed .


Moreover , the reduction of high-sensitive C-reactive protein correlates inversely with the increase of the GSM ( r = -@ , P = @ ) .


Dose-dependent effect of atorvastatin on symptomatic carotid plaque morphology may suggest a specific role of this drug in the atherosclerotic stroke prevention .


Although social support is an integral element in smoking cessation , the literature presents mixed findings regarding the type ( s ) of social support that are most helpful .


The Partner Interaction Questionnaire ( PIQ ) is commonly used to measure social support in this context .


We explored the possibility that more nuanced distinctions between items on the PIQ than what is customarily used could improve the prediction of cessation .


Baseline PIQ responses of smokers enrolled in a cessation program was submitted to an exploratory factor analysis .


Emergent factors were used to predict cessation at several time points .


Four factors emerged , which differed from the two subscales that are typically used .


The four-factor version predicted cessation ; the two-factor version did not .


Identifying the types of social support that predict smoking cessation depend on our ability to measure social support .


More nuanced measures will likely clarify the role of social support in cessation .


The present intervention study investigated the efficacy of the ACT & Check Strategy intervention to improve inference generation when reading , metacognitive ability , general reading comprehension , and social inference ability in adults with high-functioning autism spectrum disorder ( HF-ASD ) .


Twenty-five adults with HF-ASD were randomly assigned to either a treatment or a control group .


Treatment sessions were conducted in @-hr sessions , twice a week , for a total of @ weeks .


Treatment focused on explicit instruction of components of inference generation , categories of inferences , and increasingly independent strategy use .


The treatment group demonstrated significantly superior performance on @ of @ measures of inference generation in reading and @ measure of metacognitive ability compared with the control group .


Significant differences between groups were not found on measures of reading comprehension or social inference ability .


These findings suggest that the ACT & Check Strategy was effective in improving participants ' ability to generate inferences in reading and certain metacognitive abilities , but the skills do not appear to generalize to other social communication contexts , such as social inference generation .


This research provides a measure of support for explicitly teaching inference generation to address a reading inference deficit in adults with HF-ASD .


Previous studies have revealed lower prostate specific antigen concentrations in men with type @ diabetes , paralleling the reported lower prevalence of prostate cancer in diabetic men .


Data are lacking on prostate specific antigen in men with type @ diabetes whose insulin and obesity profiles differ from those with type @ diabetes mellitus .


In this study we examined the relationship between long-term glycemic control and prostate specific antigen in men with type @ diabetes mellitus .


Total prostate specific antigen was measured at one time in @ men in the EDIC , the observational followup of participants in the DCCT .


The relationship between DCCT/EDIC weighted mean hemoglobin A@c and log prostate specific antigen was assessed using linear regression modeling after adjusting for age , body mass index , total testosterone , statin and thiazide medication use , diabetes duration , and DCCT randomization arm and cohort .


Median subject age was @ years , body mass index was @ kg/m ( @ ) and DCCT/EDIC time-weighted hemoglobin A@c was @ % .


Median prostate specific antigen was @ ng/ml ( IQR @ , @ ) .


Prostate specific antigen increased significantly with age ( p < @ ) and with lower time-weighted hemoglobin A@c ( p < @ ) .


Each @ % increase in hemoglobin A@c was accompanied by an @ % reduction in prostate specific antigen ( p = @ ) .


Prostate specific antigen decreases as hemoglobin A@c increases in men with type @ diabetes mellitus .


This relationship is independent of age , body mass index , androgen levels , medication use and measures of diabetes severity , which suggests that factors related to glycemia may directly affect prostate specific antigen levels .


To validate the association between accommodation and visual asthenopia by measuring objective accommodative amplitude with the Optical Quality Analysis System ( OQAS , Visiometrics , Terrassa , Spain ) , and to investigate associations among accommodation , ocular surface instability , and visual asthenopia while viewing @D displays .


Fifteen normal adults without any ocular disease or surgical history watched the same @D and @D displays for @ minutes .


Accommodative ability , ocular protection index ( OPI ) , and total ocular symptom scores were evaluated before and after viewing the @D and @D displays .


Accommodative ability was evaluated by the near point of accommodation ( NPA ) and OQAS to ensure reliability .


The OPI was calculated by dividing the tear breakup time ( TBUT ) by the interblink interval ( IBI ) .


The changes in accommodative ability , OPI , and total ocular symptom scores after viewing @D and @D displays were evaluated .


Accommodative ability evaluated by NPA and OQAS , OPI , and total ocular symptom scores changed significantly after @D viewing ( p = @ , @ , @ , and @ , respectively ) , but yielded no difference after @D viewing .


The objective measurement by OQAS verified the decrease of accommodative ability while viewing @D displays .


The change of NPA , OPI , and total ocular symptom scores after @D viewing had a significant correlation ( p < @ ) , implying direct associations among these factors .


The decrease of accommodative ability after @D viewing was validated by both subjective and objective methods in our study .


Further , the deterioration of accommodative ability and ocular surface stability may be causative factors of visual asthenopia in individuals viewing @D displays .


Vitamin D insufficiency is common in subjects with type @ diabetes .


Observational studies suggest that vitamin D plays a role in the pathogenesis of type @ diabetes .


However , results of intervention studies have been inconsistent .


We investigated the effects of improving vitamin D status on insulin sensitivity , insulin secretion , and inflammatory markers in patients with type @ diabetes .


A double blind , randomized , placebo controlled trial was conducted .


Sixteen patients with type @ diabetes and hypovitaminosis D were recruited .


Eight patients received colecalciferol and ( @ g daily for @ weeks , @ g daily for @ weeks ) and @ patients received identical placebo tablets for @ weeks .


Before and after intervention , patients underwent IVGTT , hyperinsulinemic euglycemic clamp , assessment of baseline high-frequency insulin pulsatility , glucose-entrained insulin pulsatility , DXA scans , @-hour-ambulatory blood pressure monitorings , and fasting blood samples .


Serum-@ ( OH ) vitamin D and serum-@ ,@ ( OH ) vitamin D increased significantly after @ weeks in the intervention group ( p = @ , p = @ ) .


Serum-@ ( OH ) vitamin D was also significantly higher in the vitamin D group compared to the placebo group ( p = @ ) after intervention .


Although no significant changes in insulin sensitivity , inflammation , blood pressure , lipid profile , or HbA@c were found , we observed borderline ( p between @ and @ ) improvements of insulin secretion , in terms of c-peptide levels , first phase incremental AUC insulin and insulin secretory burst mass .


Improvement in vitamin D status does not improve insulin resistance , blood pressure , inflammation or HbA@c , but might increase insulin secretion in patients with established type @ diabetes .


We investigated acute bone turnover marker ( BTM ) responses to high-intensity resistance exercise with and without whole-body vibration ( WBV ) in young men ( n = @ ) .


In this randomized crossover study , subjects performed @ protocols separated by @-week wash out periods : @ ) resistance exercise only ( RE ) ( @ sets @ repetitions @ % @RM for @ exercises ) ; and @ ) WBV + RE ( side-alternating vibration platform @ intermittent , @-minute bouts @ Hz , @ mm peak-to-peak displacement followed by RE ) .


Fasting morning blood draws were taken before RE or WBV ( PRE ) , immediately post RE ( IP ) , and @ minutes post RE ( @P ) .


WBV + RE also had a blood draw after the WBV exposure ( POST WBV ) .


Blood samples were analyzed for lactate , hematocrit , bone-specific alkaline phosphatase ( Bone ALP , U/L ) , C-terminal telopeptide of type I collagen ( CTX-I , ng/mL ) and tartrate-resistant acid phosphatase @b ( TRAP@b , U/L ) .


Lactate , hematocrit , and Bone ALP significantly increased ( p < @ ) IP for both protocols .


Bone resorption markers did not change during RE only .


CTX-I significantly decreased POST WBV .


TRAP@b increased POST WBV , then significantly decreased at @P .


Generally , BTM changes to RE only were not significant when adjusted for hemoconcentration .


The WBV stimulus altered bone resorption marker but not bone formation marker responses .


Cervical radiculopathy caused by spondylotic foraminal stenosis may require surgical treatment .


Surgical options include anterior cervical foraminotomy and fusion or posterior cervical foraminotomy .


Controversy remains regarding the preferable surgical approach .


Pertinent clinical evidence is limited to low-quality observational reports .


Therefore , treatment decisions are predominantly based on the individual surgeon 's preference and skill .


The study objective is to evaluate the efficacy and safety of posterior foraminotomy in comparison to anterior foraminotomy with fusion for the treatment of spondylotic foraminal stenosis .


This is a multicenter randomized , controlled , parallel group superiority trial .


A total of @ adult patients are allocated in a ratio of @:@ .


Sample size and power calculations were performed to detect the minimal clinically important difference of @ points , with an expected standard deviation of @ in the primary outcome parameter , Neck Disability Index , with a power of @ % , based on an assumed maximal dropout rate of @ % .


Secondary outcome parameters include the Core Outcome Measures Index , which investigates pain , back-specific function , work disability , social disability and patient satisfaction .


Changes in physical and mental health are evaluated using the Short Form-@ ( SF-@ ) questionnaire .


Moreover , radiological and health economic outcomes are evaluated .


Follow-up is performed @ , @ , @ , @ , @ , @ and @ months after surgery .


Major inclusion criteria are cervical spondylotic foraminal stenosis causing radiculopathy of C@ , C@ or C@ and requiring decompression of one or two neuroforaminae .


Study data generation ( study sites ) and data storage , processing and statistical analysis ( Department of Medical Statistics , Informatics and Health Economics ) are clearly separated .


Data will be analyzed according to the intention-to-treat principle .


The results of the ForaC study will provide surgical treatment recommendations for spondylotic foraminal stenosis and will contribute to the understanding of its short - and long-term clinical and radiological postoperative course .


This will hopefully translate into improvements in surgical treatment and thus , clinical practice for spondylotic foraminal stenosis .


To explore the effects of five-element music therapy on elderly patients with seasonal affective disorder in a Chinese nursing home .


The patients ( n = @ ) were recruited from a Shijingshan district nursing home in Beijing , China .


They were randomly assigned to two groups , a treatment group and a control group , with @ participants in each group .


The patients received music therapy for @-@ h each week over an @-week period .


The music therapy involved four phases : introduction , activities , listening to the Chinese five-element music , and a concluding phase .


The participants in the control group did not listen to the five-element music .


This study consisted of two parts : ( a ) a qualitative study that used focus groups to understand the feelings of the patients with seasonal affective disorder ; ( b ) a quantitative study that involved administration of the self-rating depression scale ( SDS ) and Hamilton depression scale ( HAMD ) before and after treatment .


( a ) Qualitative analysis results : strength derived from the five-element group music therapy and emotional adjustment .


The five-element group music therapy can reduce patients ' psychological distress and let them feel inner peace and enhance their life satisfaction .


( b ) No significant difference in SDS and HAMD scores was found between the two groups ( P > @ ) prior to treatment .


After treatment , the mean SDS score of the control group was @ + / - @ , while the treatment group 's score was @ + / - @ .


The HAMD score of the control group was @ + / -@ , and the treatment group 's score was @ + / - @ .


Following @ weeks of music therapy , the SDS and HAMD scores of the treatment group were significantly lower than those for the control group ( P < @ ) .


Five-element music therapy alleviated the symptoms of seasonal affective disorder in the elderly patients .


Intubation in patients with suspected cervical spine injury must be cautiously performed to avoid any further neurologic trauma .


Several intubation techniques have been introduced to minimize cervical spine motion such as the use of the videolaryngoscope .


The present study aims to compare the movement of the cervical spine during intubation by using McGrath series @ videolaryngoscope ( MGL ) and that of the conventional Macintosh laryngoscope from cinefluoroscopic imaging .


Twenty-two patients undergoing elective orthopedic surgery that did not involve cervical spine procedure and required general anesthesia were recruited into the study .


All patients were randomized either to have intubation with MGL ( n = @ ) or Macintosh laryngoscope ( n = @ ) in a neutral position with manual in-line stabilization ( MILS ) .


The primary outcome was the cervical vertebral angle changes pre - and post-intubation , measured by cinefluoroscopy .


The number of intubation attempts , the laryngoscopic view , the time to intubation , and the incidence ofany complications were recorded as well .


Eleven patients were included in each group without any exclusion from the study .


The cervical vertebral angle changes pre - and post-intubation with the MGL was less than with the Macintosh laryngoscope at C@/@ ( @ vs. @ degrees , respectively ; p-value = @ ) and the cumulative changes of all cervical spine levels ( @ vs. @ degrees , respectively ; p-value = @ ) .


However , the time to intubation with the MGL was longer ( @ vs. @ seconds , p-value = @ ) , the laryngoscope view was better .


There were no statistically significant differences in the intubation success rate , the number of attempts , and the incidence of complications .


Orotracheal intubation with MGL provided less cervical spine motion and improved visualization of the vocal cords , without causing adverse consequences as compared with Macintosh laryngoscope and MILS .


Protease inhibitor monotherapy is associated with more frequent episodes of viral rebounds above @ copies/mL than triple therapy .


To evaluate if , compared to triple-drug therapy , protease inhibitor monotherapy is associated with increased levels of inflammatory/procoagulant markers and more frequent plasma residual viremia detection .


In this cross-sectional study , we included patients treated for @ year with darunavir/ritonavir or lopinavir/ritonavir as monotherapy ( n = @ ) or with two nucleos ( t ) ides ( n = @ ) .


All samples were tested for CRP , IL-@ , fibrinogen and D-dimer .


Residual viremia was determined using an ultrasensitive qualitative nested-PCR of the HIV pol gene with a limit of detection of @ copy of HIV-RNA .


We found no differences in levels of inflammatory/procoagulant markers or in the proportion of patients with plasma residual viremia detection by treatment group .


The long-term treatment with protease inhibitor monotherapy in the setting of routine clinical practice is not associated with a higher prevalence of plasma residual viremia or more elevated inflammatory/procoagulant markers levels than triple drug therapy .


There is limited evidence with regard to the effect of different sources of protein on appetite during weight loss .


Vegetarian and meat-based high-protein diets may have contrasting effects on appetite and biomarkers of protein-induced satiety .


The aim was to assess appetite response to meat or vegetarian high-protein weight-loss ( HPWL ) diets in obese men to monitor plasma amino acid profile and gut peptide response as potential satiety biomarkers .


Twenty obese -LSB- body mass index ( in kg/m ) : @ -RSB- men participated in a dietary intervention study .


After @ d of a maintenance diet , they were provided in a crossover design with either a vegetarian HPWL ( Soy-HPWL ) or a meat-based HPWL ( Meat-HPWL ) diet for @ wk .


Both diets comprised @ % protein , @ % fat , and @ % carbohydrate , provided to measured resting metabolic rate .


Body weight and the motivation to eat were measured daily .


Plasma satiety biomarkers were collected during a test-meal challenge ( @ h ) at the end of each diet period .


Over the @ wk , subjects lost , on average , @ and @ kg with consumption of the Soy - and Meat-HPWL diets , respectively -LSB- P = @ ; SE of the difference ( SED ) : @ -RSB- .


ANOVA confirmed that subjectively rated hunger ( P = @ ; SED : @ ) , fullness ( P = @ ; SED : @ ) , desire to eat ( P = @ ; SED : @ ) , preservation of lean body mass ( P = @ ; SED : @ ) , and loss of percentage fat mass ( P = @ ; SED : @ ) did not differ between the @ HPWL diets .


There were differences in absolute concentrations of ghrelin and peptide YY between the @ HPWL diets , although the response as net area under the curve was not different .


Appetite control and weight loss were similar for both HPWL diets .


Gut hormone profile was similar between the diets , which suggests that vegetarian diets can be as effective as meat-based diets for appetite control during weight loss .


Alveolar osteitis ( AO ) is a commonly seen post-operative complication during the wound-healing period after permanent tooth extraction or surgical removal of impacted third molar teeth .


The aim of this clinical study was to evaluate the effects of administration of the topical hemostatic agent Ankaferd Blood Stopper ( ABS ) into the socket on AO formation after impacted mandibular third molar extraction .


Bilaterally , @ half-impacted mandibular third molars were extracted in @ patients .


Then , @ mL ABS was administered to achieve hemostasis in one half of the sockets and as a control , the other half was irrigated with @ mL physiological serum after surgery .


There was no statistically significant difference in terms of AO formation ( P > @ ) between the extraction sites .


However , the postoperative pain in ABS administration sites was higher than in the other sites for the first @ days after surgery ( P < @ ) .


The results showed that ABS administration did not increase the incidence of AO formation .


Thus , ABS can be used safely for hemostasis after impacted mandibular third molar surgery .


To determine the effects of co-ingesting caffeine ( CAF ) and carbohydrate ( CHO ) on high-intensity intermittent sprints ( HIS ) performance and physiological responses .


Twelve active males underwent @ interventions at least @days apart in a randomized , double-blind , placebo-controlled , balanced trial .


A meal contained @ % CHO was provided @h before the HIS test .


Participants ingested the placebo ( PLA ) or CAF ( @mgkg ( -@ ) BW ) @h before taking an HIS test , and ingested a PLA or CHO solution ( @ gkg ( -@ ) BW ) before undergoing the testing protocol .


The HIS protocol comprised ten sets of @-s sprints on a cycle ergometer with a @-min recovery between each set .


There was no significant difference between peak power output and mean power output between trials ( p > @ ) .


Compared with PLA , CAF+CHO resulted in a @ % reduction in total work , corresponding to a @-@ @ % increase in fatigue at the end stage of the HIS .


The administration of CAF+CHO supplementation also resulted in an @ % increase in blood lactate , and elevated blood glucose concentrations throughout HIS testing compared with PLA ( p < @ ) .


Cortisol concentrations also increased with CAF+CHO intake compared with PLA ; however , there was no significant effect of CAF+CHO supplementation on testosterone concentrations .


Co-ingestion of CAF and CHO did not improve high-intensity sprint cycling performance or reduce fatigue in active males .


Moreover , combined CAF and CHO supplementation might facilitate catabolism during prolonged high-intensity intermittent exercise .


Transversus abdominis plane block ( TAPB ) has emerged as a safe and effective regional anesthesia technique for providing postoperative lower abdominal analgesia .


Complications associated with TAPB are rare and pose a lower overall risk to the patient receiving a TAPB versus a caudal block , which is considered the gold standard for pediatric lower abdominal regional anesthesia .


Our study hypothesis was that TAPB would initially be equivalent to caudal block in providing postoperative pain control but would also show improved pain relief beyond the anticipated caudal duration .


This study was a double-blinded randomized controlled trial .


Forty-five children between the ages of @ and @ undergoing bilateral ureteral reimplantation surgery through a low transverse incision were enrolled .


Narcotic requirement , pain scores ( FLACC/Wong-Baker FACES ) , episodes of emesis , and antispasmodic requirement were recorded in the postanesthesia care unit ( PACU ) and at @-hour intervals for @ hours from the time of block placement .


Our protocol used a multimodal approach toward pain management in all children , including randomized regional technique , scheduled ketorolac , morphine as needed , and the antispasmodic , oxybutynin , as needed .


Morphine requirement showed no statistical difference during the initial @ hours ( all P @ at PACU , @ and @ hours ) .


However , at @ hours those patients randomized to receive the TAPB required less cumulative morphine than the caudal group ( @ mg/kg @ vs @ mg/kg @ , P = @ ) .


There was a trend toward fewer episodes of emesis in the TAPB group which reached statistical significance at @ and @ hours ( @ vs @ episodes , P = @ ; and @ vs @ episodes , P = @ ) .


Pain scores ( @-@ ) were higher in the TAPB group in the PACU ( @ @ vs @ @ , P = @ ) , but there were no significant differences at all subsequent time points ( all P @ ) .


The TAPB group also had a higher requirement for the bladder antispasmodic oxybutynin at @ hours ( @ @ vs @ @ , P = @ ) .


TAPB provided superior analgesia compared with the caudal block at @ to @ hours after block placement , as demonstrated by a statistically significant decrease in cumulative opioid requirement , which was the primary end point .


The lower incidence of emesis in the TAPB group likely reflected the decreased opioid consumption .


Although TAPB appears to be less effective than the caudal block in preventing viscerally mediated bladder spasms , as evidenced by the higher PACU pain scores and increased oxybutynin requirement at @ hours , this effect may be counteracted in future clinical practice by scheduled administration of the antispasmodic medications .


Considering the overall safety advantages of the TAPB over the caudal block , this should be considered a preferred regional technique for lower abdominal surgeries .


We investigated the effects of anakinra , an interleukin-@ receptor antagonist , on coronary and left ventricular function in coronary artery disease ( CAD ) patients with rheumatoid arthritis .


In a double-blind crossover trial , @ patients with rheumatoid arthritis ( @ with CAD and @ without ) were randomized to a single injection of anakinra or placebo and after @ hours to the alternative treatment .