No-treatment Group Research Articles

No evidence that attentional bias towards pain-related words is associated with verbally induced nocebo hyperalgesia: a dot-probe study.

Placebo and nocebo effects in pain are well documented. One leading explanation is that instructions indicating that pain will either increase or decrease after receipt of a treatment give rise to expectations for increased or decreased pain. However, the psychological mechanisms through which expectations affect pain perception are not well understood. One possibility is that the expectation of increased pain leads to anticipatory anxiety, which in turn increases attention towards painful sensations. The aim of this study was to test the hypothesis that attention mediates nocebo hyperalgesia. This was done by measuring attentional bias towards pain using a dot-probe task both before and after a nocebo manipulation. Ninety-six healthy volunteers were randomized to receive one of the following: (1) an inert nasal spray with placebo instructions, (2) an inert nasal spray with nocebo instructions, or (3) no treatment. Participants completed measures of expectations, anxiety, and attention bias (dot-probe paradigm) both before and after randomization. Results showed that the nocebo instructions induced expectations for increased pain and resulted in nocebo hyperalgesia. Conversely, the placebo instruction failed to induce expectations for decreases in pain and did not demonstrate any placebo analgesia. Furthermore, despite the significant expectancies for pain and subsequent nocebo hyperalgesia, there were no differences between the nocebo group and either the placebo or no-treatment group for anxiety or attentional bias. The results are consistent with the expectancy model of placebo and nocebo effects. That is, changes in expectations seemed to be necessary to induce a placebo or nocebo effect. However, there was no evidence that anxiety or attention bias towards pain-related stimuli was necessary to achieve nocebo hyperalgesia.

Effects of a probiotic containing Bacillus subtilis on the gut microflora, yolk quality and blood lipid concentrations of laying Pharaon quails

The current literature is not comprehensive concerning the influence of Bacillus subtilis on lipid metabolism, egg chemical characteristics, and intestinal microbiota of Japanese quail. The aim of this study was to evaluate the effects of a Bacillus subtilis strain on yolk quality, gut bacterial populations, and total cholesterol and triglyceride concentrations in the plasma of organically farmed Pharaon quail layers. Forty-five-day-old female quails were randomly distributed into four groups of 10 birds each: a no-treatment control group and three test groups receiving powder of Bacillus subtilis DSM 32424 at a minimum rate of 1 × 106 colony forming units per gram, dissolved in drinking water at doses of 50, 75 and 100 mg per kg body weight, daily during 30 days. The use of the probiotic at doses of 50 and 100 mg resulted in significantly reduced faecal staphylococci count on day 30 (P<0.05), while no significant changes were detected in lactobacilli or coliform bacteria. This study gives the first evidence of the influence of Bacillus subtilis on acid value and carotenoid levels in egg yolks laid by quails. Carotenoids were significantly elevated in the 75 mg group on day 30 (P<0.05), but significantly decreased in the 50 and 100 mg groups (P<0.05). Acidity, triglyceride and total cholesterol concentrations in quail serum were not affected significantly by the treatment throughout the study, though their values were reduced. The inclusion of Bacillus subtilis DSM 32424 in drinking water for laying Pharaon quails inhibited faecal staphylococci proliferation and enhanced yolk carotenoid content. Therefore, it can be proposed that including this probiotic in laying quail diets may have beneficial outcomes for both layers and the second generation.

Identifying obstacles is not enough for everybody—Differential efficacy of an intervention fostering fifth graders’ comprehension for word problems

For students’ success in treating word problems, language obstacles have been identified. Interventions are required for students to overcome them, likewise professional development and curriculum support for teachers. But how much support do teachers need? In a controlled trial evaluation study, two interventions for n = 275 fifth graders are compared: The language-responsive intervention (LRI) uses the variation principle and strategic scaffolding fostering comprehension strategies and language awareness. The information-problems-only intervention (IPI) uses the same set of word problems, but teachers were only informed about typical obstacles. For the evaluation study, the ANOVA shows that in both interventions, students have significantly more learning gains than in the no-treatment group, and substantially more in the LRI than in IPI. Students with different language backgrounds profit comparably from LRI, but in different subscales. In conclusion, identifying obstacles is not enough for implementing effective teaching, it should be enhanced by curriculum support.

The effect of Emotional Freedom Techniques on nurses' stress, anxiety, and burnout levels during the COVID-19 pandemic: A randomized controlled trial

Background and ObjectiveInfectious disease outbreaks pose psychological challenges to the general population, and especially to healthcare workers. Nurses who work with COVID-19 patients are particularly vulnerable to emotions such as fear and anxiety, due to fatigue, discomfort, and helplessness related to their high intensity work. This study aims to investigate the efficacy of a brief online form of Emotional Freedom Techniques (EFT) in the prevention of stress, anxiety, and burnout in nurses involved in the treatment of COVID patients. MethodsThe study is a randomized controlled trial. It complies with the guidelines prescribed by the Consolidated Standards of Reporting Trials (CONSORT) checklist. It was conducted in a COVID-19 department at a university hospital in Turkey. We recruited nurses who care for patients infected with COVID-19 and randomly allocated them into an intervention group (n = 35) and a no-treatment control group (n = 37). The intervention group received one guided online group EFT session. ResultsReductions in stress (p < .001), anxiety (p < .001), and burnout (p < .001) reached high levels of statistical significance for the intervention group. The control group showed no statistically significant changes on these measures (p > .05). ConclusionsA single online group EFT session reduced stress, anxiety, and burnout levels in nurses treating COVID-19.

An Analytical Study on Research Trends in Auriculotherapy in Korea

Purpose: This study was done to analyze research articles and explore research trends in auriculotherapy between 2010 and 2019 in Korean academic journals.Methods: Domestic databases including KMbase, RISS, KISS, and NDSL were searched for studies published between 2010 and 2019. Research trends were analyzed according to The STandards Reporting Interventions in Clinical Trials of Acupuncture (STRICTA) guidelines including research design, control group type, and intervention details from a total of 78 domestic papers. Descriptive statistics were analyzed by frequency and percentage.Results: Most studies were conducted in nursing. Regarding research design, a quasi-experimental design with a no-treatment control group was most common. There were 12 conditions with 4 participant categories. The most common intervention was four-point acupuncture-buried therapy. Interventions conducted weekly with cessation of 2 days for 6 weeks were popular. Regarding dropouts, few studies reported side-effects, with personal reasons being the most frequently reported. However, 50% of the studies failed to provide adequate information regarding intervention details according to the STRICTA guidelines, such as the practitioner background, ear point used for intervention, and a flow diagram.Conclusion: Interventional studies on auriculotherapy have been steadily increasing and have included more diversified conditions. Future studies should investigate the effects of auriculotherapy with more rigorous design, and report more detailed information regarding interventions.

Effects of an Educational Program for Professional Caregivers on Behavioral Alterations in Nursing Home Residents: Pilot Study.

This pilot study aims to analyze the effectiveness of a type of non-pharmacological intervention such as the educating and training of professional caregivers on behavioral alterations and prescription of psychotropic drugs of older adults in nursing homes. One hundred and forty-five people from two nursing homes were randomized to either treatment (educational training program for healthcare professionals) or a no-treatment group. Twenty-two professional caregivers in the experimental group received 20 h of a training program. Five data collection points were collected (pre and post, and three follow-ups, all six months apart). Intervention consisted of the behavioral alterations and psychopharmacological treatment. The analysis of variance for repeated measures showed significant differences in the time-group interaction for the educational program’s effectiveness in reducing behavior alterations and psycho-pharmaceuticals’ record. The results show that an improvement in the educating and training of professional caregivers can reduce behavioral alterations (F3,407 = 9.29, p < 0.001, η2= 0.063) and prescription of psychotropic drugs (F2,10 = 18.90, p < 0.001, η2 = 0.117). In addition, these effects are maintained over time. Educating health professionals on ways to care for residents who present behavioral alterations may be one alternative for improving the quality of care that residents receive. Non-pharmacological interventions, besides being individualized and adapted to the needs and experiences of individuals, achieve effects that last longer at low cost. An educational program shows new alternatives to pharmacological intervention, achieving a reduction in behavioral alterations without the costs and effects that psychopharmaceuticals entail.

The effects of 4-aminopyridine and methylprednisolone on recovery of the facial nerve crush injury.

4-Aminopyridine (4-AP) is a potassium channel blocker that enhances nerve excitability. In this study, rat models that have facial nerve crush injury (FNCI) were grouped and treated with methylprednisolone (MP), 4-AP, and a combination of these two drugs. Electrophysiologic and histopathologic outcomes of these groups will be compared with a control group. Thirty healthy male Wistar rats (mean weight of 265g) were used in this study. The rats were randomly divided into five groups with six subjects in each: Group 1 (sham group), Group 2 (control group), Group 3 (MP group), Group 4 (4-aminopyridine group), and Group 5 (4-AP + MP group). All groups except the sham group underwent crush injury to the right facial nerve. Electrophysiologic and histologic recovery was recorded three weeks postoperatively. The 4-AP group and the combined group had a more significant recovery at Nerve Excitability Thresholds (NET) at the end of three weeks. The methylprednisolone group and the control group had a minimal recovery of NET. Histologically, when compared with the control group, the combined group was the only group that had significant recovery at all three of axonal degeneration, axon diameter, and myelin thickness. In this experimental study, we demonstrated that a combination treatment of 4-AP and MP is more effective in the recovery of peripheric FNCI than in the no-treatment control group and in the 4-AP- or MP-alone groups. Moreover, our results suggested that 4-AP can be a potent alternative to MP in the treatment of the FNCI. N/A.

Implants placed into alveoli with periapical lesions: an experimental study in dogs.

To histologically analyze the effect of a curettage of the granulation tissue on healing at implants installed immediately after the extraction of teeth presenting periapical lesions. In seven dogs, the dental pulp was removed from the pulp chamber and from the root canals of the right and left third and the fourth mandibular premolars and of the left second premolar. The chambers were left opened and, after 3 months, apical lesions were present, and the premolars were extracted. One alveolus each premolar was selected and, before implant installation, the apical lesions of two alveoli were curetted (curettage group) while the other three were not treated (no-treatment group). The second right premolar was also extracted (Negative control group). Six implants each dog were installed, and a fully submerged healing was allowed. Four months after, biopsies were collected, and histological analyses were performed. The proportions of new bone at the entire body of the implant was 70.2 ± 10.7% at the no-treatment group, 72.1 ± 14.8% at the curettage group, and 69.6 ± 3.7% at the negative control group. The respective new bone proportion at the apical aspect of the implants was 68.4 ± 17.5%, 61.5 ± 27.3%, and 78.1 ± 5.7%. None of the differences among the various groups were statistically significant. No inflammatory infiltrates were seen in the apical region. In this experimental study, it is concluded that the removal of the granulation tissue seems not to be necessary to obtain a proper osseointegration of implants installed immediately after the extraction of teeth presenting a periapical lesion.

Optimal Medical Therapy Following Transcatheter Aortic Valve Implantation

Limited data exist on optimal medical therapy post-transcatheter aortic valve implantation (TAVI) for late cardiovascular events prevention. We aimed to evaluate the benefits of beta-blocker (BB), renin-angiotensin system inhibitor (RASi), and their combination on outcomes following successful TAVI. In a consecutive cohort of 1,684 patients with severe aortic stenosis undergoing TAVI, the status of BB and RASi treatment at discharge was collected, and patients were classified into 4 groups: no-treatment, BB alone, RASi alone, and combination groups. The primary outcome was a composite of all-cause mortality and rehospitalization for heart failure (HHF) at 2-year. There were 415 (25%), 462 (27%), 349 (21%), and 458 (27%) patients in no-treatment, BB alone, RASi alone, and combination groups, respectively. The primary outcome was lower in RASi alone (21%; adjusted hazard ratio [HR]adj: 0.58; 95% confidence interval [CI]: 0.42 to 0.81) and combination (22%; HRadj: 0.53; 95% CI: 0.39 to 0.72) groups than in no-treatment group (34%) but no significant difference between RASi alone and combination groups (HRadj: 1.14; 95% CI: 0.80 to 1.62). The primary outcome results were maintained in a sensitivity analysis of patients with reduced left ventricular systolic function. Furthermore, RASi treatment was an independent predictor of 2-year all-cause mortality (HRadj: 0.68; 95% CI: 0.51 to 0.90), while that was not observed in BB therapy (HRadj: 0.94; 95% CI: 0.71 to 1.25). In conclusion, post-TAVI treatment with RASi, but not with BB, was associated with lower all-cause mortality and HHF at 2-year. The combination of RASi and BB did not add an incremental reduction in the primary outcome over RASi alone.

Pioglitazone for prevention or delay of type 2 diabetes mellitus and its associated complications in people at risk for the development of type 2 diabetes mellitus.

Pioglitazone for prevention or delay of type 2 diabetes mellitus and its associated complications in people at risk for the development of type 2 diabetes mellitus.

Abstract 16196: Nitric Oxide Delivery During Cardiopulmonary Bypass Reduces Acute Kidney Injury: Randomized Trial

Introduction: Acute kidney injury (AKI) is a serious complication of cardiac surgery with cardiopulmonary bypass (CPB). Postoperative AKI develops in 30% to 52% of cardiac surgery patients and 2% to 5% of these patients require renal replacement therapy. Hypothesis: We hypothesized that nitric oxide treatment during cardiac surgery with CPB can decrease AKI incidence in adult patients. The aim of study was to evaluate the effects of nitric oxide supplementation to CPB circuit on the development of cardiac surgery-associated AKI. Methods: A prospective randomized controlled study included 96 patients with moderate risk of renal complications who underwent elective cardiac surgery with CPB. The study protocol was registered at www.clinicaltrials.gov (#NCT03527381). Patients were randomly assigned to either the nitric oxide supplementation to CPB circuit (NO-treatment group, n = 48) or the usual care (control group, n = 48). 40-ppm nitric oxide was administered in NO-treatment group during the entire CPB period. The primary outcome was AKI incidence. Results: Nitric oxide treatment was associated with a significant decrease in AKI incidence (10 (20.8%) versus 20 (41.6%); RR 0.5 (95% CI 0.26-0.95; p =0.023) and a higher urine output during CPB (2.6 [2.1;5.08] versus 1.7 [0.80;2.50] mL/kg/h; p = 0.0002). Urinary neutrophil gelatinase-associated lipocalin levels were significantly lower in NO-treatment group 4 h after surgery: 1.12 [0.75;5.8] versus 4.62 [2.02;34.55] ng/mL; p = 0.005. Concentrations of nitric oxide metabolites in NO-treatment group significantly increased at 5 min post-clamping, 5 min after declamping, and at the end of surgery. The concentrations of proinflammatory and anti-inflammatory mediators and free plasma hemoglobin did not significantly differ between groups. Conclusions: Nitric oxide administration to patients at moderate risk of renal complications undergoing elective cardiac surgery with CPB was associated with a decrease in AKI incidence. The implications of study for clinical practice expand the array of methods, which may be used for prevention of AKI in cardiac surgery patients.

Abstract 14986: A Randomized Trial of Statins to Reduce Vascular Endothelial Inflammation in Psoriasis

Introduction: Psoriasis (PsO) is a chronic skin disease associated with increased CV risk. Systemic and vascular endothelial inflammation in PsO is highly prevalent and associated with CVD. Statins reduce LDL-C, systemic inflammation, and CV events. There is minimal data supporting the use of statins in PsO. We, therefore, investigated the effect of statins on circulating and vascular endothelial biomarkers of CV risk in PsO. Methods: We performed blood RNA sequencing, targeted proteomics (n=88), and brachial vein endothelial harvesting in PsO participants (n=45, average age 45 ± 14 years, 49% male, body surface area [BSA] of PsO 8 ± 14%, Framingham Risk Score 6 ± 7%) and age- gender-matched controls (n=18). Next, PsO subjects were randomly assigned to 40 mg atorvastatin (n=15) or no-treatment (n=10). A repeat assessment occurred at week two with the primary end-point change in vascular endothelial inflammation (mean composite of LTB, CCL3, CX3CL1, CCL2, CXCL1, ICAM1, iNOS, IL-8, IL-1B, COX- 2 expression). Results: Blood RNA sequencing with pathway analysis revealed inflammasome signaling as highly upregulated in PsO compared to control with protein expression of IL-6 ( r =0.68, p &lt;0.001) and hs-CRP ( r =0.80, p &lt;0.001) each correlated with PsO severity (psoriasis area and severity index [PASI]). Mean vascular endothelial inflammation was also 3-fold higher ( p =0.02) in PsO compared to control and correlated with both PASI ( r =0.40, p =0.01) and LDL-C ( r =0.29, p =0.05). In PsO patients randomized to two weeks of statin therapy, LDL-C was reduced by ~50% compared to the no-treatment group (60 mg/dL vs. 111 mg/dL, p &lt;0.001 respectively). While no decrease in inflammatory pathways at the whole blood transcriptome and protein levels were noted, vascular endothelial inflammation was 60% lower in the statin vs. no-treatment group ( p =0.02). Change in vascular endothelial inflammation correlated with change in LDL-C ( r =0.53, p &lt;0.05) but not IL-6 ( r =-0.25, p =0.30) or hs-CRP ( r =0.15, p =0.58). Conclusions: Two-weeks of high-intensity atorvastatin reduced vascular endothelial but not systemic inflammation in PsO. These findings suggest that statins may reduce CV risk in PsO either through lipid-mediated or a direct effect of statins on the vascular endothelium.

Dry Needling of a Healthy Rat Achilles Tendon Increases Its Gene Expressions: A Pilot Study.

Tendon dry needling is a potential treatment for tendinopathies. Several hypotheses have been proposed to explain its underlying mechanisms. No studies (to the best of our knowledge) have investigated changes in gene expression. To investigate histological and gene expression changes after the application of dry needling to the healthy Achilles tendons of rats. Six Sprague-Dawley male rats were randomly divided into two groups: no intervention or dry needling. Dry needling consisted of three sessions (once per week) to the Achilles tendon. Molecular expression of several genes involved in tendon repair and remodeling (e.g., Cox2, Mmp2, Mmp9, Col1a1, Col3a1, Vefg, and Scx) was assessed 7days after the last needling session (day 28) or 28days after for the no-intervention group. Histological tissue changes were determined with hematoxylin-eosin analyses. The hematoxylin-eosin-stained images revealed no substantial differences in collagen structure or the presence of inflammatory cells between the dry needling and no-intervention groups. A significant increase in the molecular expression of Cox2, Mmp2, Col3a1, and Scx genes was observed in Achilles tendons treated with dry needling when compared with the no-intervention group. This animal pilot study found that the application of dry needling to the healthy Achilles tendons of rats is able to increase the expression of genes associated with collagen regeneration and tissue remodeling of the extracellular matrix with no further histological damage to the tendon.

Reexamining the effect of emotional freedom techniques on stress biochemistry: A randomized controlled trial.

In a direct replication of Church, Yount, and Brooks (2012), this study examined changes in stress biochemistry and psychological distress symptoms in 53 participants randomly allocated to one of three 60-min group interventions: Emotional Freedom Techniques (EFT), psychoeducation (PE), and no treatment (NT). The Symptom Assessment-45 (SA-45) was used to assess psychological distress symptoms. Salivary cortisol assays were administered 30 min pre- and postintervention to test cortisol levels. The original study by Church et al. indicated the EFT group showed statistically significant improvements in anxiety (-58.34%, p < .05), depression (-49.33%, p < .002), overall severity of symptoms (-50.5%, p < .001), and symptom breadth (-41.93%, p < .001). The group also experienced a significant decrease in cortisol (-24.39%) compared to the PE group (-14.25%) and NT group (-14.44%). The present results indicated the EFT group experienced a significant decrease in cortisol greater than the original study (-43.24%, p < .05), but these results were not mirrored by subjective reports of psychological distress. The EFT group reduction in cortisol was significantly different from that of the PE group (-19.67%), and as expected, the posttreatment cortisol level detected among the EFT group was lower than that of the NT group (2.02%); however, there was not a statistically significant difference between the 2 groups. Additionally, there were no significant improvements in cortisol reduction among the NT and PE groups. Findings support the original study indicating EFT to be an efficient and effective brief treatment for reducing biological markers of stress. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Frequency, diagnosis, pathogenesis and management of osteoporosis in alkaptonuria: data analysis from the UK National Alkaptonuria Centre.

A large cohort of alkaptonuria (AKU) patients was studied to better recognise and characterise osteoporosis and fractures in AKU. Assessments including questionnaire analysis, DEXA and CT densitometry at the neck of femur (FN), total hip (TH) and lumbar spine (LS) were performed on patients at baseline when 2 mg nitisinone was commenced, and yearly thereafter. Blood and urine samples were collected for chemical measurement. CT BMD Z-scores were generated. Between June 2007 and March 2020, 87 AKU patients attended the NAC. At baseline, there were 48 fractures in 39 patients. Prevalence of osteoporosis was 3.1 at FN, 10.8 at TH and 24.7% at LS respectively. Prevalence of fragility fractures was greatly increased at 44.8%. The group with fractures showed increased ochronosis scores (p < 0.05). CT LS showed an inverse relationship with fractures (R = - 0.28; p < 0.05). CT LS was significantly lower in the fracture group (p < 0.002). Following nitisinone only, CT FN and CT TH decreased significantly (p < 0.05 and 0.01 respectively). Following nitisinone plus antiresorptive therapy, CT FN, CT TH and CT LS all increased significantly (p < 0.05, 0.05 and 0.001 respectively). However, patients on nitisinone plus antiresorptive had more fractures than nitisinone and no-treatment groups (p < 0.05). Osteopenia and fragility fractures are common in AKU.. Anti-resorptive therapy increased BMD in AKU without decreasing fragility fractures. Bone densitometry measurements by DXA are less reliable than quantitative CT at the LS in AKU.

Enzyme assays on GPx and SOD in alloxan-induced diabetic mice given yellow velvet leaf (Limnocharis flava) extracts

In a pathological condition such as diabetes, the increase of oxidative stress may decrease endogenous antioxidant activities, so the body cannot detoxify free radicals and prevent cell damage. The yellow velvet leaf is one of the natural antioxidant sources. This research investigates anti-hyperglycemic activities of ethanol extracts from yellow velvet leaves and SOD and GPx activities, the antioxidant enzymes. This experimental laboratory research used a posttest only group design. This research subjects were 25 alloxan-induced white male rats of Wistar strains conditioned as the type 2 Diabetes Mellitus (DM). The rats were clustered into five groups: the group I was the no-treatment control group, the group II was the positive control group given glibenclamide 0.45 mg/kg BW(rat's body weight) as the treatment, and group III, IV, and V were the experimental groups treated with yellow velvet leaf ethanol extracts with the doses of 32.5 mg/kg BW, 65 mg/kg BW and 130 mg/kg BW respectively. The activity tests of SOD and GPx, furthermore, were conducted. The results revealed that the dose of 130 mg was the most effective in increasing SOD and GPx activities. The increase of SOD and GPx levels also influenced the blood glucose level, which decreased significantly on 130mg. When the blood sugar level decreases, the stress oxidative itself can be reduced, increasing the endogenous antioxidant activities. It was concluded that the ethanol extract of yellow velvet leaf ( Limnocharis flava ) on the dose of 130mg/kg BW has a significant influence on SOD and GPx activities in alloxan-induced diabetic RA, and not significantly different from glibenclamide

Effects of preemptive analgesia with intravenous acetaminophen on postoperative pain relief in patients undergoing third molar surgery: a prospective, single-blind, randomized controlled trial.

Background The efficacy of preemptive analgesia in managing postoperative pain remains controversial. The aim of this study was to compare the efficacy of intravenous (IV) acetaminophen administered before or immediately after the surgical extraction of an impacted mandibular third molar. Material and Methods This prospective randomized clinical trial included 120 patients. The patients were assigned to one of three groups: the preoperative-treatment group (pre-group), which received 1000 mg of IV acetaminophen 20 min before surgery; the postoperative-treatment group (post-group), which received 1000 mg of IV acetaminophen after surgery; the no-treatment group (control-group), which did not receive any analgesic. Rescue analgesic (60 mg loxoprofen) was issued to each patient, with instructions on self-administration if needed. For the rescue medication usage, the time of first loxoprofen usage and the total amount of loxoprofen consumption were obtained for a 17-hour period after surgery. We measured pain using the visual analogue scale at 1 hour and at 2, 3, 4, 5, and 15 hours after surgery. Results There was no significant difference in pain level among the three groups at any time interval. However, the pre-group demonstrated significantly lower rescue analgesic consumption and longer time until initial administration. Conclusions Administration of IV acetaminophen before third molar surgery provides more effective pain control than postoperative administration and no treatment. Key words:Preemptive analgesia, acetaminophen, impacted third molar, pain relief, randomized controlled trial.

The treatment of mild OSA with CPAP or mandibular advancement device and the effect on blood pressure and endothelial function after one year of treatment.

To evaluate and compare the effects of continuous positive airway pressure (CPAP), use of a mandibular advancement device (MAD), and no treatment on 24-hour ambulatory blood pressure monitoring and peripheral arterial tonometry at 6 and 12 months follow-up in individuals with mild obstructive sleep apnea (OSA), and in a subgroup who had an apnea-hypopnea index of < 5 events/h and adherence of ≥ 4 hours per night (effective-treatment subgroups). The inclusion criteria were individuals with mild obstructive sleep apnea, any sex, age between 18 and 65 years, and a body mass index of ≤ 35 kg/m². Patients were randomized into CPAP, MAD, and no-treatment groups. The evaluations included physical examination, full polysomnography, 24-hour ambulatory blood pressure monitoring, and peripheral arterial tonometry at baseline and after 6 and 12 months. A generalized linear mixed model was used for comparisons. The CPAP and MAD groups had lower apnea-hypopnea indexes than the control group at 6 and 12 months, and the CPAP group had higher blood oxygen levels (SpO₂) than the MAD group. The MAD group had more hours of treatment per night and better adaptation to treatment than the CPAP group (MAD: 5.7 ± 2.7 h/night; CPAP: 3.8 ± 3.4 h/night; MAD: 16% did not adapt; CPAP: 42% did not adapt). No differences were found in the total sample and effective treatment in relation to peripheral arterial tonometry or 24-hour ambulatory blood pressure monitoring outcomes. Treatment of mild obstructive sleep apnea with CPAP or MAD did not improve blood pressure or endothelial function after 1 year, even in patients with effective treatment. Registry: ClinicalTrials.gov; Name: Continuous Positive Airway Pressure and Oral Appliances Treatments in Mild Obstructive Sleep Apnea; URL: https://clinicaltrials.gov/ct2/show/NCT01461486; Identifier: NCT01461486.

Symptomatic cholelithiasis patients have an increased risk of pancreatic cancer: A population-based study.

Pancreatic cancer is a fatal disease; currently, the risk factor survey is not suitable for sporadic pancreatic cancer, which has neither family history nor the genetic analysis data. The aim of the present study was to evaluate the roles of cholelithiasis and cholelithiasis treatments on pancreatic cancer risk. Symptomatic adult patients with an index admission of cholelithiasis were selected from one million random samples obtained between January 2005 and December 2009. The control group was matched with a 1:1 ratio for sex, age, chronic pancreatitis, and pancreatic cystic disease. Subsequent pancreatic cancer, which we defined as pancreatic cancer that occurred ≥6months later, and total pancreatic cancer events were calculated in the cholelithiasis and control groups. The cholelithiasis group was further divided into endoscopic sphincterotomy/endoscopic papillary balloon dilatation, cholecystectomy, endoscopic sphincterotomy/endoscopic papillary balloon dilatation and cholecystectomy, and no-intervention groups for evaluation. The cholelithiasis group and the matched control group included 8265 adults. The cholelithiasis group contained 86 cases of diagnosed pancreatic cancer, and the control group contained 8 cases (P<0.001). The incidence rate ratio (IRR) of subsequent pancreatic cancer was significantly higher in the cholelithiasis group than in the control group (IRR: 5.28, P<0.001). The IRR of subsequent pancreatic cancer was higher in the no-intervention group comparing with cholecystectomy group (IRR=3.21, P=0.039) but was similar in other management subgroups. Symptomatic cholelithiasis is a risk factor for pancreatic cancer; the risk is similar regardless of the intervention chosen for cholelithiasis.

When do smartphones displace face-to-face interactions and what to do about it?

There is a public concern that smartphone communication undermines well-being by displacing face-to-face interactions. However, research on this “social displacement hypothesis” has provided mixed results. We examined when this hypothesis holds true (within-persons vs. between-persons) and tested an intervention to decrease smartphone communication. Participants (N = 109) reported daily on smartphone communication, face-to-face communication, and emotional well-being for fifteen days. At day six, participants were assigned to a mindfulness-treatment intervention group or a no-treatment control group. The social displacement hypothesis was confirmed at the within-person but not between-person level. Specifically, when someone communicates a lot using her smartphone during a particular day, that person engages in less face-to-face interactions during that same day. However, people who tend to spend a lot of time communicating on their smartphone do not engage in less face-to-face conversations than people who largely refrain from smartphone communication. The mindfulness-intervention reduced daily smartphone communication, which decreased negative emotions.