Using equivalence tests in higher tier studies of honey bees under the revised EFSA Bee Guidance-How?

The proposed use of equivalence tests instead of difference tests in the revised guidance on the risk assessment of plant protection products for bees is a reasonable approach given an adverse effect was observed in the lower tier studies, using the hypothesis that there is a risk as the null hypothesis places the burden to prove the opposite on the other side. However, some uncertainties regarding the application of equivalence tests in field studies are discussed in the present study. Here, we compare equivalence and difference testing methods using a control dataset of a honey bee field effect study conducted in northern Germany in 2014. Half of the 48 colonies were assigned to a hypothetical test item group, and the colony strength data were analyzed using t-tests, a generalized linear mixed model (GLMM), and the corresponding equivalence tests. The data reflected the natural variability of honey bee colonies, with initially approximately 12 000 adult bees. Although the t-test and GLMM confirmed that 24 + 24 colonies are sufficient to show "no adverse effect," the equivalence tests of the t-test and GLMM were not able to reject the null hypothesis and classified at least some of the assessments as "high risk," indicating a power that was too low. Based on this, different operating options to reduce the variability are discussed. One possible option, which may provide a more realistic application of equivalence to avoid false high risk, is to consider the lower confidence interval of the control as a baseline and use GLMMs. With this option, we demonstrate a relatively acceptable probability to prove that no high risk for initially similar groups can be achieved. Further studies with different numbers of colonies are still needed to develop and validate the suggested approach. Integr Environ Assess Manag 2024;00:1-8. © 2024 SETAC.

Evaluation of Food Effect on the Pharmacokinetics of Velufenacin, a New Muscarinic Receptor Antagonist, in Healthy Subjects.

Velufenacin (DA-8010) is a new muscarinic receptor antagonist under development for the treatment of overactive bladder. This study aimed to evaluate the effect of food on the pharmacokinetics (PK) and safety of velufenacin in healthy subjects. A randomized, open-label, single-dose, 4-sequence, 4-treatment, 4-period crossover study was conducted. Subjects received a single oral dose of velufenacin 2.5 or 5 mg in a fasted or fed (high-fat meal) state in each period with a 7-day washout. PK parameters including maximum plasma concentration (Cmax ) and area under the concentration-time curve from time 0 to the last measurable point were compared between the fed and fasted states. Twenty-seven subjects completed the study. The mean area under the concentration-time curve from time 0 to the last measurable point of the velufenacin 2.5 and 5 mg doses under the fed condition showed a 1.5- and 1.3-fold increase, respectively, compared to the fasted condition. The corresponding values for Cmax were a 2.3- and 2.0-fold increase, respectively. The time to reach Cmax was comparable regardless of the dose or food intake, showing median values of 4.5-5.0 hours. These results suggest a modest increase of velufenacin absorption by food intake. Velufenacin was generally safe and well tolerated at the 2.5 and 5 mg doses regardless of food.

Online-Network-Group Use and Political-Participation Intention in China: The Analysis Based on CSS 2019 Survey Data.

Although there are many studies discussing the effect of Internet use on political participation, the literature has rarely focused on the relationship between the use of online-network groups and the political-participation intention in contemporary China. The discussion of this relationship is significant, as it offers a new perspective on reviewing the mobilization theory of media, especially in the context of online-network groups, and potentially provides a new channel for mobilizing a wider range of people for politics once the relationship is significant. This study aims to answer the following question: Can we predict the political-participation intention of Chinese citizens through the use of online-network groups? Based on the data of the China Social Survey 2019, this study uses the hierarchical logistic-regression method. The research finds that the specific online-network groups that can predict political-participation intention are mainly concentrated in the category of emotional relationships. Among them, although most of the online-network groups are positively correlated with political-participation intention, the possibility of generating political-participation intention of those who join the relative network group is significantly lower than for those who do not. The virtual connection built by online communication technology, the social relations, and the influence of social groups on individuals can help to explain the correlation between them.

Where have all the beads gone? Fate of microplastics in a closed exposure system and their effects on clearance rates in Mytilus spp.

The fate of microplastic particles (MP) in exposure experiments is mostly unclear. We measured the recovery of polystyrene (PS) microbeads, which were applied in various concentrations from 0.07 to 47.47 beads/ml, from the different compartments of an experimental system with mussels (Mytilus spp.). At the end of the experiment, we detected a significant loss of MP indicating that the mussels were exposed to less particles than intended. If such a discrepancy remains un-recognized by the experimenter, observed effects are related to an inaccurate particle concentration. Additionally, we observed reduced clearance rates of the mussels in the presence of MP and the effect size increased with increasing particle concentration. This effect was more pronounced in mussels that had recently spawned than in mussels that still had mature gonads. This is a hint that effects of MP may depend on the reproductive status of an organism.

The effects of GelMA hydrogel on nerve repair and regeneration in mice with spinal cord injury.

BACKGROUND: To determine the effects of gelatin methacryloyl (GelMA) hydrogel on nerve repair and regeneration in mice with spinal cord injury (SCI). METHODS: A total of 30 ICR mice (6-8 weeks old) were randomly assigned into the control group, the model group, and the experimental group via the random digits table method. There were 10 mice in each group. All mice underwent a T8 laminectomy. For mice in the experimental group and the model group, after the T8 laminectomy, SCI models were constructed by clamping the mice spinal cord tissue for 1 minute using an aneurysm clip (25 g). Additionally, the SCI area of each mouse in the experimental group was locally injected with 0.05-0.7 mL GelMA hydrogel [10% (w/v)] and photocrosslinking was initiated under a blue light source with a wavelength of 405 nm. The exercise performance of each mouse was tested via the bedside mobility scale (BMS) on post-operative days 1, 3, 7, and 14. After 14 days, mice were sacrificed and the dorsal root ganglion (DRG) sensory neurons were isolated and cultured for 3 days in vitro. The axon lengths of the neurons were then evaluated. Immunohistochemical staining was performed to assess the development of syringomyelia in the area. Western blots (WB) and immunofluorescence staining were performed to quantify the expression of glial fibrillary acidic protein (GFAP), growth associated protein (GAP)43, and nestin in the DRG neurons from each group of mice. RESULTS: Compared with mice in the control group, mice in the SCI model group showed a notable decrease in exercise ability, while the exercise ability of mice in the experimental group recovered markedly after treatment with GelMA hydrogel. Administration of GelMA hydrogel lengthened the axon of DRG neurons in mice and reduced the area of syringomyelia. Furthermore, GelMA hydrogel inhibited scar formation and promoted the recovery of neurological function by upregulating GAP43 and nestin expression and downregulating GFAP expression. CONCLUSIONS: In mice with SCI, local injection of GelMA hydrogel strongly inhibited scar formation, reduced the area of syringomyelia, and promoted nerve regeneration and recovery of limb movement function.

Magnetic solid phase extraction of silver-based nanoparticles in aqueous samples: Influence of particle composition and matrix effects on its application to environmental samples and species-selective elution and determination of silver sulphide nanoparticles with sp-ICP-MS.

Silver-based nanoparticles (Ag-b-NPs) are currently a cause for concern because they are being produced in increasing quantities for use in industrial goods and consumer products. This goes hand in hand with their release to the environment and the resultant risks for the entire ecosystem. Therefore, it is essential that these materials are monitored. A promising technique that overcomes a number of shortcomings in handling environmental samples is magnetic solid phase extraction (MSPE) of Ag-b-NPs, which is applied in this study. It has been possible to extract different kinds of Ag-b-NPs at environmentally relevant concentrations in the low ng L-1 range using iron oxide magnetic particles (IOMPs) of different size and shape with efficiencies in the range from 80 to 100%. Furthermore, environmentally relevant inorganic ions and TiO2 particles exhibited no major effect on the extraction efficiency. However, natural organic matter (NOM) exhibited a significant influence from 1 mg L-1 resulting in a 50% drop in extraction efficiency. This effect could be overcome by adding 10 mM Ca2+ or increasing the iron oxide magnetic particle (IOMP) concentration to 500 mg L-1. Applying the presented procedure, Ag-b-NPs added to a river water sample at ßAg = 50 ng L-1 were successfully extracted. We also investigated the coextraction of Ag+, demonstrating that NOM could eliminate coextraction. The subsequent species-selective elution of Ag2S-NPs after MSPE, was carried out based on ethylene diamine tetraacetate (EDTA) as eluent in different matrices. A desorption efficiency of 76 ± 6% could be achieved while preserving the Ag2S-NPs' size. By contrast, core Ag-NPs and AgCl-NPs are dissolved if the presented method is followed.

Effects on patient-reported outcomes of "Screening of Distress and Referral Need" implemented in Dutch oncology practice.

PURPOSE: This study investigated the effect of the "Screening for Distress and Referral Need" (SDRN) process (completing a screening instrument; patient-caregiver discussion about the patient's responses, regardless of distress level, and possible referral to specialized care), implemented in Dutch oncology practice on patient-reported outcomes (PROs). METHODS: A non-randomized time-sequential study was conducted to compare two cohorts. Cohort 1 respondents (C1) were recruited before and cohort 2 respondents (C2) after SDRN implementation in nine Dutch hospitals. Participants completed the EORTC-QLQ-C30, HADS, Patient Satisfaction Questionnaire-III, and the Distress Thermometer and Problem List (DT&PL). Descriptive analyses and univariate tests were conducted. RESULTS: C2 respondents (N = 422, response = 54%) had significantly lower mean scores on the practical (t = 2.3; p = 0.02), social (t = 2.3; p = 0.03), and emotional PL domains (t = 2.9; p = 0.004) compared with C1 (N = 518, response = 53%). No significant differences were found on quality of life, anxiety, depression, satisfaction with care, distress level, the spiritual and physical PL domains, or on referral wish. CONCLUSIONS: After implementation of SDRN, patients report significantly fewer psychosocial (practical, social, and emotional) problems on the DT/PL but responses on the other patient-reported outcomes were comparable. These results add to the mixed evidence on the beneficial effect of distress screening. More and better focused research is needed.

The effects of voluntary front-of-pack nutrition labels on volume shares of products: the case of the Dutch Choices.

OBJECTIVE: The study examines the impact of a front-of-pack label (Dutch Choices) on household purchase patterns. DESIGN: Change in households' volume share of products eligible for the label (treatment group) is estimated as a function of changes in the market share of products displaying the label (treatment), while controlling for other relevant factors. SETTING: Home-scan data for five food categories, subdivided into eighteen food groups, for households participating in a Dutch consumer panel. The data are from the period 2005 to 2009, which includes the date of the introduction of the Choices label. PARTICIPANTS: Between 831 and 7216 households from all over the Netherlands. RESULTS: An increase in the market share of products displaying the label led to an increase in the volume share purchased of products eligible for the label for dairy products, yoghurts and for sauces. For some of the products, the partial effect is considerable (e.g. a 10 percentage point (pp) increase in the share of products displaying the label is associated with a 11·5 and 14·0 pp increase in the volume share of eligible products for chocolate milk and quark, respectively). CONCLUSIONS: The results suggest a positive effect from the presence of the Choices label on the volume share of eligible products purchased. Provided that eligible products are healthier than non-eligible products, the Choices label is a good guide for consumers in order to help them make healthier food choices. The positive effect is found mainly in food groups with a mix of both healthy and unhealthy food products.

The effects of a bioresponse system on the joint attention behaviour of adults with visual and severe or profound intellectual disabilities and their affective mutuality with their caregivers.

BACKGROUND: The subtle communicative behaviour of individuals with visual and severe/profound intellectual disabilities hinders the success of their interaction with professional caregivers. The bioresponse system, a tool to raise caregivers' awareness of the client's communicative behaviour, may improve the client's joint attention behaviour and the dyad's affective mutuality. METHOD: Four client-caregiver dyads participated in a randomized multiple baseline study with repeated baseline, intervention and follow-up observations. The bioresponse system's effect was evaluated with measures of joint attention and affective mutuality. RESULTS: Two clients showed a significant difference on one or two joint attention subscales (including one significant decrease), and for all clients, at least one joint attention subscale revealed a positive trend. Positive trends in affective mutuality scores were observed in two dyads. CONCLUSIONS: The results stress the importance of further research to the effects of using the bioresponse system's in daily care for persons with severe/profound intellectual disabilities.

Effect of a participative action intervention program on reducing mental retirement.

BACKGROUND: The present study aimed to investigate the effects of a stepwise, bottom-up participatory program with a tailor-made intervention process addressing the level of mental retirement in a sample of Dutch employees. Mental retirement refers to feelings of being disconnected from your work and your organization. Prevention of mental retirement is important since sustainable employability is becoming more important in today's society due to the ageing of the working population and the changes in skills demands. METHODS: This prospective cohort study with a one-year follow-up employs a sample of 683 employees of three organizations in The Netherlands, who filled out two questionnaires: at baseline and 1 year later. The dependent measure was mental retirement, which consists of three sub-concepts: developmental pro-activity, work engagement and perceived appreciation. RESULTS: Multilevel analysis (N = 466) showed that employees who more actively participated in the intervention(s) had a small but statistically significant larger decrease in mental retirement at follow-up. CONCLUSIONS: The stepwise, bottom-up participatory program with a tailor-made intervention process shows a tendency to decrease the level of mental retirement in Dutch employees. However, the implementation of interventions could be further improved since it turned out to be very challenging to keep up participants' commitment to the program. Future research should study the effectiveness of this program further with an improved study design (control group, multiple follow-ups, several data sources).

Engineered Lateral Roughness Element Implementation and Working Fluid Alteration to Intensify Hydrodynamic Cavitating Flows on a Chip for Energy Harvesting.

Hydrodynamic cavitation is considered an effective tool to be used in different applications, such as surface cleaning, ones in the food industry, energy harvesting, water treatment, biomedical applications, and heat transfer enhancement. Thus, both characterization and intensification of cavitation phenomenon are of great importance. This study involves design and optimization of cavitation on chip devices by utilizing wall roughness elements and working fluid alteration. Seven different microfluidic devices were fabricated and tested. In order to harvest more energy from cavitating flows, different roughness elements were used to decrease the inlet pressure (input to the system), at which cavitation inception occurs. The implemented wall roughness elements were engineered structures in the shape of equilateral triangles embedded in the design of the microfluidic devices. The cavitation phenomena were also studied using ethanol as the working fluid, so that the fluid behavior differences in the tested cavitation on chip devices were explained and compared. The employment of the wall roughness elements was an effective approach to optimize the performances of the devices. The experimental results exhibited entirely different flow patterns for ethanol compared to water, which suggests the dominant effect of the surface tension on hydrodynamic cavitation in microfluidic channels.

Food-effect study on uracil and dihydrouracil plasma levels as marker for dihydropyrimidine dehydrogenase activity in human volunteers.

AIMS: This study aimed to determine the effect of food intake on uracil and dihydrouracil plasma levels. These levels are a promising marker for dihydropyrimidine dehydrogenase activity and for individualizing fluoropyrimidine anticancer therapy. METHODS: A randomized, cross-over study in 16 healthy volunteers was performed, in which subjects were examined in fasted and fed state on two separate days. In fed condition, a high-fat, high-caloric breakfast was consumed between 8:00 h and 8:30 h. Whole blood for determination of uracil, dihydrouracil and uridine plasma levels was drawn on both test days at predefined time points between 8:00 h and 13:00 h. RESULTS: Uracil levels were statistically significantly different between fasting and fed state. At 13:00 h, the mean uracil level in fasting state was 12.6 ± 3.7 ng ml-1 and after a test meal 9.4 ± 2.6 ng ml-1 (P < 0.001). Dihydrouracil levels were influenced by food intake as well (mean dihydrouracil level at 13:00 h in fasting state 147.0 ± 36.4 ng ml-1 and in fed state 85.7 ± 22.1 ng ml-1 , P < 0.001). Uridine plasma levels showed curves with similar patterns as for uracil. CONCLUSIONS: It was shown that both uracil and dihydrouracil levels were higher in fasting state than in fed state. This is hypothesized to be an direct effect of uridine plasma levels, which were previously shown to be elevated in fasting state and reduced after intake of food. These findings show that, when assessing plasma uracil and dihydrouracil levels for adaptive fluoropyrimidine dosing in clinical practice, sampling should be done between 8:00 h and 9:00 h after overnight fasting to avoid bias caused by circadian rhythm and food effects.

ASCEND-8: A Randomized Phase 1 Study of Ceritinib, 450 mg or 600 mg, Taken with a Low-Fat Meal versus 750 mg in Fasted State in Patients with Anaplastic Lymphoma Kinase (ALK)-Rearranged Metastatic Non-Small Cell Lung Cancer (NSCLC).

INTRODUCTION: Ceritinib, 750 mg fasted, is approved for treatment of patients with ALK receptor tyrosine kinase gene (ALK)-rearranged (ALK-positive) NSCLC previously treated with crizotinib. Part 1 of the ASCEND-8 study determined whether administering ceritinib, 450 mg or 600 mg, with a low-fat meal may enhance gastrointestinal (GI) tolerability versus 750 mg fasted in patients with ALK-positive NSCLC while maintaining similar exposure. METHODS: ASCEND-8 is a multicenter, randomized, open-label, phase 1 study. Part 1 investigated the steady-state pharmacokinetics (PK) and safety of ceritinib, 450 mg or 600 mg, taken with a low-fat meal versus 750 mg fasted in patients with advanced ALK-positive NSCLC who were either treatment naive or pretreated with chemotherapy and/or crizotinib. Part 2 will assess efficacy and safety of ceritinib in treatment-naive patients. RESULTS: As of June 16, 2016, 137 patients were randomized (450 mg fed [n = 44], 600 mg fed [n = 47], and 750 mg fasted [n = 46]); 135 patients received ceritinib. Median follow-up duration was 4.14 months. At steady state, relative to 750 mg fasted, 450 mg with food demonstrated comparable PK as assessed by maximum (peak) concentration of drug in plasma and area under the plasma concentration-time curve from time zero to 24 hours, whereas 600 mg with food demonstrated approximately 25% higher PK. Relative to 750 mg fasted, 450 mg with food was associated with a lower proportion of patients with GI toxicities, mostly grade 1 (diarrhea [43.2%], nausea [29.5%], and vomiting [18.2%]); there were no grade 3 or 4 events, study drug discontinuations, or serious AEs due to GI toxicities. CONCLUSION: Ceritinib, 450 mg with food, had similar exposure and a more favorable GI safety profile than ceritinib, 750 mg in fasted patients with ALK-positive NSCLC.

In vitro hypoglycemic effects of unripe and ripe fruits of Musa sapientum

ABSTRACT The present study was undertaken to verify the hypoglycemic potential of unripe and ripe fruit extracts of Musa sapientum by using various in-vitro techniques, namely glucose adsorption capacity, glucose diffusion, amylolysis kinetics and glucose transport across the yeast cells. The results revealed that the unripe and ripe fruit extracts of Musa sapientum adsorbed glucose and the adsorption of glucose increased remarkably with an increase in glucose concentration. There were no significant (p≤0.05) differences between their adsorption capacities. In the amylolysis kinetic experimental model the rate of glucose diffusion was found to be increased with time from 30 to 180 min and both extracts exhibited significant inhibitory effects on the movement of glucose into external solution across the dialysis membrane as compared to control. The plant extracts also promoted glucose uptake by the yeast cells and enhancement of glucose uptake was dependent on both the sample and glucose concentration. The hypoglycemic effect exhibited by the extracts was observed to be mediated by inhibiting α-amylase, inhibiting glucose diffusion by adsorbing glucose and by increasing glucose transport across the cell membranes as revealed by an in-vitro model of yeast cells.

Study on the effect of applying syndrome differentiation and medicated diet in patients with liver cirrhosis ascites based on "Gu Ben Kai Qu" theory of TCM / 中国实用护理杂志

Objective To explore the effect of applying syndrome differentiation and medicated diet in patients with liver cirrhosis as cites based on"Gu Ben Kai Qu"theory of TCM. Methods Seventy patients of liver cirrhosis as cites were randomly divided into observation group (35 cases) and control group(35 cases).The control group was cared with care routine of liver cirrhosis as cites,The observation group was based on care routine traditional nursing and implementation of dialectical medicalated meal which based on "Gu Ben Kai Qu" theory of TCM. The two groups of patients were used to assess the efficacy of liver cirrhosis as cites,urine volume,abdominal circumference,weight,TCM syndrome scale of liver disease. Results The urine volume on the 7th day, the 14th day, 2 weeks after discharge,the weight and the abdominal circumference on the 2 weeks after discharge from the patients in the observation group were respectively(1.90±0.52)L,(2.09±0.56)L,(2.02±0.35)L,(59.36±8.19)kg,(89.56±7.24)cm,while they were(1.63±0.36)L,(1.79±0.40)L,(1.82±0.38)L,(63.33±8.21)kg,(93.57±7.56)cm in the control group,the difference between the two groups was statistically significant (F=6.083, 6.484, 5.030, 4.108, 5.144,all P<0.05). The efficacy of liver cirrhosis as cites from the patients in the observation group were cured 40.0%(14/35),improved 42.9%(15/35),not cured 17.1%(6/35),while they were cured 22.9%(8/35),improved 40.0%(14/35),not cured 37.1%(13/35),the difference between the two groups was statistically significant (Z=2.012,P<0.05). The efficacy of TCM Syndromes on liver disease from the patients in the observation group were respectively[significant effect 37.1%(13/35),valid 45.7% (16/35),invalid 17.2%(6/35)],[significant effect 60.0%(21/35),valid 28.6%(10/35),invalid 11.4%(4/35)], while they were respectively [significant effect 20.0%(7/35), valid 42.9%(15/35), invalid 37.1%(13/35)], [significant effect 40.0%(14/35),valid 25.7%(9/35),invalid 34.3%(12/35)],the difference between the two groups was statistically significant(Z=2.065,2.104,all P<0.05). Conclusions Based on"Gu Ben Kai Qu"theory of TCM,the implementation of dialectical diet can effectively improve efficacy of liver cirrhosis as cites, reduction rate of TCM symptoms scale, urine volume,reduce the weight,shrink down the abdominal circumference,worthy of clinical application.

The involvement of young people in school- and community-based noncommunicable disease prevention interventions: a scoping review of designs and outcomes.

BACKGROUND: Since stakeholders' active engagement is essential for public health strategies to be effective, this review is focused on intervention designs and outcomes of school- and community-based noncommunicable disease (NCD) prevention interventions involving children and young people. METHODS: The review process was based on the principles of scoping reviews. A systematic search was conducted in eight major databases in October 2015. Empirical studies published in English, French, Portuguese, and Spanish were considered. Five selection criteria were applied. Included in the review were (1) empirical studies describing (2) a health intervention focused on diet and/or physical activity, (3) based on children's and young people's involvement that included (4) a relationship between school and local community while (5) providing explicit information about the outcomes of the intervention. The search provided 3995 hits, of which 3253 were screened by title and abstract, leading to the full-text screening of 24 papers. Ultimately, 12 papers were included in the review. The included papers were analysed independently by at least two reviewers. RESULTS: Few relevant papers were identified because interventions are often either based on children's involvement or are multi-setting, but rarely both. Children were involved through participation in needs assessments, health committees and advocacy. School-community collaboration ranged from shared activities, to joint interventions with common goals and activities. Most often, collaboration was school-initiated. Most papers provided a limited description of the outcomes. Positive effects were identified at the organisational level (policy, action plans, and healthy environments), in adult stakeholders (empowerment, healthy eating) and in children (knowledge, social norms, critical thinking, and health behaviour). Limitations related to the search and analytical methods are discussed. CONCLUSION: There are very few published studies on the effectiveness of interventions based on children's involvement in school- and community-based NCD prevention programmes. However, interventions with these characteristics show potential benefits, and the merits of complex multi-setting approaches should be further explored through intervention-based studies assessing their effectiveness and identifying which components contribute to the observed outcomes.

Effect of community-based intervention on the improving of early detection of individuals with high risk nasopharyngeal carcinoma / 中国基层医药

Objective To analyze the effects of community-based intervention on improving early detection of individuals with high risk nasopharyngeal carcinoma and to explore the interventional mechanism of prevention and treatment in nasopharyngeal carcinoma.Methods Total of 139 344 residents of the Second Chinese Medicine Hospi-tal of Guangdong Province Hospital Community were detected per year.Individuals with high risk nasopharyngeal car-cinoma or nasopharyngeal carcinoma patients were divided into intervention group(69 616 cases) and control group (69 728 cases) according to the random number table.The two groups were given conventional treatment (radiothera-py,chemotherapy and surgery treatment) after diagnosed.The intervention group was interfered with long -term prevention,health care,medical care,rehabilitation,health education and psychological intervention by full-time phy-sician,while the control group was only treated by general education intervention.The awareness of early symptoms and the risk factor of nasopharyngeal carcinoma were analyzed.Additionally,the behavior,knowledge and attitude on nasopharyngeal carcinoma were detected before and after the intervention.Results Community-based intervention significantly improved the rate of early detection of nasopharyngeal carcinoma high-risk individuals ( 75.31% vs. 44.37%,χ2 =5.32,P<0.01) .The awareness rates of major symptoms and the damage of nasopharyngeal carcinoma were 89.34%and 91.78%in the intervention group.In the control group,the rates were 42.17%and 28.47%.The differences of the two groups were significant(P<0.05).Additionally,the awareness of diagnosis standard and good habits were improved significantly in the intervention group compared with the control group(P<0.01).Our results showed that intervention changed the attitude and understanding of patients with nasopharyngeal carcinoma and improved the quality of life of patients with nasopharyngeal carcinoma.Conclusion Intervention increased the early diagnostic rate of nasopharyngeal carcinoma and promoted the quality of life of patients with nasopharyngeal carcinoma.

Evaluation of the effect of food and age on the pharmacokinetics of oral netupitant and palonosetron in healthy subjects: A randomized, open-label, crossover phase 1 study.

Antiemetic treatment compliance is important to prevent chemotherapy-induced nausea and vomiting, a feared chemotherapy side effect. NEPA, a new oral fixed combination of netupitant, a highly selective NK1 receptor antagonist (RA), and palonosetron, a second-generation 5-HT3 RA, targets dual antiemetic pathways with a single dose. This study investigated the effect of food intake and age on NEPA pharmacokinetics (PK) and safety. In this open-label, single-center, randomized, phase 1 study, 24 adults (18-45 years) received NEPA in a fed or fasted state during the first treatment period and in the alternative state in the next treatment period. Twelve elderly subjects (≥65 years) received NEPA in a fasted state. Blood samples were taken for netupitant and palonosetron PK analysis. In the fed condition, netupitant plasma exposure increased, whereas palonosetron PK parameters were not affected. Furthermore, elderly subjects showed increased netupitant and palonosetron exposure compared with adults. All adverse events were mild/moderate, with constipation and headache the most common. Although food intake and age altered NEPA PK, dose adjustments were not needed, as netupitant and palonosetron exposure increases did not lead to safety concerns in healthy subjects.

The effects of the policy measures to control the rate of cesarean section in four counties / 中国卫生政策研究

Objective:To explore the propagable experience and methods of controlling the rate of cesarean sec-tion through the summary of the innovative measures in four counties. Methods:The cases of natural birth and cesare-an section from 2009 to 2013 in four counties were analyzed respectively. The interventions of controlling cesarean section rate have been summarized. Results:The average cesarean section rate of four counties in five years is on the decline, since 2009 the rate were 60. 2%,62. 3%,59. 3%,51. 4%,48. 1%. Conclusions: The interventions really worked, but did not do the best. Improving the social attention on these innovative measures, strengthening surveil-lance mechanism, regulating the medical behaviors of delivery hospitals, enhancing the midwifery training and promo-ting the interventions under the coordination of local government can further reduce the rate of cesarean section.

Effect of physical training on urinary incontinence: a randomized parallel group trial in nursing homes.

BACKGROUND: Residents in nursing homes (NHs) are often frail older persons who have impaired physical activity. Urinary incontinence (UI) is a common complaint for residents in NHs. Reduced functional ability and residence in NHs are documented to be risk factors for UI. OBJECTIVE: To investigate if an individualized training program designed to improve activity of daily living (ADL) and physical capacity among residents in nursing homes has any impact on UI. MATERIALS AND METHODS: This randomized controlled trial was a substudy of a Nordic multicenter study. Participants had to be >65 years, have stayed in the NH for more than 3 months and in need of assistance in at least one ADL. A total of 98 residents were randomly allocated to either a training group (n = 48) or a control group (n = 50) after baseline registrations. The training program lasted for 3 months and included accommodated physical activity and ADL training. Personal treatment goals were elicited for each subject. The control group received their usual care. The main outcome measure was UI as measured by a 24-hour pad-weighing test. There was no statistically significant difference between the groups on this measure at baseline (P = 0.15). Changes were calculated from baseline to 3 months after the end of the intervention. RESULTS: Altogether, 68 participants were included in the analysis, 35 in the intervention group and 33 in the control group. The average age was 84.3 years. The 3 months' postintervention adjusted mean difference between groups according to amount of leakage was 191 g (P = 0.03). This result was statistically significant after adjusting for baseline level, age, sex, and functional status. The leakage increased in residents not receiving the experimental intervention, while UI in the training group showed improvement. CONCLUSION: The intervention group had significant better results compared with the control group after an individualized training program designed to improve ADL and physical capacity. Further studies are needed to evaluate the effect of a goal-oriented physical training program toward NH residents UI complaints.