Lamotrigine versus levetiracetam or zonisamide for focal epilepsy and valproate versus levetiracetam for generalised and unclassified epilepsy: two SANAD II non-inferiority RCTs.

Background: Levetiracetam (Keppra, UCB Pharma Ltd, Slough, UK) and zonisamide (Zonegran, Eisai Co. Ltd, Tokyo, Japan) are licensed as monotherapy for focal epilepsy, and levetiracetam is increasingly used as a first-line treatment for generalised epilepsy, particularly for women of childbearing age. However, there is uncertainty as to whether or not they should be recommended as first-line treatments owing to a lack of evidence of clinical effectiveness and cost-effectiveness.

More passive internal tibial rotation with posterior cruciate ligament retention than with excision in a medial pivot TKA implanted with unrestricted caliper verified kinematic alignment.

Purpose: Excision of the posterior cruciate ligament (PCL) is recommended when implanting a medial pivot (MP) total knee arthroplasty (TKA) to reduce the risk of limiting flexion by over-tensioning the flexion space. The present study determined whether PCL retention (1) limits internal tibial rotation and (2) causes anterior lift-off of the insert in 90° flexion after implantation of an MP design with unrestricted caliper verified kinematic alignment (KA).

Methods: Four surgeons implanted an MP TKA design with medial ball-in-socket and lateral flat tibial insert in ten fresh-frozen cadaveric knees.

Randomised controlled trial of intermittent vs continuous energy restriction during chemotherapy for early breast cancer.

Background: Excess adiposity at diagnosis and weight gain during chemotherapy is associated with tumour recurrence and chemotherapy toxicity. We assessed the efficacy of intermittent energy restriction (IER) vs continuous energy restriction (CER) for weight control and toxicity reduction during chemotherapy.

Methods: One hundred and seventy-two women were randomised to follow IER or CER throughout adjuvant/neoadjuvant chemotherapy.

Flying after diving: a questionnaire-based evaluation of pre-flight diving behaviour in a recreational diving cohort.

Introduction: Divers are recommended to observe a pre-flight surface interval (PFSI) ≥ 24 hours before boarding a plane following a diving vacation. Decompression sickness (DCS) symptoms may occur during or post-flight. This study aimed to examine the adherence of PFSI ≥ 24 in vacationing divers, and if any perceived signs and symptoms of DCS during or after flight were experienced.

GJ 367b: A dense, ultrashort-period sub-Earth planet transiting a nearby red dwarf star.

Ultrashort-period (USP) exoplanets have orbital periods shorter than 1 day. Precise masses and radii of USP exoplanets could provide constraints on their unknown formation and evolution processes. We report the detection and characterization of the USP planet GJ 367b using high-precision photometry and radial velocity observations.

Luxeptinib disables NLRP3 inflammasome-mediated IL-1β release and pathways required for secretion of inflammatory cytokines IL-6 and TNFα.

Luxeptinib (CG-806) is an orally bioavailable multikinase inhibitor with nanomolar potency against select clusters of kinases including the BTK, FLT3, TRK, STE/MAPK and aurora kinase clusters. It is cytotoxic to primary malignant cells obtained from patients with AML, ALL, and CLL at lower concentrations than other BTK and FLT3 inhibitors, and has activity in AML and lymphoma xenografts at concentrations attainable in patients. Exposure of macrophages and monocytes to endotoxin triggers the release of IL-1β through activation of the NLRP3 inflammasome and IL-6 and TNFα through transcriptional up-regulation.

Average duration of prior treatment lines predicts clinical benefit to eribulin chemotherapy in patients with metastatic breast cancer.

Purpose: The aim of this study was to identify factors associated with progression-free survival (PFS) and overall survival (OS) in patients with metastatic breast cancer (MBC) treated with eribulin in a real-world setting, to improve information provision in those considering treatment.

Methods: Patients treated with eribulin for MBC at The Christie NHS Foundation Trust, Manchester, UK, between August 2011 and December 2018 were included (n = 439). Data were collected by retrospective review of medical records and electronic prescribing systems.

Adjusting Insert Thickness and Tibial Slope Do Not Correct Internal Tibial Rotation Loss Caused by PCL Resection: In Vitro Study of a Medial Constraint TKA Implanted with Unrestricted Calipered Kinematic Alignment.

Most medial stabilized (MS) total knee arthroplasty (TKA) implants recommend excision of the posterior cruciate ligament (PCL), which eliminates the ligament's tension effect on the tibia that drives tibial rotation and compromises passive internal tibial rotation in flexion. Whether increasing the insert thickness and reducing the posterior tibial slope corrects the loss of rotation without extension loss and undesirable anterior lift-off of the insert is unknown. In 10 fresh-frozen cadaveric knees, an MS design with a medial ball-in-socket (i.

Sleep-wake disturbances in supra-and infratentorial stroke: an analysis of post-acute sleep architecture and apnea.

Background And Purpose: Sleep-wake disturbances (SWD) are common following stroke, and often extend into the post-acute to chronic periods of recovery. Of particular interest to recovery is a reduction in rapid eye movement (REM) sleep, as we know REM sleep to be important for learning and memory. While there is a breadth of evidence linking SWD and stroke, much less work has been done to identify and determine if differences in sleep architecture and apnea severity are dependent on stroke infarct topographies.

Eosinophilic esophagitis in individuals with sex chromosome aneuploidies: Clinical presentations and management implications.

Background: Supernumerary sex chromosome aneuploidies (SCA) are common genetic conditions characterized by additional X or Y chromosome, affecting ~1/500 individuals, with the most frequent karyotypes of 47,XXY (Klinefelter syndrome), 47,XXX (Trisomy X), and 47,XYY (Jacob syndrome). Although there is considerable phenotypic variation among these diagnoses, these conditions are characterized by the presence of overlapping physical, medical, developmental, and psychological features. Our interdisciplinary clinic's experience anecdotally supports previous published findings of atopic conditions, feeding difficulties, and gastroesophageal reflux to be more prevalent in SCAs (Bardsley et al.

Dental Anesthesia for Medical Providers: A Novel Interprofessional Course.

Purpose: To limit the use of opioids for nontraumatic dental conditions in emergency settings, the physician assistant (PA) and dental faculty at A.T. Still University designed a course that teaches PA students to administer dental anesthesia.

Response to cardiac resynchronisation therapy in men and women: a secondary analysis of the SMART-AV randomised controlled trial.

Objectives: There is a controversy about whether both sexes' response to cardiac resynchronisation therapy (CRT) is similar. We aimed to assess a causal effect of sex on CRT response.

Design: Secondary analysis of a randomised controlled trial (RCT) data.

Observations of supermicron-sized aerosols originating from biomass burning in southern Central Africa.

During the 3 years of the ObseRvations of Aerosols above CLouds and their intEractionS (ORACLES) campaign, the NASA Orion P-3 was equipped with a 2D stereo (2D-S) probe that imaged particles with maximum dimension () ranging from 10 < < 1280 μm. The 2D-S recorded supermicron-sized aerosol particles (SAPs) outside of clouds within biomass burning plumes during flights over the southeastern Atlantic off Africa's coast. Numerous SAPs with 10 < < 1520 μm were observed in 2017 and 2018 at altitudes between 1230 and 4000 m, 1000 km from the coastline, mostly between 7-11° S.

Impact of a mass media campaign on presentations and ambulance use for acute coronary syndrome.

Objective: Between 2009 and 2013, the National Heart Foundation of Australia ran mass media campaigns to improve Australian's awareness of acute coronary syndrome (ACS) symptoms and the need to call emergency medical services (EMS). This study examined the impact of this campaign on emergency department (ED) presentations and EMS use in Victoria, Australia.

Methods: The Victorian Department of Health and Human Services provided data for adult Victorian patients presenting to public hospitals with an ED diagnosis of ACS or unspecified chest pain (U-CP).

Advanced Glycation End Products Associated With Cardiometabolic Biomarkers in Treated Human Immunodeficiency Virus Infection.

Background: Despite advances in antiretroviral therapy (ART), people living with human immunodeficiency virus (HIV) continue to be at increased risk of cardiometabolic complications compared to HIV-uninfected individuals. Advanced glycation end products (AGEs) are implicated in the development and progression of cardiometabolic complications in the general population. Their role in HIV remains unclear.

Mapping the literature of health care management: an update.

Objective: This study aims to identify the core journals cited in the health care management literature and to determine their coverage in the foremost bibliographic databases used by the discipline.

Methods: Using the methodology outlined by the Medical Library Association's Nursing and Allied Health Resource Section (NAHRS) protocol for "Mapping the Literature of Nursing and Allied Health Professions," this study updates an earlier study published in 2007. Cited references from articles published in a three-year range (2016-2018) were collected from five health care management journals.

Reduced sialidase activity of influenza A(H3N2) neuraminidase associated with positively charged amino acid substitutions.

Neuraminidase (NA) inhibitors (NAI), oseltamivir and zanamivir, are the main antiviral medications for influenza and monitoring of susceptibility to these antivirals is routinely done by determining 50 % inhibitory concentrations (IC) with MUNANA substrate. During 2010-2019, levels of A(H3N2) viruses presenting reduced NAI inhibition (RI) were low (~0.75 %) but varied year-on-year.

Development of a fluorogenic ADAMTS-7 substrate.

The extracellular protease ADAMTS-7 has been identified as a potential therapeutic target in atherosclerosis and associated diseases such as coronary artery disease (CAD). However, ADAMTS-7 inhibitors have not been reported so far. Screening of inhibitors has been hindered by the lack of a suitable peptide substrate and, consequently, a convenient activity assay.