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181. Prediction of Tibial Rotation Pathologies Using Particle Swarm Optimization and K-Means Algorithms (PubMed)

Prediction of Tibial Rotation Pathologies Using Particle Swarm Optimization and K-Means Algorithms The aim of this article is to investigate pathological subjects from a population through different physical factors. To achieve this, particle swarm optimization (PSO) and K-means (KM) clustering algorithms have been combined (PSO-KM). Datasets provided by the literature were divided into three clusters based on age and weight parameters and each one of right tibial external rotation (RTER

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2018 Journal of clinical medicine

182. Pharmacological and Non-pharmacological Means for Prevention of Fractures among Elderly (PubMed)

Pharmacological and Non-pharmacological Means for Prevention of Fractures among Elderly Fractures are major cause of morbidity, mortality, and healthcare and social services expenditure in elderly. Fractures often have multifactorial etiologies and the condition emerges due to the interaction between the different predisposing and precipitating factors. One of the most common causes leading to fractures after minimal trauma in older people is osteoporosis. The objective of this article (...) is to describe the clinical concept and summarize the evidence and to explain the future directions for research, focusing on specific issues related to prevent fracture in the elderly. This study reviewed the scientific literature addressing strategies for primary and secondaryprevention of fractures among elderly in the context of pharmacological and non-pharmacological means. A growing body of scientific evidence supports the use of both non-pharmacological and pharmacological interventions

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2018 International journal of preventive medicine

183. What do Vitiligo Impact Scale (VIS)-22 scores mean? Studying the clinical interpretation of scores using an anchor-based approach. (PubMed)

methods.This was a cross-sectional study conducted in a large teaching hospital in North India. Patients with vitiligo > 15 years of age (n = 391) completed the VIS-22 and Dermatology Life Quality Index (DLQI) questionnaires, and answered a Global Question (GQ) on the effect of vitiligo on their lives on a five-point Likert scale. Multiple band sets of VIS-22 scores were devised using GQ as the anchor. A weighted kappa-coefficient was calculated to estimate the level of agreement between different band (...) sets of VIS-22 and GQ. VIS-22 and DLQI were compared based on their degree of correlation and agreement with GQ.The mean ± SD of VIS-22 scores was 24·8 ± 14·0 (range 0-61). VIS-22 scores showed good correlation with GQ (r = 0·76). Of the various VIS-22 band sets tested, the following was chosen: 0-5, 6-15, 16-25, 26-40 and 41-66 (weighted κ = 0·57), corresponding to the five categories of GQ. The degree of correlation (VIS-22, r = 0·77; DLQI, r = 0·69) and agreement (VIS-22, 51·6%; DLQI, 36·1%; P

2018 British Journal of Dermatology

184. Effects of non-medical health coaching on multimorbid patients in primary care: a difference-in-differences analysis. (PubMed)

Surveys between 2013 and 2017. We use a weighted difference-in-differences design to compare changes in outcomes over time between intervention practices and comparable control practices in the rest of England. We conduct our main analysis on multimorbid patients and additional analysis on all patients to assess population-level effects.For multimorbid patients, we find reductions in psychological wellbeing (short and medium term) of -0.0174 (95% confidence interval -0.0283 to -0.0065), relative (...) difference -2% from the pre-intervention mean; and person-centeredness (short term) of -0.0356 (-0.0530 to -0.0183), -4%. We find no significant effects on other outcome measures. For population-level effects, in the short term we find reductions in primary care utilisation of -0.0331 (-0.0448 to -0.0214), -5%. All other outcomes are not consistently statistically significant.Our results show that there is very little effect of health coaching on patient experience and outcomes in the short-to-medium

2019 BMC health services research

185. Effect of breakfast on weight and energy intake: systematic review and meta-analysis of randomised controlled trials. (PubMed)

of the effect of breakfast consumption on weight and daily energy intake were performed.Of 13 included trials, seven examined the effect of eating breakfast on weight change, and 10 examined the effect on energy intake. Meta-analysis of the results found a small difference in weight favouring participants who skipped breakfast (mean difference 0.44 kg, 95% confidence interval 0.07 to 0.82), but there was some inconsistency across trial results (I2=43%). Participants assigned to breakfast had a higher total (...) daily energy intake than those assigned to skip breakfast (mean difference 259.79 kcal/day, 78.87 to 440.71; 1 kcal=4.18 kJ), despite substantial inconsistency across trial results (I2=80%). All of the included trials were at high or unclear risk of bias in at least one domain and had only short term follow-ups (mean period seven weeks for weight, two weeks for energy intake). As the quality of the included studies was mostly low, the findings should be interpreted with caution.This study suggests

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2019 BMJ

186. Durability of a primary care-led weight-management intervention for remission of type 2 diabetes: 2-year results of the DiRECT open-label, cluster-randomised trial

(2%) control participants had weight loss of at least 15 kg (adjusted odds ratio [aOR] 7·49, 95% CI 2·05 to 27·32; p=0·0023) and 53 (36%) intervention participants and five (3%) control participants had remission of diabetes (aOR 25·82, 8·25 to 80·84; p<0·0001). The adjusted mean difference between the control and intervention groups in change in bodyweight was -5·4 kg (95% CI -6·9 to -4·0; p<0·0001) and in HbA1c was -4·8 mmol/mol (-8·3 to -1·4 [-0·44% (-0·76 to -0·13)]; p=0·0063), despite only (...) Durability of a primary care-led weight-management intervention for remission of type 2 diabetes: 2-year results of the DiRECT open-label, cluster-randomised trial The DiRECT trial assessed remission of type 2 diabetes during a primary care-led weight-management programme. At 1 year, 68 (46%) of 149 intervention participants were in remission and 36 (24%) had achieved at least 15 kg weight loss. The aim of this 2-year analysis is to assess the durability of the intervention effect.DiRECT

2019 EvidenceUpdates

187. Weight management telehealth intervention for overweight and obese rural cardiac rehabilitation participants: A randomised trial

-efficacy and use of weight management behaviours.A total of 43 subjects participated, with a mean age of 63 (±9.3) years. The WMI group had significantly more weight loss averaged across the 4 and 6 months of 13.8 (±2.8) pounds compared to the control group [mean = 7.8 (±2.2) pounds]. There were no significant differences in physical activity (activity counts or daily minutes in moderate or more intense activity). The WMI group had significantly higher levels of patient activation. They also had (...) Weight management telehealth intervention for overweight and obese rural cardiac rehabilitation participants: A randomised trial To determine whether a weight management intervention (WMI) plus cardiac rehabilitation (CR) compared to CR alone improves outcomes for overweight and obese cardiac revascularisation patients.Despite participating in cardiac rehabilitation (CR), few cardiac patients lose enough weight to achieve clinically significant cardiovascular disease risk reduction.A randomised

2019 EvidenceUpdates

188. The Effects of Long-term CPAP on Weight Change in Patients With Comorbid OSA and Cardiovascular Disease: Data From the SAVE Trial

or cerebrovascular events and moderate to severe OSA. Participants with weight, BMI, and neck and waist circumferences measured at baseline and during follow-up were included. Linear mixed models were used to examine sex-specific temporal differences, and a sensitivity analysis compared high CPAP adherers (≥ 4 h per night) with propensity-matched control participants.A total of 2,483 adults (1,248 in the CPAP group and 1,235 in the control group) were included (mean 6.1 ± 1.5 measures of weight available). After (...) a mean follow-up of 3.78 years, there was no difference in weight change between the CPAP and control groups, for male subjects (mean [95% CI] between-group difference, 0.07 kg [-0.40 to 0.54]; P = .773) or female subjects (mean [95% CI] between-group difference, -0.14 kg [-0.37 to 0.09]; P = .233). Similarly, there were no significant differences in BMI or other anthropometric measures. Although male participants who used CPAP ≥ 4 h per night gained slightly more weight than matched male control

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2019 EvidenceUpdates

189. No Effect of Glucomannan on Body Weight Reduction in Children and Adolescents with Overweight and Obesity: A Randomized Controlled Trial

, respectively). Participants were assigned to receive glucomannan or placebo (maltodextrin), both at a dose of 3 g/d for 12 weeks and were followed up for the next 12 weeks. Concomitant care included dietary and lifestyle advice. The primary outcome was the difference in the BMI-for-age z score change between the groups at 12 weeks.Compared with the placebo, glucomannan had no effect on the BMI-for-age z score at 12 weeks (mean difference: 0.0, 95% CI -0.1 to 0.1). Compared with the placebo, the glucomannan (...) group had lower total and low-density lipoprotein cholesterol concentrations at 12 weeks. In addition, the blood pressure was greater at 12 weeks (systolic) and at 24 weeks (diastolic) in the glucomannan group. No differences between the groups in adverse events and other secondary outcomes were observed.Glucomannan supplementation compared with placebo had no effect on weight reduction in children with overweight and obesity.ClinicalTrials.govNCT02280772.Copyright © 2019 Elsevier Inc. All rights

2019 EvidenceUpdates

190. Effect of antenatal dietary interventions in maternal obesity on pregnancy weight-gain and birthweight: Healthy Mums and Babies (HUMBA) randomized trial

maternal weight gain, a secondary outcome, was lower with dietary intervention compared with routine dietary advice (9.7 vs 11.4 kg, adjusted mean difference, -1.76, 95% confidence interval, -3.55 to 0.03). There were no significant differences between intervention groups in other secondary maternal or neonatal outcomes.Although dietary education and or probiotics did not alter rates of excessive gestational weight gain or birthweight in this multiethnic, high-deprivation population of pregnant women (...) in an area of high deprivation.To determine whether a culturally tailored dietary intervention and or daily probiotic capsules in pregnant women with obesity reduces the co-primary outcomes of (1) excessive gestational weight gain (mean >0.27 kg/week) and (2) birthweight.We conducted a 2 × 2 factorial, randomized controlled trial in women without diabetes at pregnancy booking, body mass index ≥30 kg/m2, and a singleton pregnancy. At 12+0 to 17+6 weeks' gestation, eligible women were randomized

2019 EvidenceUpdates

191. Effect of Integrated Behavioral Weight Loss Treatment and Problem-Solving Therapy on Body Mass Index and Depressive Symptoms Among Patients With Obesity and Depression: The RAINBOW Randomized Clinical Trial. (PubMed)

(SD, 6.0) among usual care participants (between-group mean difference, -0.7 [95% CI, -1.1 to -0.2]; P = .01). Mean SCL-20 score declined from 1.5 (SD, 0.5) to 1.1 (SD, 1.0) at 12 months among intervention participants compared with a change in mean SCL-20 score from 1.5 (SD, 0.6) to 1.4 (SD, 1.3) among usual care participants (between-group mean difference, -0.2 [95% CI, -0.4 to 0]; P = .01). There were 47 adverse events or serious adverse events that involved musculoskeletal injuries (27 (...) Effect of Integrated Behavioral Weight Loss Treatment and Problem-Solving Therapy on Body Mass Index and Depressive Symptoms Among Patients With Obesity and Depression: The RAINBOW Randomized Clinical Trial. Coexisting obesity and depression exacerbate morbidity and disability, but effective treatments remain elusive.To test the hypothesis that an integrated collaborative care intervention would significantly improve both obesity and depression at 12 months compared with usual care.The Research

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2019 JAMA Controlled trial quality: predicted high

192. Comparative effect of saxagliptin and glimepiride with a composite endpoint of adequate glycaemic control without hypoglycaemia and without weight gain in patients uncontrolled with metformin therapy: Results from the SPECIFY study, a 48-week, multi-centr

%, duration <5 years or baseline BMI ≥25 kg/m2 . Mean reduction in HbA1c was similar in the two treatment groups at Week 48 (-0.94% with saxagliptin vs -0.98% with glimepiride; P = 0.439). Bodyweight decreased with saxagliptin, but increased with glimepiride over the treatment period, and the treatment difference was -1.6 kg (P < 0.001) at Week 48. The proportion of patients experiencing hypoglycaemia was much lower with saxagliptin vs glimepiride (3.1% vs 12.8%; P < 0.001).This study provides evidence (...) Comparative effect of saxagliptin and glimepiride with a composite endpoint of adequate glycaemic control without hypoglycaemia and without weight gain in patients uncontrolled with metformin therapy: Results from the SPECIFY study, a 48-week, multi-centr To compare the efficacy and safety of saxagliptin and glimepiride in type 2 diabetes (T2D) patients who are inadequately controlled with metformin monotherapy.In this 48-week, multi-centre, open-label, randomized, parallel trial (NCT02280486

2019 EvidenceUpdates

193. Relationships between type 2 diabetes remission after gastric bypass and different weight loss metrics: arguments against excess weight loss in metabolic surgery. (PubMed)

), mean 1.6 number of T2DM medication and HbA1c 7.5%. At 1 year 95% follow-up, with BMI 30.5 kg/m(2), 52.1% T2DM remission, 86.9% HbA1c<7.0%, and 63.6% without T2DM medication. No significant differences in T2DM outcome and weight loss were found with different baseline BMI, except for %EWL (P<.001). Weight loss was significantly better with better T2DM outcome, but for %EWL contradictory relationships were found in baseline-BMI subgroups. T2DM outcome was not less successful for patients with<50 (...) Relationships between type 2 diabetes remission after gastric bypass and different weight loss metrics: arguments against excess weight loss in metabolic surgery. Percentage excess weight loss (%EWL) outcome of bariatric surgery is distorted by deviations in baseline body mass index (BMI). It has been reported that this can lead to false conclusions, most likely because bariatric weight loss in fact is baseline-BMI independent.If the metabolic effect of bariatric surgery is baseline-BMI

2015 Surgery for Obesity and Related Diseases

194. What is an Odds Ratio? What does it mean?

Search for this keyword Main menu Log in using your username and password For personal accounts OR managers of institutional accounts Username * Password * your user name or password? You are here What is an Odds Ratio? What does it mean? Article Text Research made simple What is an Odds Ratio? What does it mean? Free Allison Shorten , Brett Shorten Statistics from Altmetric.com When we read the results of healthcare research, we often read about relationships or associations between different (...) of the control group, the interval does include the value of one. Therefore, there is a chance that the true NICU admission rates could be the same for both groups. This is reinforced by the p value of 0.07, which suggests that based on this study, we are less than 95% confident that a true difference exists. In statistical terms, the difference found is not ‘statistically significant’. What does this mean? We can conclude that this result deserves further study, perhaps using a RCT, to further examine

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2015 Evidence-Based Nursing

195. A school-based lifestyle intervention didn’t help children avoid unhealthy weight gain

with parental support. Final phase four in the autumn reinforced the messages learnt. The delivery format varied from assemblies to activity workshops and drama groups. Sessions were provided by HeLP coordinators with assistance from teachers and other personnel (e.g. actors and sportspersons). A total of 1,324 children participated, and 94% had a follow-up for two years. What did it find? HeLP had no effect on the main outcome of body mass index (BMI) at 24 months (mean difference [MD] between groups -0.02 (...) . There was no difference on weekends. Analysis of the child-completed My Lifestyle Questionnaire indicated that improved knowledge, confidence and motivation, and family approval might have been behind these dietary changes. The intervention was estimated to cost £214 per child. This was mainly attributed to costs of the various personnel, their training and travel. With no weight-related effects, nor reduction in obesity-related illness (such as diabetes or cardiovascular disease), it seemed clear the programme would

2018 NIHR Dissemination Centre

196. Intensive lifestyle interventions can help obese young people lose weight

for age and gender) than controls (mean difference [MD] -1.10, 95% confidence interval [CI] -1.30 to -0.89; six trials, 1049 participants). In terms of actual weight change from baseline children in intervention groups varied from +2 to -7lb vs +8 to +17lb among controls. Contact time between 26 and 51 hours was still effective compared to control but less beneficial (BMI or z score MD -0.34, 95% CI -0.52 to -0.16; nine trials, 721 participants). Weight change was highly variable, but all groups (...) by the US Preventive Task Force. What did it find? Children receiving at least 52 hours of contact time in behaviour-based weight loss interventions showed greater reduction in BMI or BMI z score (how much BMI deviates from the norm for age and gender) than controls (mean difference [MD] -1.10, 95% confidence interval [CI] -1.30 to -0.89; six trials, 1049 participants). In terms of actual weight change from baseline children in intervention groups varied from +2 to -7lb vs +8 to +17lb among controls

2018 NIHR Dissemination Centre

197. 52-week programme leads to more weight loss than 12-week

of approaches that people can take to reduce their weight. The first challenge is losing weight, but people can find it difficult to keep off the weight that they have lost. NICE recommends that GPs refer obese people (and overweight if there is capacity) to lifestyle weight management programmes that last for at least three months. To date, studies have compared different programmes but not directly looked at whether longer programmes may offer better results. This trial investigated whether referring (...) in all groups had regained some weight, but weight loss since the start of the trial was still significantly different between groups: 52-weeks ‑4.29kg; 12-weeks ‑3.00kg; and brief intervention ‑2.30kg. Participants receiving either the 12- or 52-week programme were more likely to have lost 5% of their body weight by one year (42% and 57%, respectively) compared to the brief intervention (25%). By two years fewer people had maintained 5% loss, but both programmes were still more effective than

2018 NIHR Dissemination Centre

198. A supported web-based programme helps people lose weight in the short term

maintained nearly 3 kg of weight loss per person (mean weight per person: baseline, 104.4 kg; 6 months, 101.9 kg; 12 months, 101.7 kg). Compared with the control group, the estimated additional weight reduction with POWeR+F was 1.5 kg [95% confidence interval (CI) 0.6 to 2.4 kg; p = 0.001] and with POWeR+R was 1.3 kg (95% CI 0.34 to 2.2 kg; p = 0.007). By 12 months the mean weight loss was not statistically significantly different between groups, but 20.8% of control participants, 29.2% of POWeR+F (...) and this was similar between groups. What did it find? The three groups all lost weight, with average weight loss at 12 months of 2.65kg for the control group, 3.84kg for the POWeR+ with face-to-face support programme and 3.21kg for the POWeR+ with email or phone support programme. Differences were not statistically significant. The proportion of people who had lost at least 5% of body weight at 12 months was statistically significant for the POWeR+ group with email and phone support compared to control. At 12

2018 NIHR Dissemination Centre

199. A group weight loss programme shows promise compared with usual approach

practice (109). What did it find? The WAP group lost on average 4.2kg at 12-months compared to 2.3kg in the usual practice group (mean difference 1.9kg, 95% confidence interval ‑3.7kg to ‑0.1kg). At 12 months, 41% of WAP participants (61/149) had lost at least 5% of their starting body weight compared to 27% (22/83) of those receiving usual practice. Dropout rates were higher in the usual care group – 31% did not complete more than half of the sessions compared to 21% of the WAP group. A cost (...) . In the usual practice group diet and exercise advice was provided during four individual sessions over an eight-week period, plus two follow-up sessions. “Exercise on prescription” referrals were also available. Twice as many adults were allocated to the WAP (221) than usual practice (109). What did it find? The WAP group lost on average 4.2kg at 12-months compared to 2.3kg in the usual practice group (mean difference 1.9kg, 95% confidence interval ‑3.7kg to ‑0.1kg). At 12 months, 41% of WAP participants

2018 NIHR Dissemination Centre

200. Metformin shows early promise for controlling clozapine-related weight gain

analysis. This analysis may be misleading as the non-random drop out of participants or cross over or people from control to treatment groups are not taken into account. Well-designed European trials would help to resolve and uncertainty in the research so far. What did it find? After a follow-up period of 12 weeks to six months: There was greater weight loss for people on metformin compared to placebo (mean difference ‑3.12kg, 95% confidence interval [CI] ‑4.88kg to ‑1.37kg). BMI was lower for people (...) ? After a follow-up period of 12 weeks to six months: There was greater weight loss for people on metformin compared to placebo (mean difference ‑3.12kg, 95% confidence interval [CI] ‑4.88kg to ‑1.37kg). BMI was lower for people on metformin than placebo (mean differences ‑1.18kg/m2, 95% CI ‑1.76kg/m2 to ‑0.61kg/m2). Waist circumference was smaller in people receiving metformin compared to placebo (mean difference ‑1.69cm, 95% CI ‑3.06cm to ‑0.32cm). Glucose and triglycerides were significantly lower

2018 NIHR Dissemination Centre

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