Dueromero5047

Persistent throat symptoms are commonly attributed to 'laryngopharyngeal reflux'. Despite a limited evidence base, these symptoms are increasingly being treated in primary care with proton pump inhibitors.

To assess the value of proton pump inhibitor therapy in patients with persistent throat symptoms.

This was a double-blind, placebo-controlled, randomised Phase III trial.

This was a multicentre UK trial in eight UK ear, nose and throat departments.

A total of 346 participants aged ≥ 18 years with persistent throat symptoms and a Reflux Symptom Index score of ≥ 10, exclusive of the dyspepsia item, were recruited.

Random allocation (1  1 ratio) to either 30 mg of lansoprazole twice daily or matched placebo for 16 weeks.

Symptomatic response (i.e. total Reflux Symptom Index score after 16 weeks of therapy).

A total of 1427 patients were screened and 346 were randomised. The mean age was 52 years (standard deviation 13.7 years, range 20-84 years); 150 (43%) participants were male and 196 (57%) w Phase III trial found no evidence of benefit for patients by treating persistent throat symptoms with lansoprazole.

Current Controlled Trials ISRCTN38578686 and EudraCT number 2013-004249-17.

This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in

 ; Vol. 25, No. 3. See the NIHR Journals Library website for further project information.

This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 25, No. 3. See the NIHR Journals Library website for further project information.A bisphenol A-degrading bacterium, designated as strain H4T, was isolated from surface seawater, which was sampled from the Jiulong River estuary in southeast PR China. Strain H4T is Gram-stain-negative, aerobic, short rod-shaped, lacking bacteriochlorophyll a, motile with multifibrillar stalklike fascicle structures and capable of degrading bisphenol A. Growth of strain H4T was observed at 24-45 °C (optimum, 32 °C), at pH 5.5-9 (optimum, pH 7.0) and in 0-7 % NaCl (optimum, 2 %; w/v) . The 16S rRNA gene sequence of strain H4T showed highest similarity to Croceicoccus pelagius Ery9T (98.7 %), Croceicoccus sediminis (98.3 %), Croceicoccus naphthovorans PQ-2T (98.1 %) and Croceicoccus ponticola GM-16T (97.6 %), followed by Croceicoccus marinus E4A9T (96.7 %) and Croceicoccus mobilis Ery22T (96.0 %). GSK2256098 Phylogenetic analysis revealed that strain H4T fell within a clade comprising the type strains of Croceicoccus species and formed a phyletic line with them that was distinct from other members of the family Erythrobacteraceae. The sole respiratory quinone was quinone 10 (Q-10). The predominant fatty acids (>5 % of the total fatty acids) of strain H4T were summed feature 8 (C18  1 ω6c and/or C18  1 ω7c), summed feature 3 (C16  1 ω6c and/or C16  1 ω7c), C17  1 ω6c and C14  02-OH. The genomic DNA G+C content was 62.8 mol%. In the polar lipid profile, phosphatidylcholine, phosphatidylethanolamine, phosphatidylglycerol, two unidentified phospholipids, two sphingoglycolipids and three unknown lipids were the major compounds. Based on the genotypic and phenotypic data, strain H4T represents a novel species of the genus Croceicoccus, for which the name Croceicoccus bisphenolivorans sp. nov. is proposed. The type strain is H4T (=DSM 102182T=MCCC1 K02301T).Introduction.Staphylococcus epidermidis is predominant in implant-associated infections due to its capability to form biofilms. It can deploy several strategies for biofilm development using either polysaccharide intercellular adhesin (PIA), extracellular DNA (eDNA) and/or proteins, such as the extracellular matrix-binding protein (Embp).Hypothesis/Gap Statement. We hypothesize that the dichotomic regulation of S. epidermidis adhesins is linked to whether it is inside a host or not, and that in vitro biofilm investigations in laboratory media may not reflect actual biofilms in vivo.Aim. We address the importance of PIA and Embp in biofilm grown in 'humanized' media to understand if these components play different roles in biofilm formation under conditions where bacteria can incorporate host proteins in the biofilm matrix.Methodology.S. epidermidis 1585 WT (deficient in icaADBC), and derivative strains that either lack embp, express embp from an inducible promotor, or express icaADBC from a plasmid, were cultbiofilms formed by polysaccharide-producing and Embp-producing strains in different media, there were no differences in vancomycin penetration or susceptibility.Conclusion. We suggest that the assumed importance of polysaccharides for biofilm formation is an artefact from studying biofilms in laboratory media void of human matrix components. The cell-cell aggregation of S. epidermidis can be activated by host factors without relying on either of the major adhesins, PIA and Embp, indicating a need to revisit the basic question of how S. epidermidis deploys self-produced and host-derived matrix components to form antibiotic-tolerant biofilms in vivo.The association between the prevalence and geographical distribution of peripheral artery disease (PAD) and chronic limb-threatening ischemia (CLTI) in patients with diabetes in the context of socioeconomic deprivation is not well understood. We undertook a retrospective cohort study of 76,307 people with diabetes admitted as a hospital inpatient in a large Scottish health administrative area. Utilising linked health records, we identified diagnoses of PAD and/or CLTI and their distribution using small area cartography techniques according to multiple deprivation maps. Spatial autocorrelation techniques were applied to examine PAD and CLTI patterning. Association between crude inpatient prevalence-adjusted outcome rates and exposure to social deprivation were determined. We found crude prevalence-adjusted rates of 8.05% for PAD and 1.10% for CLTI with a five- to sevenfold difference from the least to most deprived regions. Statistically significant hot spots were found for PAD (p less then 0.001) and CLTI (p less then 0.001) in the most deprived areas, and cold spots for PAD (p less then 0.001) but not CLTI (p = 0.72) in the least deprived areas. Major health disparities in PAD/CLTI diagnoses in people with diabetes is driven by socioeconomic deprivation.

Medication for opioid use disorder (MOUD) with buprenorphine is effective in treating opioid use disorder yet remains underutilized. Scant research has examined the experience of patients, clinic staff, and providers in a "low-threshold" group-based MOUD program. This study evaluates a "low-threshold" MOUD program at a federally qualified health center (FQHC) in Philadelphia, Pennsylvania through the perspectives of its key stakeholders.

This qualitative study involved focus groups of patients, providers, and clinic staff. Focus groups were conducted between October 2017 and June 2018. Grounded theory was used for analysis.

There were a total of 10 focus groups, including 20 patient participants and 26 staff members. Program participants noted that a strength of the program is its person-centered harm reduction approach, which is reflected in the program's policies and design. Program participants discussed the programmatic design choices that facilitated their participation and engagement in the progntered harm reduction, low-barrier approach, the structure of group-based visits, and integrated care contributes to increased patient access and retention. Understanding the strengths and challenges of the program may be useful for other safety-net clinics considering a MOUD program.International emergency management and disaster risk reduction policies and planning have rarely included lesbian, gay, bisexual, transgender, intersex, and queer (LGBTIQ) people's specific health and wellbeing concerns, despite increasing research showing that these groups face some specific vulnerabilities and additional challenges. Emerging studies in the US and UK noted increased feelings of loneliness, minority stress, and vulnerability to family violence since the outbreak of COVID-19. However, little is known about LGBTIQ people's experiences of COVID-19 in Australia. This article explores the effects of COVID-19 on LGBTIQ mental health and wellbeing in Tasmania, Australia. Drawing on a survey of 231 LGBTIQ respondents aged 14-78, we use the spaces of wellbeing framework to examine the impacts of COVID-19 restrictions on LGBTIQ (in)visibility in relation to the public, private, and online spaces, arguing that COVID-19 restrictions affected LGBTIQ Tasmanians' experiences and use of spaces in ways that detracted from wellbeing, visibility, and belonging.Objective To characterize the epidemiology of overweight athletes before and after the introduction of the Early Weigh-In Policy (EWIP).Methods A retrospective cohort study examined the weigh-in results for professional mixed martial arts (MMA) events over a 2-year period around the introduction of the new EWIP between 2014 and 2018. Descriptive statistics were used to characterize the study populations. Risk ratios were used to identify differences in the study populations before and after the introduction of the EWIP.Results After the introduction of the EWIP, the number of overweight athletes increased from 5.7% to 8.4% and the average overweight mass increased from 1.3 kg (2.9 lbs) to 1.8 kg (3.9 lbs) [difference, 0.5 kg (1.0 lb), p = 4.35 × 10^(-5)]. The proportion of athletes is not distributed similarly across the different overweight mass categories when comparing the pre- and post-EWIP time frames (p = 0.006). More athletes in the pre-EWIP period were overweight by smaller amount, while in the post-EWIP period athletes were overweight by larger amount. Of the athletes who were overweight before the regulation change, 28.7% were over the weight limit by greater than 1.8 kg (4 lbs), compared to 39.5% after the new EWIP introduction. On average, the ratio of overweight athletes per events by commission was 1.2 before the introduction of the EWIP and 2.1 after.Conclusion These results appear to indicate that the EWIP has not altered weight-cutting culture in MMA in a positive manner. This study casts doubt on the benefits of an EWIP and raised the possibility of utilizing the longitudinal weight monitoring approach to mitigate rapid weight-cycling behavior. However, before additional changes are made by any athletic commission, further research is needed to examine the efficacy of the abovementioned longitudinal weight monitoring approach or any other strategy.Background Pre-loading of alcohol and other drugs has become a prevalent start to nights out in many countries. Studies into pre-loading have been using different operational definitions and descriptions, leading to confusion and debate in the research literature. Purpose/Objective We wish to propose a full taxonomy so that research into preloading, of any substances, can be specific and standardized. Methods We address this problem by analyzing (1) terminology used throughout the literature, (2) the evolving nature of this phenomenon, and (3) the operational components comprising this substance use practice. Additionally, we provide a context and rationale for how we view pre-loading in relation to the broader event-level session. Results Our results propose a full operational definition and taxonomy of pre-loading to be used, and built upon, by researchers. We also provide a visual representation of pre-loading within an event-level session and provide a method to facilitate consistency across cultures. Conclusions We propose that this system will lead to greater specificity and higher reliability in the interpretation of research results.