Cost Analysis of Long-Term Treatment of Patients with Symptomatic Gastroesophageal Reflux Disease (GERD) with Esomeprazole On-Demand Treatment or Esomeprazole Continuous Treatment: An Open, Randomized, Multicenter Study in Switzerland.

Objectives: To assess the difference in direct medical costs between on-demand (OD) treatment with esomeprazole (E) 20 mg and continuous (C) treatment with E 20 mg q.d. from a clinical practice view in patients with gastroesophageal reflux disease (GERD) symptoms. Methods: This open, randomized study (ONE: on-demand Nexium evaluation) compared two long-term management options with E 20 mg in endoscopically uninvestigated patients seeking primary care for GERD symptoms who demonstrated complete relief of symptoms after an initial treatment of 4 weeks with E 40 mg. Data on consumed quantities of all cost items were collected in the study, while data on prices during the time of study were collected separately. The analysis was done from a societal perspective. Results: Forty-nine percent (484 of 991) of patients randomized to the OD regimen and 46% (420 of 913) of the patients in the C group had at least one contact with the investigator that would have occurred nonprotocol-driven. The difference of the adjusted mean direct medical costs between the treatment groups was CHF 88.72 (95% confidence interval: CHF 41.34-153.95) in favor of the OD treatment strategy (Wilcoxon rank-sum test: P < 0.0001). Adjusted direct nonmedical costs and productivity loss were similar in both groups. Conclusions: The adjusted direct medical costs of a 6-month OD treatment with esomeprazole 20 mg in uninvestigated patients with symptoms of GERD were significantly lower compared with a continuous treatment with E 20 mg once a day. The OD therapy represents a cost-saving alternative to the continuous treatment strategy with E.

Radiotherapy and temozolomide for newly diagnosed glioblastoma: recursive partitioning analysis of the EORTC 26981/22981-NCIC CE3 phase III randomized trial.

PURPOSE: The European Organisation for Research and Treatment of Cancer and National Cancer Institute of Canada trial on temozolomide (TMZ) and radiotherapy (RT) in glioblastoma (GBM) has demonstrated that the combination of TMZ and RT conferred a significant and meaningful survival advantage compared with RT alone. We evaluated in this trial whether the recursive partitioning analysis (RPA) retains its overall prognostic value and what the benefit of the combined modality is in each RPA class. PATIENTS AND METHODS: Five hundred seventy-three patients with newly diagnosed GBM were randomly assigned to standard postoperative RT or to the same RT with concomitant TMZ followed by adjuvant TMZ. The primary end point was overall survival. The European Organisation for Research and Treatment of Cancer RPA used accounts for age, WHO performance status, extent of surgery, and the Mini-Mental Status Examination. RESULTS: Overall survival was statistically different among RPA classes III, IV, and V, with median survival times of 17, 15, and 10 months, respectively, and 2-year survival rates of 32%, 19%, and 11%, respectively (P < .0001). Survival with combined TMZ/RT was higher in RPA class III, with 21 months median survival time and a 43% 2-year survival rate, versus 15 months and 20% for RT alone (P = .006). In RPA class IV, the survival advantage remained significant, with median survival times of 16 v 13 months, respectively, and 2-year survival rates of 28% v 11%, respectively (P = .0001). In RPA class V, however, the survival advantage of RT/TMZ was of borderline significance (P = .054). CONCLUSION: RPA retains its prognostic significance overall as well as in patients receiving RT with or without TMZ for newly diagnosed GBM, particularly in classes III and IV.

Water stress before harvest of pepper-rosmarin

The objective of this work was to assess the effect of different periods of water stress before harvest of pepper-rosmarin (Lippia sidoides) on the contents of essential oil and flavonoids. The experiment was carried out during 270 days of cultivation, with drainage lysimeters, in a completely randomized block design with five treatments: 0, 2, 4, 6, and 8 days of water suppression before harvest, with four replicates. Fresh and dry matter yield, essential oil content, total flavonoids content, and water potential and temperature of leaves were determined. There was a decrease of approximately 50% in oil content and of 60% in total flavonoid content with the reduction of leaf water potential in 0.3 MPa. Essential oil is more sensitive to water stress than total flavonoids.

Glioblastoma in elderly patients: health-related quality of life (hrqol) in a randomized trial comparing 6-weeks of tadiotherapy (rt) vs hypofractionated rt over 2 weeks vs temozolomide chemotherapy (tmz)

BACKGROUND: Despite advances in treatment, survival of patients with GBM over 60 years is still often less than 1 year. In the perspective of a short expected survival, the quality of the remaining life and the effects of therapy on health-related quality of life (HRQoL) should be given special emphasis when recommending treatment for the individual patients. Several studies have focused on survival of the elderly, but few data are available on HRQoL for different treatments. In a randomized trial, we compared survival and HRQoL for 3 treatment options, 6 weeks of RT, vs hypofractionated RT, or chemotherapy with TMZ. MATERIALS AND METHODS: Newly diagnosed GBM patients, age ≥60 years with PS 0-2, were randomized to either standard RT (60 Gy in 2-Gy fractions over 6 weeks), hypofractionated RT (34 Gy in 3.4-Gy fractions over 2 weeks), or 6 cycles of chemotherapy with TMZ (200 mg/m2 day 1-5 every 28 days). QoL was determined by the EORTC QLQ 30 questionnaire and the Brain Cancer Module at inclusion, before start of therapy, at 6 weeks, 3 months, and 6 months after start of treatment. Patients were followed until death. The primary study endpoint was overall survival (OS) and secondary objectives were HRQoL, neurologic symptom control, and safety. RESULTS: A total of 342 patients were included and 292 patients were randomized between the 3 treatment options and 50 patients between hypofractionated RT and TMZ. Median age was 70 years (range 60-92) with 58% being male. Performance status was 0-1 for 75% of patients and 73% had undergone surgical resection. CONCLUSION: The results from the HRQoL analysis of this trial will be presented together with survival data at the upcoming EANO meeting.

Prediction of direct and indirect genetic gains and genotypic correlations in rubber tree progenies

The objective of this work was to estimate the genetic parameters, genotypic and phenotypic correlations, and direct and indirect genetic gains among and within rubber tree (Hevea brasiliensis) progenies. The experiment was set up at the Municipality of Jaú, SP, Brazil. A randomized complete block design was used, with 22 treatments (progenies), 6 replicates, and 10 plants per plot at a spacing of 3x3 m. Three‑year‑old progenies were assessed for girth, rubber yield, and bark thickness by direct and indirect gains and genotypic correlations. The number of latex vessel rings showed the best correlations, correlating positively and significantly with girth and bark thickness. Selection gains among progenies were greater than within progeny for all the variables analyzed. Total gains obtained were high, especially for girth increase and rubber yield, which were 93.38 and 105.95%, respectively. Young progeny selection can maximize the expected genetic gains, reducing the rubber tree selection cycle.

Acclimatization of Tapeinochilos ananassae plantlets in association with arbuscular mycorrhizal fungi

The objective of this work was to assess the potential of three isolates of arbuscular mycorrhizal fungi to promote growth of micropropagated plantlets of Tapeinochilos ananassae during acclimatization. The experiment was carried out in greenhouse, in a completely randomized block design, with four inoculation treatments: non‑inoculated control and plants inoculated with Glomus etunicatum, Acaulospora longula or Gigaspora albida, with ten replicates. After 90 days, the following parameters were evaluated: survival rate, height, leaf and tiller number, leaf area, fresh and dry biomass, contents of macro‑ and micronutrients in the root and shoot, glomerospore number, and mycorrhizal colonization. The survival percentage was 100%, except for plants inoculated with G. albida (80%). The isolate G. etunicatum is more suitable for plant development, since it improves survival, growth, dry matter production, nutritional status, and vigor of T. ananassae micropropagated plants.

'Royal Gala' apple quality stored under ultralow oxygen concentration and low temperature conditions

The objective of this work was to evaluate the interaction of ultralow oxygen concentrations (ULO) with storage temperatures and carbon dioxide partial pressures and its influence on fruit quality preservation and on the occurrence of physiological disorders in 'Royal Gala' apples. The experiment was carried out in a completely randomized design, with four replicates 25-fruit. ULO conditions (1.0 kPa O2 + 2.0 kPa CO2; 0.8 kPa O2 + 1.5 kPa CO2; 0.8 kPa O2 + 1.0 kPa CO2; 0.6 kPa O2 + 1.5 kPa CO2; and 0.6 kPa O2 + 1.0 kPa CO2) were tested at 0, 0.5 and 1.0°C, in a 5x3 factorial arrangement. Fruit quality and ripening analyses were performed after eight-month storage plus seven days of shelf-life at 20°C. Oxygen partial pressures below 0.8 kPa increased the occurrence of internal breakdown and mealiness. The best ULO condition was 1.0 kPa O2 + plus 2.0 kPa CO2 at 1.0°C. The interaction of ULO conditions and storage temperatures shows the need of increasing O2 partial pressure at higher storage temperatures.

Leaf miner incidence in coffee plants under different drip irrigation regimes and planting densities

The objective of this work was to evaluate the effect of different drip irrigation regimes and planting densities on the incidence of the leaf miner, Leucoptera coffeella, in arabica coffee plants for one year. The experiment was carried out in 2008, in a complete randomized block design, in a split-plot in time arrangement, with four replicates. The treatments consisted of four drip irrigation regimes - soil water balance, irrigations at 20 and 60 kPa soil tensions, and a nonirrigated treatment -, which were distributed at three plant densities: 2, 500, 5, 000, and 10, 000 plants per hectare. The evaluations were made on a monthly basis between January and December 2008. The highest pest occurrence period was from August to November, a season with low-air relative humidity preceded by a drought period. Irrigated coffee plants showed an incidence of intact mines 2.2 times lower than that of nonirrigated plants. Irrigation and increasing of plant density contribute to the reduction of coffee leaf miner occurrence.

Cover crops and herbicide timing management on soybean yield under no-tillage system

The objective of this work was to evaluate the effect of cover crops and timing of pre-emergence herbicide applications on soybean yield under no-tillage system. The experiment consisted of four cover crops (Panicum maximum, Urochloa ruziziensis, U. brizantha, and pearl millet) and fallow, in addition to four herbicide timings (30, 20, 10, and 0 days before soybean sowing), under no-tillage system (NTS), and of two control treatments under conventional tillage system (CTS). The experimental design was a completely randomized block, in a split-plot arrangement, with three replicates. Soybean under fallow, P. maximum, U. ruziziensis, U. brizantha, and pearl millet in the NTS and soybean under U. brizantha in the CTS did not differ significantly regarding yield. Soybean under fallow in the CTS significantly reduced yield when compared to the other treatments. The amount of straw on soil surface did not significantly affect soybean yield. Chemical management of P. maximum and U. brizantha near the soybean sowing date causes significant damage in soybean yield. However, herbicide timing in fallow, U. ruziziensis, and pearl millet does not affect soybean yield.

Motivational brief intervention for the prevention of sexually transmitted infections in travelers: a randomized controlled trial.

Background: Sexually transmitted infections (STIs) are among the frequent risks encountered by travelers. Efficient interventions are needed to improve the understanding of the risks of STIs. We investigated the potential benefits of a motivational brief intervention (BI) and the provision of condoms on the engagement in unprotected casual sex.Methods: 3-arm randomized controlled trial performed among single travelers aged 18-44 years visiting a travel clinic in Switzerland. The main outcomes were the prevalence of casual unprotected sexual intercourse and their predictors.Results: 5148 eligible travelers were seen from 2006 to 2008. 1681 agreed to participate and 1115 subjects (66%) completed the study. 184/1115 (17%) had a casual sexual relationship abroad and overall 46/1115 (4.1%) had inconsistently protected sexual relations. Women (adjusted OR 2.7 [95% CI 1.4-5.6]) and travelers with a history of past STI (adjusted OR 2.8 [95% CI 1.1-7.4]) had more frequent casual sexual relationships without consistent protection. Regarding the effect of our intervention, the prevalence of subjects using condoms inconsistently was 28% (95% CI 16-40) in the motivational BI group, 24% (95% CI 10-37) in the condoms group and 24% (95% CI 14-33) in the control group (p = 0.7).Conclusion: This study showed that a motivational brief intervention and/or the provision of free condoms did not modify risky sexual behavior of young travelers. The rate of inconsistently protected sexual relationships during travel was however lower than expected

Soil fertility and upland rice yield after biochar application in the Cerrado

The objective of this work was to evaluate the effect of biochar made from Eucalyptus on soil fertility, and on the yield and development of upland rice. The experiment was performed during two years in a randomized block design with four replicates, in a sandy loam Dystric Plinthosol. Four doses of NPK 05-25-15, annually distributed in stripes (0, 100, 200 and 300 kg ha-1), and four doses of biochar (0, 8, 16 and 32 Mg ha-1), applied once in the first year - alone or with NPK - were evaluated. In the first year, biochar positively affected soil fertility [total organic carbon (TOC), Ca, P, Al, H+Al, and pH], at 0-10 cm soil depth, and it was the only factor with significant effect on yield. In the second year, the effect of biochar diminished or was overcome by the fertilizer. TOC moved down in the soil profile to the 0-20 cm depth, influencing K availability in this layer. In the second year, there was a significant interaction between biochar and the fertilizer on plant growth and biomass dry matter accumulation.

Phosphorus utilization by corn as affected by green manure, nitrogen and phosphorus fertilizers

The objective of this work was to evaluate the utilization by corn plants of P from triple superphosphate fertilizer labeled with 32P (32P‑TSP), and of P from soil as affected by N rates and by the green manures (GM) sunn hemp (Crotalaria juncea) and millet (Pennisetum glaucum). The experiment was carried out using pots filled with 5 kg Oxisol (Rhodic Hapludox). A completely randomized design was used, in a 4x4x2 factorial arrangement, with four replicates. The treatments were: four P rates as TSP (0, 0.175, 0.350, and 0.700 g P per pot); four N rates as urea (0, 0.75, 1.50, and 2.25 g N per pot); and sunn hemp or millet as green manure. The additions of N and P by the GM were taken into account. After grain physiologic maturation, corn dry matter, P contents, accumulated P, and P recovery in the different treatments were measured. 32P‑TSP recovery by corn increased with N increasing rates, and decreased with increasing rates of 32P‑TSP. The mineral fertilizer provides most of the accumulated P by corn plants. The recovery of 32P‑TSP by corn was 13.12% in average. The green manure species influence the assimilation of 32P‑TSP by the plants.

Gas exchange rates, plant height, yield components, and productivity of upland rice as affected by plant regulators

The objective of this work was to evaluate gas exchange rates, plant height, yield components, and productivity of upland rice, as affected by type and application time of plant growth regulators. A randomized block design, in a 4x2 factorial arrangement, with four replicates was used. Treatments consisted of three growth regulators (mepiquat chloride, trinexapac-ethyl, and paclobutrazol), besides a control treatment applied at two different phenological stages: early tillering or panicle primordial differentiation. The experiment was performed under sprinkler-irrigated field conditions. Net CO2 assimilation, stomatal conductance, plant transpiration, and water-use efficiency were measured four times in Primavera upland rice cultivar, between booting and milky grain phenophases. Gas exchange rates were neither influenced by growth regulators nor by application time. There was, however, interaction between these factors on the other variables. Application of trinexapac-ethyl at both tillering and differentiation stages reduced plant height and negatively affected yield components and rice productivity. However, paclobutrazol and mepiquat chloride applied at tillering, reduced plant height without affecting rice yield. Mepiquat chloride acted as a growth stimulator when applied at the differentiation stage, and significantly increased plant height, panicle number, and grain yield of upland rice.

Influence of misoprostol or prostaglandin E(2) for induction of labor on the incidence of pathological CTG tracing: a randomized trial.

OBJECTIVE: To compare the efficacy and safety of misoprostol (prostaglandin E(1) (PGE(1))) with dinoprostone (prostaglandin E(2) (PGE(2))) for third trimester cervical ripening and labor induction. STUDY DESIGN: Patients requiring induction of labor were randomly assigned to receive either 50 microg of intravaginal misoprostol every 4 h or 0.5 mg of intracervical dinoprostone gel every 6 h. Eligibility criteria included gestation = 36 weeks. Primary outcome was the time interval from induction to delivery; secondary outcomes were mode of delivery, perinatal outcome, and interpretation of cardiotocogram (CTG) records. RESULTS: Two hundred women were randomly enrolled to receive either misoprostol (n = 100) or dinoprostone (n = 100). Time induction-to-delivery at 12, 24 and 48 h and the need for oxytocin were reduced with misoprostol (P < 0.05). Pathological CTG tracing according to FIGO and Melchior scores were more frequent in the misoprostol-treated group (P < 0.001). CONCLUSION: Misoprostol shortened the induction-to-delivery interval, but is associated with a higher incidence of abnormal CTG than prostaglandin E(2).