Operative treatment of dislocated midshaft clavicular fractures: Plate or intramedullary nail fixation?: A randomized controlled trial

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Acquisition and clearance of perianal human papillomavirus infection in relation to HIV-positivity in men who have sex with men in the Netherlands

This study was performed to establish the prevalence of perianal human papillomavirus (HPV) infection in relation to HIV-positivity in a group of men who have sex with men (MSM), and to correlate follow-up data with regard to acquisition and clearance of HPV infection. Data with regard to HPV prevalence and HIV serostatus during two visits were compared. At both visits participants underwent a routine venereological examination and swabs were taken from the perianal region for HPV DNA testing. During both visits HPV types 16, 18, 31, 33 and 52 were significantly more often detected in HIV-positive individuals. Persistence of HPV type 31 at the perianal region was significantly more often seen in HIV-positive MSM (p=0.036) while the incidence of type 16 may be associated with HIV positivity (p=0.059). In HIV-positive MSM significantly more high-risk HPV types were detected at the perianal region

Prevention of dementia using mobile phone applications (PRODEMOS): protocol for an international randomised controlled trial.

IntroductionProfiles of high risk for future dementia are well understood and are likely to concern mostly those in low-income and middle-income countries and people at greater disadvantage in high-income countries. Approximately 30%-40% of dementia cases have been estimated to be attributed to modifiable risk factors, including hypertension, smoking and sedentary lifestyle. Tailored interventions targeting these risk factors can potentially prevent or delay the onset of dementia. Mobile health (mHealth) improves accessibility of such prevention strategies in hard-to-reach populations while at the same time tailoring such approaches. In the current study, we will investigate the effectiveness and implementation of a coach-supported mHealth intervention, targeting dementia risk factors, to reduce dementia risk.Methods and analysisThe prevention of dementia using mobile phone applications (PRODEMOS) randomised controlled trial will follow an effectiveness-implementation hybrid design, taking place in the UK and China. People are eligible if they are 55-75 years old, of low socioeconomic status (UK) or from the general population (China); have ≥2 dementia risk factors; and own a smartphone. 2400 participants will be randomised to either a coach-supported, interactive mHealth platform, facilitating self-management of dementia risk factors, or a static control platform. The intervention and follow-up period will be 18 months. The primary effectiveness outcome is change in the previously validated Cardiovascular Risk Factors, Ageing and Incidence of Dementia dementia risk score. The main secondary outcomes include improvement of individual risk factors and cost-effectiveness. Implementation outcomes include acceptability, adoption, feasibility and sustainability of the intervention.Ethics and disseminationThe PRODEMOS trial is sponsored in the UK by the University of Cambridge and is granted ethical approval by the London-Brighton and Sussex Research Ethics Committee (reference: 20/LO/01440). In China, the trial is approved by the medical ethics committees of Capital Medical University, Beijing Tiantan Hospital, Beijing Geriatric Hospital, Chinese People's Liberation Army General Hospital, Taishan Medical University and Xuanwu Hospital. Results will be published in a peer-reviewed journal.Trial registration numberISRCTN15986016

Ecological Guild Evolution and the Discovery of the World's Smallest Vertebrate

Living vertebrates vary drastically in body size, yet few taxa reach the extremely minute size of some frogs and teleost fish. Here we describe two new species of diminutive terrestrial frogs from the megadiverse hotspot island of New Guinea, one of which represents the smallest known vertebrate species, attaining an average body size of only 7.7 mm. Both new species are members of the recently described genus Paedophryne, the four species of which are all among the ten smallest known frog species, making Paedophryne the most diminutive genus of anurans. This discovery highlights intriguing ecological similarities among the numerous independent origins of diminutive anurans, suggesting that minute frogs are not mere oddities, but represent a previously unrecognized ecological guild

Neonatal herpes infections in The Netherlands in the period 2006-2011

Objective: To monitor the incidence of neonatal herpes in The Netherlands between 2006 and 2011, as well as the adherence to the rather conservative Dutch prevention policy. Methods: Questionnaires were sent to all virology laboratories (n=44), gynaecology and paediatrics departments of all hospitals in The Netherlands (n=89). Questionnaires for the laboratories pertained to rates of proven cases of neonatal herpes; for the gynaecologists and paediatricians it pertained to rates of genital herpes during pregnancy and neonatal herpes, and their policy. For gynaecologists this concerned the risk of herpes simplex virus transmission in case of primary genital herpes during pregnancy or labour; for paediatricians it concerned the diagnostic policy in a neonate suspected of neonatal herpes. Results: For the period 2006-2011 38 cases of neonatal herpes were reported, yielding an incidence of 4.7 per 100 000 births. The estimated annual number of pregnant women with primary or recurrent genital herpes was 278. Of the responding gynaecologists and paediatricians, only 59% and up to 39%, respectively, reported a policy in accordance with the national guideline. Conclusions: The incidence of neonatal herpes in The Netherlands seems to have increased in the period 2006-2011. Combined with suboptimal guideline adherence this warrants strategies to improve awareness and subsequent adherence