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citentan, riociguat, and selexipag sufficiently improved clinical parameters and was well tolerated in patients with PAH. This combination could be a particularly promising strategy in patients with low/intermediate risk and possibly even in half of patients with high risk. Further studies are needed to validate these findings.The reviews of this paper are available via the supplemental material section.A systematic review and thematic synthesis were conducted on the motivations, purposes, and influence of pornography use among women who are in committed relationships. Pornography use was identified as having both positive and negative outcomes for women's sexual and relationship lives. Women watched pornography for diverse reasons to feel sexually empowered, to enhance sexual arousal, and for masturbation purposes. Shared use of pornography with partners provided variety in sexual activities, could aid communication about sexual issues and helped improve intimacy. Pornography use can help some women feel sexually empowered, relaxed and better able to enjoy their sexual lives.Purpose Translate and adapt the Multidimensional Outcome Expectations for Exercise Scale (MOEES) into Swedish language and to explore psychometric properties, in terms of test-retest reliability, internal consistency as well as factor structure and floor and ceiling effects, of the Swedish version of MOEES in cardiac patients.Materials and methodsThis prospective psychometrical study set in a Swedish cardiac rehabilitation outpatient clinic included 74 patients; age 318 years after acute coronary syndrome or that had undergone cardiac surgery. Translation and adaptation procedure of the MOEES followed established international guidelines. To evaluate test-retest reliability, relative (intra-class correlation coefficient ICC, 2.1)and absolute reliability (standard error of measurement (SEM) standard error of measurement % (SEM%), percentage of absolute agreement and Kappa coefficient for each item were calculated. Internal consistency was assessed with Cronbach´s alpha. The original 3-factor structure was tested with a confirmatory factor analysis. Floor and ceiling effects were calculated. Results In total, 60 patients, mean age 65 years, were included in the study. The test-retest showed for the three outcome expectations subscales (Physical, Self-evaluative and Social) ICC-values of 0.40 (CI 95% 0.20-0.58), 0.57 (0.39-0.71) and 0.72 (0.57-0.83), respectively. selleck In general, the Kappa coefficients were low and varied between 0.11 and 0.44. Two questions had low loadings in the confirmatory factor analysis ( less then 0.5) , contributing to a weak fit of the model. There was no floor effect, but the subscales physical and self-evaluative outcome expectation showed ceiling effects. ConclusionThis is the first study to analyse test-retest reliability of the translated version of MOEES into Swedish in cardiac patients and shows need for further development of the instrument before use in clinical practice and research.

To investigate the relationship between falls, physical activity, and other socio-demographic and visual factors among cataract patients in Ho Chi Minh City, Vietnam.

A cross-sectional study was conducted between April and November 2018. Patients presenting to two hospitals with age-related unilateral or bilateral cataract, aged ≥50years, literate, and scheduled for a first-eye cataract surgery were recruited. The International Physical Activity Questionnaires short form was used to measure physical activity. Visual disability score was self-reported using the Catquest-9SF. The number of falls in the last 12months prior to data collection were self-reported. Visual acuity and contrast sensitivity were measured using standard protocols.

A total of 340 patients had complete data, the majority of whom were women (62.4%), living with a spouse (66.5%), had an education level of Grade 5 or below (68.2%), and a monthly income from medium to high (58.5%). Average age was 65.7years. A total of 135 falls were repo prevent falls may also prioritise cataract surgery for women and those with lower income.

Patients with a moderate level of physical activity were less likely to fall compared to those with low or high levels although this U-shape relationship needs to be further investigated in prospective interventional trials. Men and those with high monthly income, better visual acuity and visual disability score were also less likely to fall. Cataract patients might be advised to maintain a moderate level of physical activity while waiting for surgery. Strategies to prevent falls may also prioritise cataract surgery for women and those with lower income.

We prospectively evaluated whether the addition of iguratimod (IGU) could sustain clinical remission in rheumatoid arthritis (RA) patients after tapering of methotrexate (MTX).

The study included 47 patients; 25 patients in the MTX maintenance group, and 22 patients in the IGU addition group who were treated with additional IGU and tapering of MTX dose. Clinical efficacy and safety were evaluated at 12, 24, and 36weeks.

In the IGU addition group, the dose of MTX could be reduced from 8.6 ± 2.4 mg/week at baseline to 4.7 ± 2.2 mg/week at 36 weeks (p < .001). Clinical remission was maintained (disease activity score [DAS]28-ESR 1.48 ± 0.63 at baseline and 1.69 ± 0.76 at 36weeks, p = .911), and disease activity remained low (clinical disease activity index [CDAI] 2.4 ± 1.5 at baseline and 3.1 ± 3.4 at 36weeks, p = .825). The US-GLOSS score significantly decreased from 9.2 ± 5.3 at baseline to 6.4 ± 4.3 at 36weeks (p = .034). In the IGU addition group, two patients discontinued IGU because of stomatitis and three patients relapsed during the follow-up period (flare rate 15.0%). There was no significant difference in RA disease activity at 36 weeks between the two groups.

Additional use of IGU can effectively reduce the MTX dose required by patients during clinical remission without inducing a flare.

Additional use of IGU can effectively reduce the MTX dose required by patients during clinical remission without inducing a flare.