nils-herrmann/clean_scirepeval huggingface dataset:
Epidural analgesia is superior to local infiltration analgesia in children with cerebral palsy undergoing unilateral hip reconstruction

Treatment of postoperative pain in children with cerebral palsy (CP) is a major challenge. We investigated the effect of epidural analgesia, high-volume local infiltration analgesia (LIA), and an approximated placebo control on early postoperative pain in children with CP who were undergoing unilateral hip reconstruction.



Between 2009 and 2014, we included 18 children with CP. The first part of the study was a randomized double-blind trial with allocation to either LIA or placebo for postoperative pain management, in addition to intravenous or oral analgesia. In the second part of the study, the children were consecutively included for postoperative pain management with epidural analgesia in addition to intravenous or oral analgesia. The primary outcome was postoperative pain 4 h postoperatively using 2 pain assessment tools (r-FLACC and VAS-OBS) ranging from 0 to 10. The secondary outcome was opioid consumption over the 21-h study period.



The mean level of pain 4 h postoperatively was lower in the epidural group (r-FLACC: 0.7; VAS-OBS: 0.6) than in both the LIA group (r-FLACC: 4.8, p = 0.01; VAS-OBS: 5.2, p = 0.02) and the placebo group (r-FLACC: 5.2, p = 0.01; VAS-OBS: 6.5, p < 0.001). Corrected for body weight, the mean opioid consumption was lower in the epidural group than in the LIA group and the placebo group (both p < 0.001).



Epidural analgesia is superior to local infiltration analgesia for early postoperative pain management in children with cerebral palsy who undergo unilateral hip reconstruction.
Peripheral hemodynamic effects of ibopamine in patients with congestive heart failure. A placebo-controlled, double-blind study

Under double-blind conditions, 150 mg of ibopamine (di-isobutiric ester of N-methyldopamine) or placebo were given orally to 11 patients with congestive heart failure; after 3 hours, 50 mg of sulpiride were administered intramuscularly. Peripheral hemodynamics were evaluated at the level of the forearm using strain-gauge plethysmography. Ibopamine increased arterial blood flow and venous capacity and decreased arterial peripheral resistance; these effects were counteracted by sulpiride. No significant changes were observed after placebo and sulpiride. These findings confirm the vasodilating effects of ibopamine on peripheral hemodynamics and its utility in patients for the treatment of congestive heart failure.
Optical design of nanowire absorbers for wavelength selective photodetectors

We propose the optical design for the absorptive element of photodetectors to achieve wavelength selective photo response based on resonant guided modes supported in semiconductor nanowires. We show that the waveguiding properties of nanowires result in very high absorption efficiency that can be exploited to reduce the volume of active semiconductor compared to planar photodetectors, without compromising the photocurrent. We present a design based on a group of nanowires with varying diameter for multi-color photodetectors with small footprint. We discuss the effect of a dielectric shell around the nanowires on the absorption efficiency and present a simple approach to optimize the nanowire diameter-dielectric shell thickness for maximizing the absorption efficiency.
Beneficial hemodynamic effects of prone positioning in patients with acute respiratory distress syndrome.

The effects of prone positioning during acute respiratory distress syndrome on all the components of cardiac function have not been investigated under protective ventilation and maximal alveolar recruitment.



To investigate the hemodynamic effects of prone positioning.



We included 18 patients with acute respiratory distress syndrome ventilated with protective ventilation and an end-expiratory positive pressure titrated to a plateau pressure of 28-30 cm H2O. Before and within 20 minutes of starting prone positioning, hemodynamic, respiratory, intraabdominal pressure, and echocardiographic data were collected. Before prone positioning, preload reserve was assessed by a passive leg raising test.



In all patients, prone positioning increased the ratio of arterial oxygen partial pressure over inspired oxygen fraction, the intraabdominal pressure, and the right and left cardiac preload. The pulmonary vascular resistance decreased along with the ratio of the right/left ventricular end-diastolic areas suggesting a decrease of the right ventricular afterload. In the nine patients with preload reserve, prone positioning significantly increased cardiac index (3.0 [2.3-3.5] to 3.6 [3.2-4.4] L/min/m(2)). In the remaining patients, cardiac index did not change despite a significant decrease in the pulmonary vascular resistance.



In patients with acute respiratory distress syndrome under protective ventilation and maximal alveolar recruitment, prone positioning increased the cardiac index only in patients with preload reserve, emphasizing the important role of preload in the hemodynamic effects of prone positioning.
An experimental test of an alcohol expectancy challenge in mixed gender groups of young heavy drinkers.

Several studies have shown that a multisession experiential expectancy challenge successfully reduces positive alcohol expectancies and alcohol use in heavy drinking young men, but this has not been shown for heavy drinking young women. Main aim of this study was to test the effect of a multisession expectancy challenge in mixed gender groups of young heavy drinkers. Twenty-five (11 males) heavy drinking students were randomly assigned to the expectancy challenge or control condition (the challenge was adapted to be more suitable for women). Positive expectancies decreased significantly in the experimental but not in the control group. In the experimental group, positive expectancies decreased significantly more in women than in men, and alcohol use showed a statistical trend in the same direction. These findings are the first to indicate that a multisession expectancy challenge may result in reduced positive expectancies and alcohol consumption in young heavy drinking women. An important next question is whether a single experiential session could be effective because recruitment for a multisession challenge proved difficult, which is problematic for further implementation.
Suppressor cell activity in a randomized trial of patients receiving active specific immunotherapy with melanoma cell vaccine and low dosages of cyclophosphamide.

Previous studies have shown that melanoma patients develop an immune response to cell surface melanoma-associated antigens. The presence of this antibody response to cell surface antigens has been correlated with a better clinical outcome when melanoma patients are treated with an allogeneic melanoma cell vaccine (MCV) as an active immunotherapy protocol. It was hypothesized that the inability to consistently induce or enhance existing immune responses to melanoma-associated antigens was related to the downregulation by suppressor cells. Patients received treatments of MCV 3 times in a 4-week interval and then every fourth week. The biological response modifier cyclophosphamide (CYP) is an immunomodulator of suppressor T-cell function. In this study we set out to determine whether CYP given prior to MCV could reduce suppressor cell activity during vaccination. In a randomized trial stage II and III melanoma patients (n = 41) were given MCV alone or in conjunction with CYP at dosages of 300, 150, or 75 mg/m2. CYP was given 3 days prior to each MCV treatment. Suppressor cell activity in patients was monitored by a concanavalin A suppressor assay using peripheral blood lymphocytes from serial phlebotomies during a 12-week period of treatment. In each trial group there were patients who had major reduction in suppressor cell activity (greater than 50%). Overall, the greatest reduction in suppressor cell activity occurred in patients receiving 300 mg/m2 CYP compared to the other CYP dosages or MCV alone. For the first two treatments at all CYP dosages there was a greater number of patients showing reduced suppressor cell activity compared to later treatments. In a comparison of patients receiving MCV alone to MCV + CYP 300 mg/m2 phenotypic analysis of lymphocyte subsets showed significant (P = 0.03) reduction in the CD8+CD11B+ (suppressor) cells of the latter group. These studies suggest that CYP can be used at low dosages in conjunction with MCV to reduce suppressor cell activity.
Concurrent Cognitive Control Training Augments the Antidepressant Efficacy of tDCS: A Pilot Study

Major depressive disorder (MDD) is frequently associated with underactivity of the dorsolateral prefrontal cortex (DLPFC) which has led to this brain region being identified as an important target for the development of neurobiological treatments. Transcranial direct current stimulation (tDCS) administered to the DLPFC has antidepressant efficacy, however the magnitude of antidepressant outcomes are limited. Concurrent cognitive activity has been shown to enhance tDCS induced stimulation effects. Cognitive control training (CCT) is a new cognitive therapy for MDD that aims to enhance DLPFC activity via behavioral methods.



We tested the hypothesis that co-administration of DLPFC tDCS and CCT would result in a greater reduction in depressive symptomology than administration of tDCS or CCT alone.



27 adult participants with MDD were randomized into a three-arm sham-controlled between-groups pilot study comparing the efficacy of 2 mA tDCS + CCT, sham tDCS + CCT and sham CCT + 2 mA tDCS (5 sessions administered on consecutive working days). Blinded assessments of depression severity and cognitive control were conducted at baseline, end of treatment and a three week follow up review.



All three treatment conditions were associated with a reduction in depression severity at the end of five treatment sessions. However, only administration of tDCS + CCT resulted in sustained antidepressant response at follow up, the magnitude of which was greater than that observed immediately following conclusion of the treatment course.



The results provide preliminary evidence that concurrent CCT enhances antidepressant outcomes from tDCS. In the current sample, participants receiving concurrent tDCS and CCT continued to improve following cessation of treatment. The clinical superiority of a combined therapeutic approach was apparent even in a small sample and following a relatively short treatment course.
Sofosbuvir plus ribavirin for the treatment of chronic genotype 4 hepatitis C virus infection in patients of Egyptian ancestry.

We conducted an open-label phase 2 study to assess the efficacy and safety of the oral nucleotide polymerase inhibitor sofosbuvir in combination with ribavirin in patients of Egyptian ancestry, chronically infected with genotype 4 hepatitis C virus (HCV).



Treatment-naive and previously treated patients with genotype 4 HCV were randomly allocated in a 1:1 ratio to receive sofosbuvir 400mg and weight-based ribavirin, for 12 or 24 weeks. The primary efficacy endpoint was the proportion of patients with sustained virologic response (HCV RNA <25IU/ml) 12 weeks after cessation of therapy (SVR12).



Thirty treatment-naive and thirty previously treated patients were enrolled and treated for 12 weeks (n=31) or 24 weeks (n=29). Overall, 23% of patients had cirrhosis and 38% had diabetes. 14% of treatment-naive patients were interferon ineligible and 63% of treatment-experienced patients had prior non-response. SVR12 was achieved by 68% of patients (95% CI, 49-83%) in the 12-week group, and by 93% of patients (95% CI, 77-99%) in the 24-week group. The most common adverse events were headache, insomnia, and fatigue. No patient discontinued treatment due to an adverse event.



The findings from the present study suggest that 24 weeks of sofosbuvir plus ribavirin is an efficacious and well tolerated treatment in patients with HCV genotype 4 infection.
Accuracy of Pulse Oximeters in Detecting Hypoxemia in Patients with Chronic Thromboembolic Pulmonary Hypertension

Pulse oximetry is routinely used to continuously and non-invasively monitor arterial oxygen saturation (SaO2). When oxygen saturation by pulse oximeter (SpO2) overestimates SaO2, hypoxemia may be overlooked. We compared the SpO2 - SaO2 differences among three pulse oximeters in patients with chronic thromboembolic pulmonary hypertension (CTEPH) who spent their daily lives in a poor oxygen state.



This prospective observational study recruited 32 patients with CTEPH undergoing elective cardiac catheterization. As we collected arterial blood samples in the catheter laboratory, SpO2 values were simultaneously recorded. Three pulse oximeters were used on each patient, and SpO2 values were compared with oximetry readings using a blood gas analyzer. To determine the optimal SpO2 value by which to detect hypoxemia (SaO2≦90%), we generated receiver operating characteristic (ROC) curves for each pulse oximeter.



The root mean square of each pulse oximeter was 1.79 (OLV-3100), 1.64 (N-BS), and 2.50 (Masimo Radical). The mean bias (SpO2 - SaO2) for the 90%-95% saturation range was significantly higher for Masimo Radical (0.19 +/- 1.78% [OLV-3100], 0.18 +/- 1.63% [N-BS], and 1.61 +/- 1.91% [Masimo Radical]; p<0.0001). The optimal SpO2 value to detect hypoxemia (SaO2≦90%) was 89% for OLV-3100, 90% for N-BS, and 92% for Masimo Radical.



We found that the biases and precision with which to detect hypoxemia differed among the three pulse oximeters. To avoid hypoxemia, the optimal SpO2 should be determined for each pulse oximeter.
High cerebral insulin sensitivity is associated with loss of body fat during lifestyle intervention

Loss of weight and body fat are major targets in lifestyle interventions to prevent diabetes. In the brain, insulin modulates eating behaviour and weight control, resulting in a negative energy balance. This study aimed to test whether cerebral insulin sensitivity facilitates reduction of body weight and body fat by lifestyle intervention in humans. The study was performed as an additional arm of the TUebingen Lifestyle Intervention Program (TULIP). In 28 non-diabetic individuals (14 female/14 male; mean ± SE age 42 ± 2 years; mean ± SE BMI 29.9 ± 0.8 kg/m2), we measured cerebrocortical insulin sensitivity by using magnetoencephalography before lifestyle intervention. Total and visceral fat were measured by using MRI at baseline and after 9 months and 2 years of lifestyle intervention. Insulin-stimulated cerebrocortical theta activity at baseline correlated with a reduction in total adipose tissue (r = −0.59, p = 0.014) and visceral adipose tissue (r = −0.76, p = 0.001) after 9 months of lifestyle intervention, accompanied by a statistical trend for reduction in body weight change (r = −0.37, p = 0.069). Similar results were obtained after 2 years. Our results suggest that high insulin sensitivity of the human brain facilitates loss of body weight and body fat during lifestyle intervention.
Canadian Outcomes Study in Dementia: study methods and patient characteristics.

To describe the methods and patient characteristics of the Canadian Outcomes Study in Dementia (COSID).



COSID is a 3-year prospective study of dementia patients living in the community at the time of study registration. We assessed patients' cognition, behaviour, and functioning every 6 months, using the Modified Mini-Mental State Examination (3MS), the Neuropsychiatric Inventory (NPI), and the Functional Autonomy Measurement System (SMAF), respectively. We assessed caregivers, using the Zarit Burden Interview (ZBI). Additional information included the Global Deterioration Scale (GDS), patients' driving status, and clinical information including family history, dementia type, concomitant medications, and comorbid conditions. From the patient or caregiver, we collected details of inpatient and outpatient resources used by the patient and (or) caregiver.



We enrolled 766 patients from 31 Canadian sites. Overall mean age was 76.8 years, and mean age of onset was 73.1 years. Of the total patients, 98% were white, 54% were women, and 84% were diagnosed with Alzheimer's disease. Mean baseline 3MS was 66.5, NPI was 9.5, and SMAF was 18.30. Of these patients, 48% reported a GDS score of 3 (that is, moderate), 16% reported a GDS score of 4 (that is, moderately severe), and the remaining 36% reported a GDS score of 1 or 2 (that is, mild or very mild). At baseline, 83% of patients received cholinesterase inhibitors, 46% received nonsteroidal antiinflammatory drugs, 39% received vitamin E, and 25% received antidepressants. Adult day care and home help were the largest cost factors in this population, with mean monthly costs of $65 and $64, respectively. We found interesting differences in the resources used among geographic regions and care settings.



COSID is already generating valuable information about treatment patterns, outcomes, and resource use in Canadian patients with dementia. As the data mature, it will be possible to build robust models on treatment effectiveness and costs of care.
Endoscopic hemostasis is rarely used for hematochezia: a population-based study from the Clinical Outcomes Research Initiative National Endoscopic Database.

Data on the use of endoscopic hemostasis performed during colonoscopy for hematochezia are primarily derived from expert opinion and case series from tertiary care settings.



To characterize patients with hematochezia who underwent in-patient colonoscopy and compare those who did and did not receive endoscopic hemostasis.



Retrospective analysis.



Clinical Outcomes Research Initiative National Endoscopic Database, 2002 to 2008.



Adults with hematochezia.



None.



Demographics, comorbidities, practice setting, adverse events, and colonoscopy procedural characteristics and findings.



We identified 3151 persons who underwent in-patient colonoscopy for hematochezia. Endoscopic hemostasis was performed in 144 patients (4.6%). Of those who received endoscopic hemostasis, the majority were male (60.3%), white (83.3%), and older (mean age 70.9 ± 12.3 years); had a low-risk American Society of Anesthesiologists classification (53.9%); and underwent colonoscopy in a community setting (67.4%). The hemostasis-receiving cohort was significantly more likely to be white (83.3% vs 71.0%, P = .02), have more comorbidities (classes 3 and 4, 46.2% vs 36.0%, P = .04), and have the cecum reached (95.8% vs 87.7%, P = .003). Those receiving hemostasis were significantly more likely to have an endoscopic diagnosis of arteriovenous malformations (32.6% vs 2.6%, P = .0001) or a solitary ulcer (8.3% vs 2.1%, P < .0001).



Retrospective database analysis.



Less than 5% of persons presenting with hematochezia and undergoing inpatient colonoscopy received endoscopic hemostasis. These findings differ from published tertiary care setting data. These data provide new insights into in-patient colonoscopy performed primarily in a community practice setting for patients with hematochezia.
Prediction and course of symptoms and lung function around an exacerbation in chronic obstructive pulmonary disease

Frequent exacerbations induce a high burden to Chronic Obstructive Pulmonary Disease (COPD). We investigated the course of exacerbations in the published COSMIC study that investigated the effects of 1-year withdrawal of fluticasone after a 3-month run-in treatment period with salmeterol/fluticasone in patients with COPD.



In 373 patients, we evaluated diary cards for symptoms, Peak Expiratory Flow (PEF), and salbutamol use and assessed their course during exacerbations.



There were 492 exacerbations in 224 patients. The level of symptoms of cough, sputum, dyspnea and nocturnal awakening steadily increased from 2 weeks prior to exacerbation, with a sharp rise during the last week. Symptoms of cough, sputum, and dyspnea reverted to baseline values at different rates (after 4, 4, and 7 weeks respectively), whereas symptoms of nocturnal awakening were still increased after eight weeks. The course of symptoms was similar around a first and second exacerbation. Increases in symptoms and salbutamol use and decreases in PEF were associated with a higher risk to develop an exacerbation, but with moderate predictive values, the areas under the receiver operating curves ranging from 0.63 to 0.70.



Exacerbations of COPD are associated with increased symptoms that persist for weeks and the course is very similar between a first and second exacerbation. COPD exacerbations are preceded by increased symptoms and salbutamol use and lower PEF, yet predictive values are too low to warrant daily use in clinical practice.
Global dietary quality, undernutrition and non-communicable disease: a longitudinal modelling study

To determine the relationship between global dietary energy availability and dietary quality, and nutrition-related health outcomes.



A worldwide longitudinal modelling study using country-level data. Data on total dietary energy availability and dietary energy from 10 distinct food groups (as a proxy for dietary quality) were obtained from the FAO Food Balance Sheets database. Indicators of development were abstracted from the World Bank's World Development Indicators database. Data on nutrition and health outcomes were taken from the WHO mortality database and major cross-country analyses. We investigated associations of energy availability from food groups and health and nutrition outcomes in the combined data set using mixed effects models, while adjusting for measures of development.



124 countries over the period 1980-2009.



Prevalence of stunting in children under 5 years and mortality rate from ischaemic heart disease (IHD) in adults aged 55+ years.



From 1980 to 2009, global dietary energy availability increased, and rates of child stunting and adult IHD mortality declined. After adjustment for measures of development, increased total dietary energy availability was significantly associated with reduced stunting rates (-0.84% per 100 kcal increase in energy, 95% CI -0.97 to -0.72) and non-significantly associated with increased IHD mortality rates (by 4.2 deaths per 100,000/100 kcal increase, 95% CI -1.85 to 10.2). Further analysis demonstrated that the changing availability of energy from food groups (particularly fruit, vegetables, starchy roots, meat, dairy and sugar) was important in explaining the associations with health outcomes.



Our study has demonstrated that by combining large, publicly available data sets, important patterns underlying trends in diet-related health can be uncovered. These associations remain even after accounting for measures of development over a 30-year period. Further work and joined-up multisectoral thinking will be required to translate these patterns into policies that can improve nutrition and health outcomes globally.