nils-herrmann/clean_scirepeval huggingface dataset:
Retinal imaging by laser polarimetry and optical coherence tomography evidence of axonal degeneration in multiple sclerosis.

Optical coherence tomography (OCT) and scanning laser polarimetry with variable corneal compensation (GDx) are similar yet provide information on different aspects of retinal nerve fiber layer (RNFL) structure (thickness values similar to histology for OCT vs birefringence of microtubules for GDx).



To compare the ability of OCT and GDx to distinguish eyes of patients with multiple sclerosis (MS) from eyes of disease-free controls and thus identify RNFL abnormalities. We also sought to examine the capacity of these techniques to distinguish MS eyes from those without a history of optic neuritis and to correlate with visual function.



Cross-sectional study.



Academic tertiary care MS center.



Eighty patients with MS (155 eyes) and 43 disease-free controls (85 eyes) underwent both OCT and GDx imaging using protocols that measure RNFL thickness.



Areas under the curve (AUC), adjusted for within-patient, intereye correlations, were used to compare the abilities of OCT and GDx temporal-superior-nasal-inferior-temporal average RNFL thicknesses to discriminate between MS and control eyes and to distinguish MS eyes with a history of optic neuritis. Visual function was evaluated using low-contrast letter acuity and high-contrast visual acuity.



Average peripapillary RNFL thickness (360 degrees around the optic disc) was reduced in patients with MS compared with controls for both methods. Age-adjusted AUC did not differ between OCT (0.80; 95% confidence interval [CI], 0.72-0.88) and GDx (0.78; 95% CI, 0.68-0.86; P = .38). Optical coherence tomography-measured RNFL thickness was somewhat better at distinguishing MS eyes with a history of optic neuritis from those without (OCT: AUC, 0.73; 95% CI, 0.64-0.82; GDx: AUC, 0.66; 95% CI, 0.57-0.66; P = .17). Linear correlations of RNFL thickness for OCT vs GDx were significant yet moderate (r = 0.67, P < .001); RNFL thickness measures correlated moderately and significantly with low-contrast acuity (OCT: r = 0.54, P < .001; GDx: r = 0.55, P < .001) and correlated less with high-contrast visual acuity (OCT: r = 0.44, P < .001; GDx: r = 0.32, P < .001).



Scanning laser polarimetry with variable corneal compensation measurements of RNFL thickness corroborates OCT evidence of visual pathway axonal loss in MS and provides new insight into structural aspects of axonal loss that relate to RNFL birefringence (microtubule integrity). These results support validity for RNFL thickness as a marker for axonal degeneration and support use of these techniques in clinical trials that examine neuroprotective and other disease-modifying therapies.
The rate of serious bacterial infections among HIV-infected children with immune reconstitution who have discontinued opportunistic infection prophylaxis.

Receipt of highly active antiretroviral therapy is associated with a decrease in the incidence of opportunistic infections (OIs) among HIV-infected adults. The goal of Pediatric AIDS Clinical Trials Group protocol 1008 was to evaluate prospectively the incidence of serious bacterial infections (SBIs) and other OIs after discontinuation of OI and/or Pneumocystis jiroveci pneumonia (PCP) prophylaxis among HIV-infected pediatric subjects who experienced immune reconstitution while receiving stable antiretroviral therapy.



HIV-infected children and adolescents, 2 to 21 years of age, who had received OI and/or PCP prophylaxis for > or =6 months were enrolled if they had sustained responses (>16 weeks before study entry) to antiretroviral therapy, with CD4+ cell percentages of > or =20% for patients >6 years of age or > or =25% for patients 2 to 6 years of age. Prophylaxis was discontinued at entry. To identify whether any correlation existed between functional immune reconstitution and protection from OIs, subjects were immunized with the hepatitis A virus vaccine. The association between the humoral immune response and the likelihood of developing an OI was evaluated.



A total of 235 HIV-infected subjects from 43 participating sites had a median follow-up period of 132 weeks, yielding 547 person-years of observation. Twenty SBIs were observed among 19 subjects, resulting in an incidence rate of 3.66 SBIs per 100 person-years (95% confidence interval: 2.24-5.66 SBIs per 100 person-years). Sixteen of the events were presumed bacterial pneumonia, with 4 proven SBIs. One participant experienced 2 separate pneumonia episodes, of presumed bacterial cause. Ten subjects who developed SBIs had baseline CD4+ cell counts of > or =750 cells per mm3, and 15 had CD4+ cell percentages of > or =25% at the time of their SBIs. Two subjects died as a result of non-SBI-related causes. There were no statistically significant differences in changes over time in CD4+ cell counts or CD4+ cell percentages between subjects who experienced primary end points and those who did not. There was no evidence that baseline protease inhibitor use, gender, race/ethnicity, age, or CD4+ cell count or percentage affected the time to development of a SBI.



OI or PCP prophylaxis can be withdrawn safely for HIV-infected pediatric patients who experience CD4+ cell recovery while receiving stable antiretroviral therapy. More studies are needed to assess the association between antibody responses to neoantigens and the development of SBIs.
The effect of high-intensity progressive resistance training on adiposity in children: a randomized controlled trial

High-intensity progressive resistance training (PRT) improves adiposity and metabolic risk in adults, but has not been investigated in children within a randomized controlled trial (We hypothesized that high-intensity PRT (8 weeks, twice a week) would decrease central adiposity in children, as assessed via waist circumference.Concealed randomization stratified by age and gender was used to allocate rural New Zealand school students to the wait-list control or PRT group.Participants were prescribed two sets (eight repetitions per set) of 11 exercises targeting all the major muscle groups at high intensity.Waist circumference; secondary outcomes included whole body fat, muscular fitness (one repetition maximum), cardiorespiratory fitness (peak oxygen consumption during a treadmill test), lipids, insulin sensitivity and fasting glucose.Of the 78 children (32 girls and 46 boys; mean age 12.2(1.3) years), 51% were either overweight (33%) or obese (18%). High-intensity PRT significantly improved waist circumference (mean change PRT −0.8 (2.2) cm vs +0.5 (1.7) cm control; F=7.59, P=0.008), fat mass (mean change PRT +0.2 (1.4) kg vs +1.0 (1.2) kg control; F=6.00, P=0.017), percent body fat (mean change PRT –0.3 (1.8)% vs +1.2 (2.1)% control; F=9.04, P=0.004), body mass index (mean change PRT −0.01 (0.8) kg m−2 vs +0.4 (0.7) kg m−2 control; F=6.02, P=0.017), upper body strength (mean change PRT+11.6(6.1) kg vs +2.9(3.7) kg control; F=48.6, P<0.001) and lower body strength (mean change PRT +42.9(26.6) kg vs +28.5(26.6) kg control; F=4.72, P=0.034) compared to the control group. Waist circumference decreased the most in those with the greatest baseline relative strength (r=−0.257, P=0.036), and greatest relative (r=−0.400, P=0.001) and absolute (r=0.340, P=0.006) strength gains during the intervention.Isolated high-intensity PRT significantly improves central and whole body adiposity in association with muscle strength in normal-weight and overweight children. The clinical relevance and sustainability of these changes in adiposity should be addressed in future long-term studies.
Adjuvanted HLA-supertype restricted subdominant peptides induce new T-cell immunity during untreated HIV-1-infection.

We investigated the potential of inducing additional T-cell immunity during chronic HIV-1 infection directed to subdominant HIV-1 epitopes from common HLA-supertypes. Ten treatment-naïve HIV-1-infected individuals were immunized with peptides in the adjuvant CAF01. One individual received placebo. T-cell immunogenicity was examined longitudinally by a flow cytometry (CD107a, IFNγ, TNFα, IL-2 and/or MIP1β expression) as well as IFNγ ELISPOT. Safety was evaluated by clinical follow up combined with monitoring of biochemistry, hematology, CD4 T-cell counts and viral load. New CD4 and CD8 T-cell responses specific for one or more vaccine epitopes were induced in 10/10 vaccinees. The responses were dominated by CD107a and MIP1β expression. There were no significant changes in HIV-1 viral load or CD4 T-cell counts. Our study demonstrates that the peptide/CAF01 vaccine is safe and that it is possible to generate new HIV-1 T-cell responses to defined epitopes in treatment-naïve HIV-1-infected individuals.
Systemic use of antibiotics does not prevent postoperative infection in elective colorectal surgery: a randomized controlled trial.

We assessed the clinical impact of the systemic use of antibiotics on postoperative infection in colorectal surgery. Perioperative administration prevents postoperative infection: a statement which is based on the results of five randomized controlled trials performed in the 1970s and 1980s. Our study design was a randomized controlled trial. We created two groups, one using the systemic antibiotic cefotiam (CTM), and the other using no antibiotic as the control. The primary end point was the overall postoperative infection rate. There were 100 patients assigned to this study. The patients were divided into two groups; the control group consisted of 51 cases and the CTM group had 49 cases. The backgrounds of the patients in the two groups were not significantly different. The overall postoperative infection rate was 28/51 (54.9%) in the control group and 25/49 (51.0%) in the CTM group. The surgical site infection (SSIs) (superficial, deep, and space/organ ) were 23/51 (45.1%) in the control group and 20/49 (40.8%) in the CTM group. No significant difference was observed between the CTM group and the control group regarding postoperative infection after elective colorectal surgery.
Atracurium in patients with renal failure. Clinical trial of a new neuromuscular blocker.

Atracurium was given to 30 patients with terminal chronic renal insufficiency, in two regimens. Group I (20 patients) received a single dose of 0.6 mg kg-1 and group II (10 patients), received one or several injections of 0.2 mg kg-1. Tracheal intubation was performed with ease in all patients 3 min after the injection of atracurium. A supramaximal stimulus was applied to the ulnar nerve at wrist level, and thumb adduction force was recorded. Muscular blockade was 100% in 29/30 patients and 95% in one. Mean time between atracurium injection and reappearance of 25% of the initial muscular power (HT25) was 49 min. The recovery time index (IR25-75) was 12 min and did not increase after re-injection. No side-effects were observed and no significant differences in any of the measurements made were seen between the two groups.
Rectal cancer

The aim of this study was to evaluate the short-term test-retest reproducibility of diffusion-weighted magnetic resonance imaging (DW-MRI) parameters of rectal cancer with 3.0T MRI.Twenty-six patients with rectal cancer underwent MRI, including diffusion-weighted imaging with 8 b values. Apparent diffusion coefficient (ADC) and intravoxel incoherent motion (IVIM) parameters (D, pure diffusion; f, perfusion fraction; D*, pseudodiffusion coefficient) were, respectively, calculated. The short-term test-retest reproducibility, the intra and interobserver variation of the IVIM parameters were assessed based on the repeatability coefficient and Bland-Altman limits of agreement.There was no significant intra or interobserver difference observed in the parameters on the same DW-MRI scan. The corresponding repeatability coefficient of intra- and interobserver analysis for ADC, D, f, and D* was 5.4%, 11.1%, 55.4%, and 40.3%; 10.9%, 41.6%, 134.0%, and 177.6%, respectively. The test-retest repeatability coefficient for ADC, D, f, and D* was 19.1%, 24.5%, 126.3%, and 197.4%, respectively, greater than the intraobserver values.ADC and D have better short-term test-retest reproducibility than f and D*. Considering the poor test-retest reproducibility for f and D,* variance in these 2 parameters should be interpreted with caution in longitudinal studies on rectal cancer in which treatment response and recurrence are monitored.
Cryopreservation of ovarian tissue in breast cancer patients: 10 years of experience.

To present a decade of experience with ovarian tissue cryopreservation in breast cancer patients.



The safety of the procedure was histologically evaluated before and after freezing in 94 patients. Out of 94 patients, 48 prechemotherapy patients were randomly selected to determine stroma and follicle preservation and follicular density.



The ovarian tissue from 94 patients did not identify any micrometastases. After cryopreservation, morphology of the ovarian tissue and density of healthy follicles were similar in fresh and frozen tissue. Follicular density decreased with the increasing age of patients in both fresh and frozen tissue (p < 0.0001). A variation in follicular density was observed between fresh and frozen tissue (p < 0.05).



These results suggest that ovarian tissue cryopreservation is highly feasible for preserving the fertility of young breast cancer patients.
Early Probiotic Supplementation for Eczema and Asthma Prevention: A Randomized Controlled Trial.

To determine if probiotic administration during the first 6 months of life decreases childhood asthma and eczema.



We conducted a randomized, double-blind controlled trial of Lactobacillus rhamnosus GG (LGG) supplementation on the cumulative incidence of eczema (primary end point) and asthma and rhinitis (secondary end points) in high-risk infants. For the first 6 months of life, intervention infants (n = 92) received a daily dose of 10 billion colony-forming units of LGG and 225 mg of inulin (Amerifit Brands, Cromwell, CT), and control infants (n = 92) received 325 mg of inulin alone. We used survival analysis methods to estimate disease incidences in the presence or absence of LGG and to estimate the efficacy of LGG in delaying or preventing these diseases.



Infants were accrued over a 6-year period (median follow-up: 4.6 years; 95% retention rate at 2 years). At 2 years of age, the estimated cumulative incidence of eczema was 30.9% (95% confidence interval [CI], 21.4%-40.4%) in the control arm and 28.7% (95% CI, 19.4%-38.0%) in the LGG arm, for a hazard ratio of 0.95 (95% CI, 0.59-1.53) (log-rank P = .83). At 5 years of age, the cumulative incidence of asthma was 17.4% (95% CI, 7.6%-27.1%) in the control arm and 9.7% (95% CI, 2.7%-16.6%) in the LGG arm, for a hazard ratio of 0.88 (95% CI, 0.41-1.87) (log-rank P = .25).



For high-risk infants, early LGG supplementation for the first 6 months of life does not appear to prevent the development of eczema or asthma at 2 years of age.
Denitrification pathways and rates in the sandy sediments of the Georgia continental shelf, USA

A prospective randomised multicentre clinical study was undertaken for 2 years and 3 months from November 1982, with the aim of examining the significance of using a combination of ftorafur (FT) and tamoxifen (TAM) for post-operative adjuvant therapy of breast cancer. Patients had either stage II or stage IIIa disease, were age 75 or below and had undergone radical mastectomy. Patients were divided into two groups and received one of the following treatment protocols: treatment A, intravenous administration of doxorubicin (DOX), 20 mg on the day of surgery and 10 mg the next day, followed by oral FT 50 mg day-1 for 2 years from the 14th day; treatment B, the same pattern of DOX administration for the first 2 days, followed by a combined therapy of FT and TAM 20 mg day-1 for 2 years. The number of patients was 546 (treatment A 274 and treatment B 272), of whom 34 (6%) were ineligible. The remaining 512 patients (treatment A 254 and treatment B 258) were followed up for 5 years for analysis. Significantly higher 5 year disease-free rate and 5 year survival rates were observed with treatment B compared with treatment A. When seen in terms of background factors, node-positive patients appeared to derive more benefit from tamoxifen than node-negative patients, but the oestrogen receptor-negative and premenopausal subgroups appeared to derive about the same benefit as those who were oestrogen receptor positive and post-menopausal. Indeed, survival in the premenopausal group was significantly better with tamoxifen (P = 0.04). No increase in side-effects was seen by combining TAM with FT. The study results demonstrate that concomitant administration of FT and TAM is better than FT alone for post-operative adjuvant therapy for breast cancer.
Institutional report-Congenital Fenoldopam in newborn patients undergoing cardiopulmonary bypass : controlled clinical trial

We determined if low dose fenoldopam in neonates already receiving conventional diuretics improves urine output, fluid balance, acute kidney injury incidence (AKI) and time to extubation. A prospective controlled clinical trial in a pediatric cardiac intensive care unit on 40 neonates undergoing cardiac surgery with cardiopulmonary bypass, excluding simple ventricular septal defect and atrial septal defect. Fenoldopam was infused at a low dose of 0.1 mgykgymin soon after anesthesia induction and infusion prolonged for 72 h in 20 patients. Twenty neonates with standardized perioperative therapy except fenoldopam administration served as controls. Demographic, hemodynamic, daily urine output, creatinine, creatinine clearance, serum and urinary sodium and potassium were recorded. Inotropic score (IS) was calculated as a surrogate for the degree of hemodynamic impairment. Low dose fenoldopam infusion did not show beneficial effects in renal function. The treatment did not significantly affect IS value, AKI incidence, fluid balance control, time to sternal closure, time to extubation and time to intensive care unit discharge. Low dose fenoldopam in neonates undergoing cardiac surgery with CPB did not produce effects on urine output, fluid balance and AKI incidence. Fenoldopam was well tolerated and did not negatively affect hemodynamics and vasopressor support.
Combined lateral retinacular release with drilling chondroplasty for treatment of patellofemoral osteoarthritis associated with patellar malalignment in elderly patients.

This paper described a less invasive surgical technique that was performed for treatment of elderly patients with isolated patellofemoral (PF) osteoarthritis (OA) associated with patellar malalignment, although their tibiofemoral joints are minimally osteoarthritic. Two hundred and thirty-four knees in 126 consecutive elderly patients (average, 72 yrs) diagnosed with combined disorders were treated by lateral retinacular release with drilling chondroplasty. The inclusion criteria were patient age ≥ 65 yrs, isolated stage 2 or 3 PF-OA (modified Iwano staging by radiology), and a laterally subluxed patella shown on a Merchant's axial radiograph. Outcome was judged by three parameters: clinical PF function (modified Kujala scoring), congruence angle, and PF-OA staging. Two hundred and one knees in 107 patients were followed-up for an average of 4.2 yrs (range, 2.1-7.5 yrs) and 19 patients were lost to follow-up. No surgical complications occurred through the course of treatment. Clinical PF function improved in knees that showed unsatisfactory performance (modified Kujala scoring < 32) preoperatively, with 78.1% of the knees showing satisfactory performance (modified Kujala scoring ≥ 32) at the latest follow-up. Congruence angle improved in 85.6% of the knees and PF-OA staging improved in 77.1% of the knees. Combined lateral retinacular release with drilling chondroplasty is a feasible alternative for treatment of PF-OA associated with patellar malalignment in elderly patients where knee arthroplasty cannot be performed by various reasons. Advantages of this combined surgical technique include a less invasive procedure, minimal complication rate, and an acceptable success rate (78%, modified Kujala scoring≥32).
Risk of death during and after opiate substitution treatment in primary care: prospective observational study in UK General Practice Research Database

To investigate the effect of opiate substitution treatment at the beginning and end of treatment and according to duration of treatment.



Prospective cohort study. Setting UK General Practice Research Database.



Primary care patients with a diagnosis of substance misuse prescribed methadone or buprenorphine during 1990-2005. 5577 patients with 267 003 prescriptions for opiate substitution treatment followed-up (17 732 years) until one year after the expiry of their last prescription, the date of death before this time had elapsed, or the date of transfer away from the practice.



Mortality rates and rate ratios comparing periods in and out of treatment adjusted for sex, age, calendar year, and comorbidity; standardised mortality ratios comparing opiate users' mortality with general population mortality rates.



Crude mortality rates were 0.7 per 100 person years on opiate substitution treatment and 1.3 per 100 person years off treatment; standardised mortality ratios were 5.3 (95% confidence interval 4.0 to 6.8) on treatment and 10.9 (9.0 to 13.1) off treatment. Men using opiates had approximately twice the risk of death of women (morality rate ratio 2.0, 1.4 to 2.9). In the first two weeks of opiate substitution treatment the crude mortality rate was 1.7 per 100 person years: 3.1 (1.5 to 6.6) times higher (after adjustment for sex, age group, calendar period, and comorbidity) than the rate during the rest of time on treatment. The crude mortality rate was 4.8 per 100 person years in weeks 1-2 after treatment stopped, 4.3 in weeks 3-4, and 0.95 during the rest of time off treatment: 9 (5.4 to 14.9), 8 (4.7 to 13.7), and 1.9 (1.3 to 2.8) times higher than the baseline risk of mortality during treatment. Opiate substitution treatment has a greater than 85% chance of reducing overall mortality among opiate users if the average duration approaches or exceeds 12 months.



Clinicians and patients should be aware of the increased mortality risk at the start of opiate substitution treatment and immediately after stopping treatment. Further research is needed to investigate the effect of average duration of opiate substitution treatment on drug related mortality.