nils-herrmann/clean_scirepeval huggingface dataset:
Transcutaneous electrical stimulation on acupuncture points improves muscle function in subjects after acute stroke: a randomized controlled trial.

To investigate whether transcutaneous electrical stimulation, when applied to acupuncture points in patients after acute stroke, decreases spasticity and/or increases muscle strength more effectively than placebo stimulation and standard rehabilitation.



Randomized control trial.



Sixty-two patients aged 70.0 (standard deviation 7.4) years and 9.2 (standard deviation 3.4) days post-stroke.



The patients were randomly assigned to 3 groups receiving transcutaneous electrical stimulation, placebo stimulation, or standard rehabilitation alone. Stimulation was applied to 4 acupuncture points in the affected lower leg for 60 min, 5 days a week for 3 weeks. Plantarflexor spasticity, ankle muscle strength, and functional mobility were measured before treatment, weekly during treatment, and at follow-up at week 8 post-stroke.



No significant difference was found in the outcome measures among groups before treatment. When compared with standard rehabilitation or placebo stimulation, transcutaneous electrical stimulation to acupuncture points significantly increased the percentage of patients with normal tone, increased ankle dorsiflexor strength, and decreased antagonist co-contraction ratio (p < 0.05). The patients in the transcutaneous electrical stimulation group also tended to walk 2-4 days earlier than the patients in the other 2 groups.



Three weeks of transcutaneous electrical stimulation to lower leg acupuncture points, given 5 times a week within 10 days post-stroke, significantly decreased ankle plantarflexor spasticity, and increased dorsiflexor strength concomitant with a decrease in antagonist co-contraction.
Acute, low-dose methamphetamine administration improves attention/information processing speed and working memory in methamphetamine-dependent individuals displaying poorer cognitive performance at baseline

Abstinent methamphetamine (Meth) dependent individuals demonstrate poorer performance on tests sensitive to attention/information processing speed, learning and memory, and working memory when compared to non-Meth dependent individuals. The poorer performance on these tests may contribute to the morbidity associated with Meth-dependence. In light of this, we sought to determine the effects of acute, low-dose Meth administration on attention, working memory, and verbal learning and memory in 19 non-treatment seeking, Meth-dependent individuals. Participants were predominantly male (89%), Caucasian (63%), and cigarette smokers (63%). Following a four day, drug-free washout period, participants were given a single-blind intravenous infusion of saline, followed the next day by 30 mg of Meth. A battery of neurocognitive tasks was administered before and after each infusion, and performance on measures of accuracy and reaction time were compared between conditions. While  Meth exposure did not affect test performance for the entire sample, participants who demonstrated relatively poor performance on these tests at baseline, identified using a median split on each test, showed significant improvement on measures of attention/information processing speed and working memory when administered Meth. Improved performance was seen on the following measures of working memory: choice reaction time task (p≤0.04), a 1-back task (p≤0.01), and a 2-back task (p≤0.04). In addition, those participants demonstrating high neurocognitive performance at baseline experienced similar or decreased performance following Meth exposure. These findings suggest that acute administration of Meth may temporarily improve Meth-associated neurocognitive performance in those individuals experiencing lower cognitive performance at baseline. As a result, stimulants may serve as a successful treatment for improving cognitive functioning in those Meth-dependent individuals experiencing neurocognitive impairment.
Saturation oxygen pressure index for assessment of pulmonary disease in neonates on non-invasive ventilation.

This prospective observational study on 36 neonates aimed to estimate the correlation between the new Saturation Oxygen distending Pressure Index (SOPI) and Oxygenation index. SOPI had high correlation (r=0.94) with oxygenation index. SOPI of <2, 2, and 3.7 represented mild, moderate and severe pulmonary disease, respectively with high sensitivity and specificity.
Closed loop stimulation in prevention of vasovagal syncope. Inotropy Controlled Pacing in Vasovagal Syncope (INVASY): a multicentre randomized, single blind, controlled study.

To determine whether dual-chamber rate-adaptive Closed Loop Stimulation (CLS) could prevent recurrence of Vasovagal Syncope (VVS).



During VVS, an increase in myocardial contractility associated with a reduction of ventricular filling produces an increase in baroreceptor afferent flow and a consequent decrease in the heart rate. The CLS algorithm is a form of rate-adaptive pacing, which responds to myocardial contraction dynamics, by measuring variations in right ventricular intracardiac impedance: during an incipient VVS it could increase paced heart rate and avoid bradycardia, arterial hypotension and syncope.



Fifty patients (27 males, mean age 59+/-18 year) with severe and recurrent vasovagal syncope and positive Head Up Tilt Test (HUTT) with cardioinhibition, received a CLS pacemaker (INOS2, Biotronik GmbH Co., Germany). The primary end point was recurrence of two VVSs during a minimum of 1 year of follow-up. Randomization between DDD-CLS and DDI mode (40 bpm) pacing was performed only during the first stage of the study (first year): 9/26 randomized to DDI mode (control group) and 17/26 in DDD-CLS mode. All the 24 patients recruited in the second stage of the study (second year) were programmed in DDD-CLS mode.



Of the nine patients randomized to the DDI mode, seven had recurrences of syncope during the first year. At the end of the first year the nine patients were reprogrammed to the CLS mode and no syncope occurred after reprogramming. The 41 patients programmed to CLS had a mean follow-up of 19+/-4 months: none reported VVS, only four (10%) reported occasional presyncope and their quality of life greatly improved. Positive HUTT at the end of the first year failed to predict the clinical response to CLS pacing.



The study demonstrates the effectiveness of CLS pacing in preventing cardioinhibitory VVS. A possible placebo effect of pacemaker implantation occurred in 22% of patients.
Heart rate recovery and aerobic endurance capacity in cancer survivors: interdependence and exercise-induced improvements

Whilst evidence supports beneficial effects of exercise on heart rate variability in cancer patients, its impact on heart rate recovery (HRR) and possible associations of exercise capacity and HRR have not yet been investigated. We aimed to evaluate the effects of an exercise intervention on HRR in relation to the baseline aerobic capacity. Cancer patients (n = 309, 178 females) performed a cardiopulmonary exercise test at baseline and at a 4-month interval follow-up with home-based and supervised exercise programs in-between. VO2 and heart rate were assessed during and HRR at 60 and 120 s after test termination. Based on a median split of the VO2 peak baseline values, participants were dichotomized into two groups: below median (47 female; 57.5 ± 10 years) and above median (48 female; 54.3 ± 12 years). In the baseline sample (n = 309), VO2 peak correlated significantly with HRR60 (r = .327, p < .01) and HRR120 (r = .524, p < .01). For the compliers who completed intervention and assessments (n = 158), group comparisons demonstrated differences between below median versus above median group in absolute changes of HRR60 (3.1 ± 10.5 bpm (95 % CI +0.6; +5.4) vs −1.8 ± 8.7 bpm (95 % CI −3.7; +0.5)) and VO2 peak (2.9 ± 3.5 ml/kg/min (95 % CI +2.1; +3.7) vs 0.66 ± 4 ml/kg/min (95 % CI −0.6; +1.5)) (p < .01), but not in HRR120 (3.9 ± 11.8 bpm (95 % CI +1.2; +6.6) vs 0.8 ± 10.8 bpm (95 % CI −1.7; +3.5); p > .05). These findings point toward a positive linear relationship between aerobic capacity and vagal reactivation in cancer patients. Patients with initial VO2 peak values below median showed improved VO2 peak, HRR60 and HRR120 following the moderate aerobic exercise intervention and differences to patients above median in all outcomes compared.
Genetic Risk Score of 46 Type 2 Diabetes Risk Variants Associates With Changes in Plasma Glucose and Estimates of Pancreatic β-Cell Function Over 5 Years of Follow-Up

More than 40 genetic risk variants for type 2 diabetes have been validated. We aimed to test whether a genetic risk score associates with the incidence of type 2 diabetes and with 5-year changes in glycemic traits and whether the effects were modulated by changes in BMI and lifestyle. The Inter99 study population was genotyped for 46 variants, and a genetic risk score was constructed. During a median follow-up of 11 years, 327 of 5,850 individuals developed diabetes. Physical examinations and oral glucose tolerance tests were performed at baseline and after 5 years (n = 3,727). The risk of incident type 2 diabetes was increased with a hazard ratio of 1.06 (95% CI 1.03-1.08) per risk allele. While the population in general had improved glucose regulation during the 5-year follow-up period, each additional allele in the genetic risk score was associated with a relative increase in fasting, 30-min, and 120-min plasma glucose values and a relative decrease in measures of β-cell function over the 5-year period, whereas indices of insulin sensitivity were unaffected. The effect of the genetic risk score on 5-year changes in fasting plasma glucose was stronger in individuals who increased their BMI. In conclusion, a genetic risk score based on 46 variants associated strongly with incident type 2 diabetes and 5-year changes in plasma glucose and β-cell function. Individuals who gain weight may be more susceptible to the cumulative impact of type 2 diabetes risk variants on fasting plasma glucose.
Early statin treatment following acute myocardial infarction and 1-year survival.

Randomized trials have established statin treatment as secondary prevention in coronary artery disease, but it is unclear whether early treatment with statins following acute myocardial infarction (AMI) influences survival.



To evaluate the association between statin treatment initiated before or at the time of hospital discharge and 1-year mortality after AMI.



Prospective cohort study using data from the Swedish Register of Cardiac Intensive Care on patients admitted to the coronary care units of 58 Swedish hospitals in 1995-1998. One-year mortality data were obtained from the Swedish National Cause of Death Register.



Patients with first registry-recorded AMI who were younger than 80 years and who were discharged alive from the hospital, including 5528 who received statins at or before discharge and 14 071 who did not.



Relative risk of 1-year mortality according to statin treatment.



At 1 year, unadjusted mortality was 9.3% (1307 deaths) in the no-statin group and 4.0% (219 deaths) in the statin treatment group. In regression analysis adjusting for confounding factors and propensity score for statin use, early statin treatment was associated with a reduction in 1-year mortality (relative risk, 0.75; 95% confidence interval, 0.63-0.89; P =.001) in hospital survivors of AMI. This reduction in mortality was similar among all subgroups based on age, sex, baseline characteristics, previous disease manifestations, and medications.



Early initiation of statin treatment in patients with AMI is associated with reduced 1-year mortality. These results emphasize the importance of implementing the results of randomized statin trials in unselected AMI patients.
Detection of coronary plaques using MR coronary vessel wall imaging: validation of findings with intravascular ultrasound

Compared with X-ray coronary angiography (CAG), magnetic resonance imaging of the coronary vessel wall (MR-CVW) may provide more information about plaque burden and coronary remodelling. We compared MR-CVW with intravascular ultrasound (IVUS), the standard of reference for coronary vessel wall imaging, with regard to plaque detection and wall thickness measurements. In this study 17 patients with chest pain, who had been referred for CAG, were included. Patients underwent IVUS and MR-CVW imaging of the right coronary artery (RCA). Subsequently, the coronary vessel wall was analysed for the presence and location of coronary plaques. Fifty-two matching RCA regions of interest were available for comparison. There was good agreement between IVUS and MR-CVW for qualitative assessment of presence of disease, with a sensitivity of 94% and specificity of 76%. Wall thickness measurements demonstrated a significant difference between mean wall thickness on IVUS and MR-CVW (0.48 vs 1.24 mm, P < 0.001), but great heterogeneity between wall thickness measurements, resulting in a low correlation between IVUS and MR-CVW. MR-CVW has high sensitivity for the detection of coronary vessel wall thickening in the RCA compared with IVUS. However, the use of MRI for accurate absolute wall thickness measurements is not supported when a longitudinal acquisition orientation is used. • Both MRI and IVUS can assess coronary vessels • Both MRI and IVUS can identify coronary vessel wall thickening. • MRI provides more information about the coronary plaque burden than conventional angiography. • However, MRI overestimates absolute coronary wall thickness when compared with IVUS.
Cancer regression in patients after transfer of genetically engineered lymphocytes.

Through the adoptive transfer of lymphocytes after host immunodepletion, it is possible to mediate objective cancer regression in human patients with metastatic melanoma. However, the generation of tumor-specific T cells in this mode of immunotherapy is often limiting. Here we report the ability to specifically confer tumor recognition by autologous lymphocytes from peripheral blood by using a retrovirus that encodes a T cell receptor. Adoptive transfer of these transduced cells in 15 patients resulted in durable engraftment at levels exceeding 10% of peripheral blood lymphocytes for at least 2 months after the infusion. We observed high sustained levels of circulating, engineered cells at 1 year after infusion in two patients who both demonstrated objective regression of metastatic melanoma lesions. This study suggests the therapeutic potential of genetically engineered cells for the biologic therapy of cancer.
Non-invasive brain stimulation and robot-assisted gait training after incomplete spinal cord injury: A randomized pilot study.

Locomotor training with a robot-assisted gait orthosis (LT-RGO) and transcranial direct current stimulation (tDCS) are interventions that can significantly enhance motor performance after spinal cord injury (SCI). No studies have investigated whether combining these interventions enhances lower extremity motor function following SCI.



Determine whether active tDCS paired with LT-RGO improves lower extremity motor function more than a sham condition, in subjects with motor incomplete SCI.



Fifteen adults with SCI received 36 sessions of either active (n = 9) or sham (n = 6) tDCS (20 minutes) preceding LT-RGO (1 hour). Outcome measures included manual muscle testing (MMT; primary outcome measure); 6-Minute Walk Test (6MinWT); 10-Meter Walk Test (10MWT); Timed Up and Go Test (TUG); Berg Balance Scale (BBS); and Spinal Cord Independence Measure-III (SCIM-III).



MMT showed significant improvements after active tDCS, with the most pronounced improvement in the right lower extremity. 10MWT, 6MinWT, and BBS showed improvement for both groups. TUG and SCIM-III showed improvement only for the sham tDCS group.



Pairing tDCS with LT-RGO can improve lower extremity motor function more than LT-RGO alone. Future research with a larger sample size is recommended to determine longer-term effects on motor function and activities of daily living.
Differential effects of lercanidipine and nifedipine GITS on plasma norepinephrine in chronic treatment of hypertension.

This study aimed to compare the effects of two long-acting dihydropyridine calcium channel blockers (CCBs) with different pharmacologic properties, lercanidipine and nifedipine Gastro-Intestinal Therapeutic System (GITS), in the chronic treatment of essential hypertension. After a 4-week placebo run-in period, 60 patients of both sexes were randomly treated with lercanidipine 10 to 20 mg or nifedipine GITS 30 to 60 mg taken orally for 48 weeks, according to a double-blind, parallel group design. For the first 4 weeks of treatment, the lowest dose of each drug was used, followed by higher doses if diastolic blood pressure (BP) was >90 mm Hg. At the end of the placebo period and after 4, 8, 12, 24, and 48 weeks of active treatment BP, heart rate (HR), and plasma norepinephrine (NE) levels were assessed. Lercanidipine and nifedipine GITS similarly reduced BP values after 48 weeks (-21.7/15.9 mm Hg and -20.7/14.6 mm Hg, respectively, both P <.001 v placebo), with no change in HR. Despite the similar lack of effect on HR, the two drugs displayed different influences on plasma NE, which was significantly increased by nifedipine GITS (+56 pg/mL, P <.05 v placebo) but not by lercanidipine. These findings suggest that 1) sympathetic activation occurs during chronic therapy with nifedipine GITS but not with lercanidipine, which might be related to the different pharmacologic characteristics of the two CCBs at the doses evaluated; and 2) nifedipine GITS seems to activate peripheral but not cardiac sympathetic nerves, consistent with differing regulation of cardiac and peripheral sympathetic activity.
Safe and effective sedation in endoscopic submucosal dissection for early gastric cancer: a randomized comparison between propofol continuous infusion and intermittent midazolam injection

Endoscopic submucosal dissection (ESD) for early gastric cancer (EGC) generally takes longer to perform than conventional endoscopy and usually requires moderate/deep sedation with close surveillance for patient safety. The aim of this study was to compare the safety profiles and recovery scores propofol continuous infusion and intermittent midazolam (MDZ) injection as sedation for ESD. Sixty EGC patients scheduled for ESDs between August and November 2008 were included in this prospective study and randomly divided into a propofol (P-group, 28 patients) and an MDZ (M-group, 32 patients) group using an odd–even system. The P-group received a 0.8 mg/kg induction dose and a 3 mg/kg/h maintenance dose of 1% propofol using an infusion pump. All patients received 15 mg pentazocine at the start of the ESD and at 60-min intervals thereafter. We recorded and analyzed blood pressure, oxygen saturation and heart rate during and following the procedure and evaluated post-anesthetic recovery scores (PARS) and subsequent alertness scores. The propofol maintenance and total dose amounts were (mean ± standard deviation) 3.7 ± 0.6 mg/kg/h and 395 ± 202 mg, respectively. The mean total dose of MDZ was 10.3 ± 4.5 mg. There were no cases of de-saturation <90% or hypotension <80 mmHg in either group. Alertness scores 15 and 60 min after the procedures were significantly higher in the P-group (4.9/4.9) than in the M-group (4.6/4.5; p < 0.05). The mean PARS 15 and 30 min after the ESDs were significantly higher in the P-group (9.6/9.9) than in the M-group (8.6/9.2; p < 0.01). Based on our results, the ESDs for EGC performed under sedation using propofol continuous infusion were as safe as those performed using intermittent MDZ injection. Propofol-treated patients had a quicker recovery profile than those treated with MDZ. We therefore recommend the use of continuous propofol sedation for ESD, but sedation guidelines for the use of propofol are necessary.
Perioperative assessment of psychological state and quality of life of head and neck cancer patients undergoing surgery.

This study assessed psychological state and quality of life (QOL) in head and neck cancer patients during the perioperative period. Patients who had undergone primary surgery at the Department of Oral and Maxillofacial Surgery, Tokyo Medical and Dental University Hospital, Tokyo, Japan were enrolled. After obtaining informed consent, three tests were administered: the Hospital Anxiety and Depression Scale (HADS) to assess psychological state, and the Functional Assessment of Cancer Therapy General (FACT-G) and Functional Assessment of Head and Neck (FACT-H&N) to assess QOL. Japanese language versions of all tests were administered. Tests were administered 1 day before surgery, 1 week after surgery, and 1 and 6 months after discharge. Test scores were analyzed, as were relationships between psychological state, QOL and clinical factors. Anxiety was greatest before surgery, while depression was greatest immediately after surgery. QOL in the somatic and specific domains also decreased immediately after surgery. QOL in most domains improved 1 month after discharge. This study offers important information regarding perioperative psychological state and QOL in head and neck cancer patients.
Effect of dipyridamole on fluorodeoxyuridine cytotoxicity in vitro and in cancer patients

Dipyridamole (DP) has previously been studied both in vitro and in vivo in combination with various antimetabolites, including methotrexate and 5-fluorouracil (5FU). We evaluated in vitro and clinically the effects of adding DP to fluorodeoxyuridine (FUDR) in colorectal cancer. Using a human colony-forming assay, we observed that 0.05 μM DP increased the cytotoxicity of FUDR by a median of 33.5-fold vs 1.5-fold for 5FU against human colon-cancer cell lines. The mechanism of the DP-enhanced antitumor activity of FUDR is not completely understood but appears to be related to a profound inhibition by DP of thymidine accumulation in and FUDR efflux from colon-cancer cell lines. On the basis of these in vitro results, 28 patients with metastatic colon cancer were entered in a clinical trial of monthly courses of 0.1 mg/kg FUDR daily for 14 days and 75 mg oral DP 5 times daily for 14 days starting on the 3rd day of continuous i.v. FUDR infusion. The pharmacokinetics of DP was studied in three patients; the results showed that 98% of total serum DP was protein-bound and that free DP levels were significantly lower than the concentrations necessary for the expected in vitro DP/FUDR modulation. Treatment was well tolerated, with only 12 patients developing mild to moderate toxicity. Of 27 evaluable patients, 4 achieved a partial response that lasted 2, 3, 5, and 6+ months. This relatively low response rate (15%), which is similar to that achieved with FUDR alone, may be explained by the low steady-state plasma concentrations of free DP achieved in our patients. Other means of DP administration, such as i.v., i.a., and i.p. injection, may be required to achieve free DP concentrations necessary for successful biochemical modulation of FUDR in patients.