nils-herrmann/clean_scirepeval huggingface dataset:
Validity and reliability of the French version of the STarT Back screening tool for patients with low back pain.

Observational prospective study.



Our objective was to assess the reliability and validity of the French version of the Keele STarT Back Screening Tool (SBST).



The SBST is a recently validated tool developed to identify subgroups of patients with low back pain (LBP) to guide early secondary prevention in primary care.



Outpatients 18 years or older with LBP, attending a rehabilitation center, a back school, a private physiotherapy unit, or a fitness center were included. Patients were assessed through the SBST, Roland-Morris Disability Questionnaire, Örebro Musculoskeletal Pain Screening Questionnaire, Medical Outcomes Survey Short Form-36 questionnaire, and a pain visual analogue scale. Test-retest reliability was assessed with Kappa score or the intraclass correlation coefficient, internal consistency of the Psychological subscale with the Cronbach α coefficient, construct validity with the Spearman correlation coefficient, and floor and ceiling effects by percentage frequency of lowest or highest possible score achieved by respondents.



One hundred eight patients with LBP were included. The test-retest reliability of the SBST total score was excellent with an intraclass correlation coefficient of 0.90 (0.81-0.95). The Cronbach α coefficient was 0.73 showing a good internal consistency for the Psychological subscale. High Spearman correlation coefficients of 0.74 between SBST and Roland-Morris Disability Questionnaire, and 0.74 between the SBST and Örebro Musculoskeletal Pain Screening Questionnaire were observed. As expected, low-to-moderate correlations were observed between the SBST total score and some dissimilar measures of the Short-Form 36. The lowest possible SBST score was observed for 8 patients (7.4%), whereas only 3 patients (2.8%) had the highest possible SBST score.



The French version of the SBST is a reliable and valid questionnaire consistent with the original English version. Therefore, this new version may help French-speaking clinicians and scientists to stratify patients with LBP.
Comparison of the effects of low-dose rosuvastatin on plasma levels of cholesterol and oxidized low-density lipoprotein in 3 ultracentrifugally separated low-density lipoprotein subfractions.

Plasma-oxidized (ox) low-density lipoprotein (LDL) is an atherogenic lipoprotein. The distribution of ox-LDL in plasma LDL subfractions and the effect of statins on this distribution have not been investigated in detail.



We examined the distribution of cholesterol and ox-LDL in 3 ultracentrifugally separated plasma LDL subfractions and investigated the effects of a statin, rosuvastatin, on the levels of these lipoproteins.



Thirty-one polygenic hypercholesterolemic subjects were included in this study. Levels of cholesterol and ox-LDL in 3 plasma LDL subfractions and plasma levels of remnant-like particle cholesterol, ox-LDL, and adiponectin were measured after 0, 3, 6, and 12 months of treatment with rosuvastatin. Sequential ultracentrifugation was performed to subfractionate plasma lipoproteins.



The mean daily dose of rosuvastatin over the 12 months of treatment was 2.9 ± 1.0 mg (mean ± standard deviation). The cholesterol subfraction distribution was 43 ± 10% as low-density LDL, 46 ± 8% as medium-density LDL, and 13 ± 5% as high-density LDL. Similarly, the distribution of ox-LDL was 31 ± 10% as low-density LDL, 48 ± 7% as medium-density LDL, and 22 ± 8% as high-density LDL. After 12 months of treatment with rosuvastatin, the level of cholesterol was significantly reduced in all 3 subfractions (P < .0001), as was the level of ox-LDL (P < .0001). Furthermore, the plasma cholesterol level in high-density lipoprotein2 increased significantly.



The distribution of ox-LDL in plasma LDL subfractions was more skewed toward the denser subfractions, compared with cholesterol. Rosuvastatin treatment significantly reduced plasma levels of cholesterol and ox-LDL in all LDL subfractions.
Identification of the best complete blood count-based predictors for bladder cancer outcomes in patients undergoing radical cystectomy

We sought to determine which parsimonious combination of complete blood count (CBC)-based biomarkers most efficiently predicts oncologic outcomes in patients undergoing radical cystectomy (RC) for bladder cancer (BC).Methods:Using our institutional RC database (1992–2012), nine CBC-based markers (including both absolute cell counts and ratios) were evaluated based on pre-treatment measurements. The outcome measures were recurrence-free survival (RFS), cancer-specific survival (CSS), and overall survival (OS). Time-dependent receiver-operating characteristics curves were used to characterise each biomarker. The CBC-based biomarkers, along with several clinical predictors, were then considered for inclusion in predictive multivariable Cox models based on the Akaike Information Criterion.Our cohort included 418 patients. Neutrophil–lymphocyte ratio (NLR) was the only biomarker satisfying criteria for inclusion into all models, independently predicting RFS (HR per 1-log unit=1.52, 95% CI=1.17–1.98, P=0.002), CSS (HR=1.47, 95% CI=1.20–1.80, P<0.001), and OS (HR=1.56, 95% CI=1.16–2.10, P=0.004). Haemoglobin was also independently predictive of CSS (HR per 1 g/dl=0.91, 95% CI=0.86–0.95, P<0.001) and OS (HR=0.90, 95% CI=0.88–0.93, P<0.001), but not RFS.Conclusions:Among CBC biomarkers studied, NLR was the most efficient marker for predicting RFS, whereas NLR and haemoglobin were most efficient in predicting CSS and OS. NLR and haemoglobin are promising, cost-effective, independent biomarkers for predicting oncologic BC outcomes following RC.Condensed abstract:Various CBC-based biomarkers have separately been shown to be predictive of oncologic outcomes in patients undergoing cystectomy for BC. Our study evaluated these biomarkers, and determined that NLR is the best CBC-based biomarker for predicting RFS, whereas NLR and haemoglobin are most efficient for predicting CSS and OS.
Methods to assess aphasic stroke patients.

The Community Stroke Study was designed to raise the quality of life and improve the long-term rehabilitation outcomes of neurologically impaired stroke patients. This threeyear randomized clinical trial is based on a program that was developed by Valerie Eaton Griffith in Great Britain to help patients recover from stroke through the efforts of community volunteers(I-5). Although her program has expanded to 63 stroke schemes in the United Kingdom with approximately 2,000 patients receiving volunteer visits, Griffith's intervention had never before been replicated and scientifically tested through a randomized clinical trial(6). With funding from the Health Services Research and Development Service of the Veterans Administration , the Community Stroke Study enlisted the aid of over 100 community volunteers trained by nurses and
Effects of modified sit-to-stand training on balance control in hemiplegic stroke patients: a randomized controlled trial.

To explore the effectiveness of modified sit-to-stand training on balance function in hemiplegic stroke patients.



Randomized controlled trial.



Rehabilitation medical centre.



A total of 50 hemiplegic patients with stroke were randomly assigned to the control and experimental groups (n = 25 for each group).



Patients in the control group received the sit-to-stand training with symmetrical foot position, while patients in the experimental group were given the modified sit-to-stand training in which the paretic foot placed posterior. Subjects in both groups received 30 minutes of sit-to-stand training, five times a week, for four weeks.



The time and weight-bearing distribution during sit-to-stand movement, the centre of pressure sway length during quiet standing, the centre of pressure sway areas during dynamic standing and Berg Balance Scale were assessed before and after completing the four-week sit-to-stand training.



Our data showed significant improvements in standing balance and the sit-to-stand movement for two groups in the post-training compared with the pre-training. After training, the rise time shortened more significantly in the experimental group (mean change, 0.90 ±0.25 seconds) than the control group (mean change, 0.42 ±0.18 seconds). Weight-bearing asymmetry showed significantly greater improvement in the experimental group (mean change, 0.17 ±0.10) than in the control group (mean change, 0.06 ±0.05). Centre of pressure sway length was significantly smaller in the experimental group (mean change, 27.85 ±10.58 cm) than in the control group (mean change, 21.95 ±8.19 cm). Centre of pressure sway areas was significantly larger in the experimental group (mean change, 84.24 ±26.48 cm(2)) than in the control group (mean change, 67.74 ±22.84 cm(2)) (P = 0.027). The Berg Balance Scale was significantly higher in the experiment group (mean change, 8.4 ±3.1) than the control group (mean change, 5.8±2.8).



A modified sit-to-stand training improves the balance function in hemiplegic stroke patients.
Effect of dobutamine stress on basal septal tissue dynamics in hypertensive patients with basal septal hypertrophy

Left ventricular outflow tract (LVOT) obstruction has been classically observed in hypertrophic cardiomyopathy in which the LVOT obstruction is associated with asymmetric septal hypertrophy producing a systolic pressure gradient across the LVOT. Basal septal hypertrophy (BSH) with hypertension may result in dynamic LVOT obstruction as well. It was suggested that regional hypertrophy may be related to enhanced ventricular dynamics.
Clinical course of extrarenal symptoms in Henoch-Schonlein purpura: a 6-month prospective study.

To describe the extrarenal symptoms and clinical course of Henoch-Schönlein purpura (HSP).



A prospective national multicentre trial with 6-month follow-up.  A total of 223 newly diagnosed paediatric HSP patients.



Purpura was the initial symptom in 73% of the patients and was preceded by joint or gastrointestinal manifestations in the rest by a mean of 4 days. Joint symptoms, abdominal pain, melena, nephritis and recurrences occurred in 90%, 57%, 8%, 46% and 25% of the patients, respectively. Orchitis affected 17/122 (14%) of the boys. Seven patients developed protein-losing enteropathy characterised by abdominal pain, oedema and serum albumin under 30 g/l, and an additional 49 patients had subnormal albumin levels without any proteinuria. Positive fecal occult blood (26/117, 22%) and α1-antitrypsin (7/77, 9%) suggested mucosal injury even in the patients without gastrointestinal symptoms. HSP was often preceded by various bacterial, especially streptococcal (36%) and viral infections. Previous streptococcal infection did not induce changes in the level of complement component C3. Recurrences were more frequent in patients >8 years of age (OR 3.7, CI 2.0 to 7.0, p<0.001) and in patients with nephritis (OR 4.6, CI 2.3 to 8.9, p<0.001). Patients with severe HSP nephritis had more extrarenal symptoms up to 6 months. There was no difference in the clinical course between the prednisone-treated and non-treated patients during the 6-month follow-up.



Serum albumin is often low in HSP patients without proteinuria, due to protein loss via the intestine. Although corticosteroids alleviate the symptoms, they seem not to alter the clinical course of HSP during 6 months of follow-up.
Consumption of yerba mate ( Ilex paraguariensis ) improves serum lipid parameters in healthy dyslipidemic subjects and provides an additional LDL-cholesterol reduction in individuals on statin therapy.

The objective of this study was to verify the effect of yerba mate (Ilex paraguariensis) consumption on lipid and lipoprotein levels in humans. One hundred and two individuals participated of this single-blind controlled trial. Normolipidemic (n = 15), dyslipidemic (n = 57), and hypercholesterolemic subjects on long-term statin therapy (n = 30) ingested 330 mL, 3 times/day, of green or roasted yerba mate infusions for 40 days. In normolipidemic subjects, yerba mate consumption reduced LDL-cholesterol by 8.7% (p < 0.05). Compared with the baseline period, yerba mate intake by dyslipidemic individuals for 20 and 40 days lowered LDL-cholesterol by 8.1 and 8.6% (p < 0.001) and non-HDL cholesterol by 5.4 and 6.5% (p < 0.01). After 20 days of yerba mate intake, apolipoprotein B was reduced by 6.0% (p < 0.05) and HDL-cholesterol was increased by 4.4% (p < 0.01). In all participants triglyceride levels remained unchanged. The consumption of yerba mate by hypercholesterolemic individuals on statin therapy promoted additional 10.0 and 13.1% reductions in LDL-C after 20 and 40 days, respectively (p < 0.001) and increased HDL-cholesterol by 6.2% after 40 days (p < 0.05). It was thus concluded that intake of yerba mate infusion improved the lipid parameters in normolipidemic and dyslipidemic subjects and provided an additional LDL-cholesterol reduction in hypercholesterolemic subjects on statin treatment, which may reduce the risk for cardiovascular diseases.
Reduced Basal ATP Synthetic Flux of Skeletal Muscle in Patients with Previous Acromegaly

Impaired mitochondrial function and ectopic lipid deposition in skeletal muscle and liver have been linked to decreased insulin sensitivity. As growth hormone (GH) excess can reduce insulin sensitivity, we examined the impact of previous acromegaly (AM) on glucose metabolism, lipid storage and muscular ATP turnover.



Seven AM (4f/3 m, age: 46+/-4 years, BMI: 28+/-1 kg/m(2)) and healthy volunteers (CON: 3f/4 m, 43+/-4 years, 26+/-2 kg/m(2)) matched for age and body mass underwent oral glucose testing for assessment of insulin sensitivity (OGIS) and ss-cell function (adaptation index, ADAP). Whole body oxidative capacity was measured with indirect calorimetry and spiroergometry. Unidirectional ATP synthetic flux (fATP) was assessed from (31)P magnetic resonance spectroscopy (MRS) of calf muscle. Lipid contents of tibialis anterior (IMCLt) and soleus muscles (IMCLs) and liver (HCL) were measured with (1)H MRS.



Despite comparable GH, insulin-like growth factor-1 (IGF-I) and insulin sensitivity, AM had approximately 85% lower ADAP (p<0.01) and approximately 21% reduced VO(2)max (p<0.05). fATP was similarly approximately 25% lower in AM (p<0.05) and related positively to ADAP (r = 0.744, p<0.01), but negatively to BMI (r = -0.582, p<0.05). AM had approximately 3 fold higher HCL (p<0.05) while IMCLt and IMCLs did not differ between the groups.



Humans with a history of acromegaly exhibit reduced insulin secretion, muscular ATP synthesis and oxidative capacity but elevated liver fat content. This suggests that alterations in ss-cell function and myocellular ATP production may persist despite normalization of GH secretion after successful treatment of acromegaly.
Performance characteristics of Pap test, VIA, VILI, HR-HPV testing, cervicography, and colposcopy in diagnosis of significant cervical pathology

We sought to evaluate the performance of diagnostic tools to establish an affordable setting for early detection of cervical cancer in developing countries. We compared the performance of different screening tests and their feasibility in a cohort of over 12,000 women: conventional Pap smear, liquid-based cytology, visual inspection with acetic acid (VIA), visual inspection with Iodine solution (VILI), cervicography, screening colposcopy, and high-risk human papillomavirus (HPV) testing (HR-HPV) collected by physician and by self-sampling. HR-HPV assay collected by the physician has the highest sensitivity (80 %), but high unnecessary referrals to colposcopy (15.1 %). HR-HPV test in self-sampling had a markedly lower (57.1 %) sensitivity. VIA, VILI, and cervicography had a poor sensitivity (47.4, 55, and 28.6 %, respectively). Colposcopy presented with sensitivity of 100 % in detecting CIN2+, but the lowest specificity (66.9 %). Co-testing with VIA and VILI Pap test increased the sensitivity of stand-alone Pap test from 71.6 to 87.1 % and 71.6 to 95 %, respectively, but with high number of unnecessary colposcopies. Co-testing with HR-HPV importantly increased the sensitivity of Pap test (to 86 %), but with high number of unnecessary colposcopies (17.5 %). Molecular tests adjunct to Pap test seems a realistic option to improve the detection of high-grade lesions in population-based screening programs.
A universal formula based on cystatin C to perform individual dosing of carboplatin in normal weight, underweight, and obese patients.

2527  It has recently been shown that it is possible to improve the prediction of carboplatin clearance by adding plasma cystatin C level (cysC), an endogenous marker of glomerular filtration rate, to the other patient characteristics routinely used for carboplatin individual dosing, namely serum creatinine (Scr), body weight (BW), age, and sex. This multi-center pharmacokinetic study was performed to evaluate prospectively the benefit of using cysC for carboplatin individual dosing.



The 357 patients included in the study were receiving carboplatin as part of established protocols. A population pharmacokinetic analysis was performed using the NONMEM program. Seven covariates were studied: Scr, cysC, age, sex, BW, ideal body weight, and lean body mass.



The best covariate equation was: carboplatin clearance (mL/min) = 105.
[Symptom-oriented follow-up of early breast cancer compared to intensive surveillance. Results of a prospective multicentre study: update and 10-year overall survival].

In a prospective, non-randomised, multicentre cohort study we compared intensive surveillance to symptom-oriented control in the follow-up of patients with early breast cancer after curative surgical treatment. Five-year overall survival had shown that symptom-oriented follow-up was not inferior to intensive control. However, a more intensive, instrumental based follow-up is still claimed by many patients and their physicians. In this context the recent data of 10-year overall survival (OS) are reported.



In the prospective, non-randomised, multicentre cohort study carried out between 1995 and 2000, 244 patients underwent an intensive follow-up (scheduled laboratory tests including CEA and CA 15-3, chest X-rays and liver ultrasound). 426 patients were monitored in a symptom-oriented manner (additional tests only in the case of symptoms indicating possible recurrence). Mammography, structured histories and physical examinations were done regularly in both groups.



In the clinical follow-up group, 90 deaths (21.2 %) were observed with an estimated 10-year overall survival rate of 83.0 % (95 % CI 79.1 -86.3 %).  In the intensive follow-up group, 59 deaths (24.2 %) were observed with an estimated 10-year overall survival rate of 78.5 % (95 % CI 72.6 -83.2 %). The Cox proportional hazards model for OS includes the variables follow-up form, stage of primary tumor and lymph nodes, hormone receptor status, grading and age at diagnosis. This model resulted in a hazard ratio of 1.10 (95 % CI 0.78-1.54) for the follow-up protocol (intensive vs. clinical). Welleks' test for non-inferiority showed that clinical follow-up is not inferior in comparison to intensive follow-up (p < 0.05) for a non-inferiority limit of + 7 % at 10-years.



This analysis of 10-year overall survival of patients with early breast cancer after curative primary treatment confirms that follow-up without regular imaging and laboratory tests is not inferior in the sense of a relevant higher mortality. To what extent new concepts in the treatment of breast cancer have any influence on follow-up care has to be examined in further studies.
Discriminative and predictive properties of multidimensional prognostic indices of chronic obstructive pulmonary disease: a validation study in Taiwanese patients.

Chronic obstructive pulmonary disease (COPD) is a pulmonary disease with systemic involvement. Several multidimensional indices have been developed to predict long-term outcomes. However, these indices have not been compared and validated in Taiwanese patients with COPD.



A prospective, observational, hospital-based study was designed, and a total of 621 patients were recruited from May 2006 to December 2011. Patients followed at least 1 year were enrolled and 594 patients eligible for inclusion. Three prognostic indices--the ADO (age, dyspnoea and airflow obstruction), BODEx (body mass index, airflow obstruction, dyspnoea and exacerbations), and CPI (the COPD Prognostic Index)--were validated and the predictive power of each was analysed.



The median follow-up of the 594 patients was 33 months (range 1-72 months), and the mortality rate was 19.2% (114 deaths). All indices were significantly predictive for all-cause mortality in our validation cohort. Furthermore, the C statistics of the three indices, indicating their predictive accuracy, were all >0.7 (area under the curve of the CPI 0.718, P < 0.001, ADO 0.702, P < 0.001, BODEx 0.702, P < 0.001).



ADO, BODEx and CPI scores are useful predictors of all-cause mortality with significantly discriminative properties in Taiwanese patients with COPD.
RUNX1 mutations in cytogenetically normal acute myeloid leukemia are associated with a poor prognosis and up-regulation of lymphoid genes.

The RUNX1 (AML1) gene is a frequent mutational target in myelodysplastic syndromes and acute myeloid leukemia. Previous studies suggested that RUNX1 mutations may have pathological and prognostic implications.



We screened 93 patients with cytogenetically normal acute myeloid leukemia for RUNX1 mutations by capillary sequencing of genomic DNA. Mutation status was then correlated with clinical data and gene expression profiles.



We found that 15 out of 93 (16.1%) patients with cytogenetically normal acute myeloid leukemia had RUNX1 mutations. Seventy-three patients were enrolled in the AMLCG-99 trial and carried ten RUNX1 mutations (13.7%). Among these 73 patients RUNX1 mutations were significantly associated with older age, male sex, absence of NPM1 mutations and presence of MLL-partial tandem duplications. Moreover, RUNX1-mutated patients had a lower complete remission rate (30% versus 73% P=0.01), lower relapse-free survival rate (3-year relapse-free survival 0% versus 30.4%; P=0.002) and lower overall survival rate (3-year overall survival 0% versus 34.4%; P<0.001) than patients with wild-type RUNX1. RUNX1 mutations remained associated with shorter overall survival in a multivariate model including age and the European Leukemia Net acute myeloid leukemia genetic classification as covariates. Patients with RUNX1 mutations showed a unique gene expression pattern with differential expression of 85 genes. The most prominently up-regulated genes in patients with RUNX1-mutated cytogenetically normal acute myeloid leukemia include lymphoid regulators such as HOP homeobox (HOPX), deoxynucleotidyltransferase (DNTT, terminal) and B-cell linker (BLNK), indicating lineage infidelity.



Our findings firmly establish that RUNX1 mutations are a marker of poor prognosis and provide insights into the pathogenesis of RUNX1 mutation-positive acute myeloid leukemia.