nils-herrmann/clean_scirepeval huggingface dataset:
Randomized controlled equivalence trial comparing videoconference and in person delivery of cognitive processing therapy for PTSD.

In an effort to improve access to and utilization of health care, the Veterans Health Administration (VHA) continues to investigate the effectiveness of video-teleconferencing (VTC) technologies for service delivery. While previous research focused on the efficacy of VTC treatment for post-traumatic stress disorder (PTSD) in Vietnam era veterans, few studies have evaluated the efficacy of this modality and treatment for the Iraq/Afghanistan era veterans. The aim of this randomized clinical trial was to evaluate equivalence between in person and VTC psychotherapy for PTSD in this newer cohort.



Veterans of the Iraq/Afghanistan conflict from two VHA hospitals in the United States were recruited and randomized to receive cognitive processing therapy (CPT) for PTSD either in person (IP) or over VTC. Clinician-administered and self-report measures were collected before, during, and after treatment.



A trend was observed which suggested that CPT over VTC may be equivalent to the treatment delivered in person, as suggested by previous studies. Regardless of treatment, veterans who received the intervention in both conditions reported significant decreases on post-treatment measures.



This study highlighted research and clinical challenges in providing services to the newest veteran generation in general as well as unique challenges with VTC. One complicating factor to the statistical power of this study was a treatment dropout rate twice the original estimate. Factors that could have influenced this high dropout rate are explored.
Evaluation of the effectiveness of therapeutic massage in patients with neck pain.

Neck pain is one of the most common musculoskeletal ailments. The aim of this study was to evaluate the effectiveness and impact of therapeutic massage on the range of motion in patients with neck pain.



The study involved 60 patients aged 37-82 years (mean age: 62.8 ± 9.86 years) treated for neck pain at the Rehabilitation Department of Zamość University of Management and Administration. The patients were divided into two groups: one (30 persons) received kinesiotherapy and physiotherapy, and the other group (30 persons) additionally received therapeutic massage. The effectiveness of rehabilitation was assessed with a Saunders digital inclinometer, the Neck Disability Index (NDI) and a Visual Analogue Scale (VAS).



Both groups did not differ significantly in terms of NDI and VAS scores at baseline (NDI: p = 0.56,  P = 0.231) and after rehabilitation (NDI: p = 0.203; VAS: P = 0.401). The NDI questionnaire and VAS revealed a significant pain reduction (p <0.001), and improved performance and function (p <0.001) after rehabilitation in both groups. Patients who had received massage demonstrated a statistically significant improvement in the range of flexion (p = 0.022), lateral bend to the right (p = 0.018), and lateral bend to the left (p = 0.003).



1. Therapeutic massage increases ranges of motion. 2. The effectiveness of therapeutic massage is comparable to the effectiveness of rehabilitation based only on physical therapy and kinesiotherapy.
National review of deaths among HIV-infected adults.

This review describes patterns of mortality among adults infected with HIV in the UK and assesses the contributions of late diagnosis of HIV infection and non-HIV-related disease to such mortality. In total, 387 adults with HIV who died between 1 October 2004 and 30 September 2005 after receiving care at 90 clinical centres in the UK were reviewed. Causes of death and scenarios accounting for death were measured. Of the 387 deaths, 218 (56.3%) were readily attributable to infection with HIV. Only 123 (31.8%) deaths were considered not directly related to HIV. Late diagnosis of HIV accounted for 24.0% of all deaths and 35.2% of HIV-related deaths. Infection with HIV remains the main cause of mortality among infected patients in the era of highly active antiretroviral therapy. Late diagnosis of infection with HIV may be the largest potentially remediable factor for HIV-associated death.
Von Neumann hybrid cellular automata for generating deterministic test sequences

We propose an on-chip test pattern generator that uses an one-dimensional cellular automaton (CA) to generate either a precomputed sequence of test patterns or pairs of test patterns for path delay faults. To our knowledge, this is the first approach that guarantees successful on-chip generation of a given test pattern sequence (or a given test set for path delay faults) using a finite number of CA cells. Given a pair of columns (C<subscrpt><italic>u</italic></subscrpt>, C<subscrpt><italic>v</italic></subscrpt>) of the test matrix, the proposed method uses alternative “link procedures” P<subscrpt><italic>j</italic></subscrpt> that compute the number of extra CA cells to enable the generation of (C<subscrpt>u</subscrpt>, C<subscrpt><italic>v</italic></subscrpt>) by the  CA. A systematic approach uses the link procedures to minimize the total number of needed CA cells. The performance of the scheme depends on an appropriate choice of link procedures P<subscrpt><italic>j</italic></subscrpt>.
Goal setting using telemedicine in rural underserved older adults with diabetes: experiences from the informatics for diabetes education and telemedicine project.

To describe the use of telemedicine for setting goals for behavior change and examine the success in achieving these goals in rural underserved older adults with diabetes.



Medicare beneficiaries with diabetes living in rural upstate New York who were enrolled in the telemedicine intervention of the Informatics for Diabetes Education and Telemedicine (IDEATel) project (n = 610) participated in home televisits with nurse and dietitian educators every 4-6 weeks for 2-6 years. Behavior change goals related to nutrition, physical activity, monitoring, diabetes health maintenance, and/or use of the home telemedicine unit were established at the conclusion of each televisit and assessed at the next visit.



Collaborative goal setting was employed during 18,355 televisits (mean of 33 goal-setting televisits/participant). The most common goals were related to monitoring, followed by diabetes health maintenance, nutrition, exercise, and use of the telemedicine equipment. Overall, 68% of behavioral goals were rated as "improved" or "met." The greatest success was achieved for goals related to proper insulin injection technique and daily foot care. These elderly participants had the most difficulty achieving goals related to use of the computer. No gender differences in goal achievement were observed.



Televisits can be successfully used to collaboratively establish behavior change goals to help improve diabetes self-management in underserved elderly rural adults.
Exercise reduces the intensity and prevalence of low back pain in 12-13 year old children: a randomised trial.

Does an eight-week exercise program reduce the intensity and prevalence of low back pain in 12-13 year old children? Does it decrease the childhood physical risk factors for low back pain and promote a sense of well-being?



Randomised trial with concealed allocation and assessor blinding.



Seventy-two 12-13 year old children, who had complained of low back pain in the past three months.



The experimental group completed eight exercise classes of 40-45 minutes duration over eight weeks conducted by a physiotherapist, whilst the control group received no intervention.



The primary outcome was pain intensity measured on a 10-cm visual analogue scale. Secondary outcomes included 3-month prevalence of pain, childhood physical risk factors for low back pain, and sense of well-being. Measures were taken at baseline (Month 0), post-intervention (Month 3), and three months later (Month 6).



Pain intensity over the past month had decreased by 2.2 cm (95% CI 1.0 to 3.5) more for the experimental group than the control group at Month 3 and was still 2.0 cm (95% CI 0.5 to 3.5) less than the control group at Month 6. The absolute risk reduction for 3-month prevalence in low back pain in the experimental group was 24% (95% CI 4 to 41) compared with the control group at Month 3, and 40% (95% CI 18 to 57) at Month 6. There were also statistically-significant between-group differences in neural mobility.



Exercise is effective in reducing the intensity and prevalence of low back pain in children.
Effect of nebulised aerosol size on lung deposition in patients with mild asthma.

A radioaerosol technique has been used to investigate whether the size distribution of aerosols released from a jet nebuliser affects the amount of aerosol delivered to the lungs. Six subjects with mild asthma (FEV1 81% of predicted) were studied on three occasions. On each visit they received one of three aerosols tagged with technetium-99m in 0.9% saline. The aerosols were generated by either (A) a Turret nebuliser operated at 8 l min-1 (mass median diameter (MMD) 1.8 micron); (B) an Upmist nebuliser operated at 6 l min-1 (MMD 4.6 microns); or (C) an Inspiron Mini-neb operated at 4 l min-1 (MMD 10.3 microns). The aerosols were given in a randomised single blind manner and inhaled under identical conditions of inspiratory volume and frequency. The mean (SD) percentage of aerosols A, B, C released from the nebulisers during inhalation that was recovered in an expiratory filter was 23 (6), 25 (4), and 24 (4) respectively. Of the aerosols released from the nebuliser and deposited in the body, the percentage deposited in the lung was 79 (3) for aerosol A, 59 (4) for aerosol B, and 44 (5) for aerosol C. The remaining aerosol was deposited in the oropharynx and swallowed. It is concluded that small nebulised aerosols (MMD less than 2 microns) deliver a larger dose to the lungs and should be used to maximise lung deposition.
Design and rationale of a comparative effectiveness trial evaluating transcendental meditation against established therapies for PTSD.

Although meditation therapies such as the Transcendental Meditation (TM) technique are commonly used to assist with stress and stress-related diseases, there remains a lack of rigorous clinical trial research establishing the relative efficacy of these treatments overall and for populations with psychiatric illness. This study uses a comparative effectiveness design to assess the relative benefits of TM to those obtained from a gold-standard cognitive behavioral therapy for posttraumatic stress disorder (PTSD) in a Veteran population.



This paper describes the rationale and design of an in progress randomized controlled trial comparing TM to an established cognitive behavioral treatment - Prolonged Exposure (PE) - and an active control condition (health education [HE]) for PTSD. This trial will recruit 210 Veterans meeting DSM-IV criteria for PTSD, with testing conducted at 0 and 3 months for PTSD symptoms, depression, mood disturbance, quality of life, behavioral factors, and physiological/biochemical and gene expression mechanisms using validated measures. The study hypothesis is that TM will be noninferior to PE and superior to HE on changes in PTSD symptoms, using the Clinician Administered PTSD Scale (CAPS).



The described study represents a methodologically rigorous protocol evaluating the benefits of TM for PTSD. The projected results will help to establish the overall efficacy of TM for PTSD among Veterans, identify bio-behavioral mechanisms through which TM and PE may improve PTSD symptoms, and will permit conclusions regarding the relative value of TM against currently established therapies for PTSD.
Using an office system intervention to increase breast cancer screening

To evaluate an innovative approach to continuing medical education, an outreach intervention designed to improve performance rates of breast cancer screening through implementation of office systems in community primary care practices.  Randomized, controlled trial with primary care practices assigned to either the intervention group or control group, with the practice as the unit of analysis.  Twenty mostly rural counties in North Carolina.  Physicians and staff of 62 randomly selected family medicine and general internal medicine practices, primarily fee-for-service, half group practices and half solo practitioners.  Physician investigators and facilitators met with practice physicians and staff over a period of 12 to 18 months to provide feedback on breast cancer screening performance, and to assist these primary care practices in developing office systems tailored to increase breast cancer screening.  Physician questionnaires were obtained at baseline and follow-up to assess the presence of five indicators of an office system. Three of the five indicators of office systems increased significantly more in intervention practices than in control practices, but the mean number of indicators in intervention practices at follow-up was only 2.8 out of 5. Cross-sectional reviews of randomly chosen medical records of eligible women patients aged 50 years and over were done at baseline (n=2,887) and follow-up (n=2,874) to determine whether clinical breast examinations and mammography, were performed. Results for mammography were recorded in two ways, mention of the test in the visit note and actual report of the test in the medical record. These reviews showed an increase from 39% to 51% in mention of mammography in intervention practices, compared with an increase from 41% to 44% in control practices (p=.01). There was no significant difference, however, between the two groups in change in mammograms reported (intervention group increased from 28% to 32.7%; control group increased from 30.6% to 34.0%, p=.56). There was a nonsignificant trend (p=.06) toward a greater increase in performance of clinical breast examination in intervention versus control practices.  A moderately intensive outreach intervention to increase rates of breast cancer screening through the development of office systems was modestly successful in increasing indicators of office systems and in documenting mention of mammography, but had little impact on actual performance of breast cancer screening. At follow-up, few practices had a complete office system for breast cancer screening. Outreach approaches to assist primary care practices implement office systems are promising but need further development.
Pro-calcitonin and inflammation in chronic hemodialysis.

Procalcitonin (PCT) has emerged as a marker of infection, a frequent complication in hemodialysis (HD). We analyzed PCT levels in chronic non-acutely infected HD subjects, assessed its correlation with inflammatory and nutritional markers and propose a PCT reference value for non-infected HD patients. In an observational cross-sectional study, 48 chronic HD patients and 36 controls were analyzed.



age, gender, time on HD; diabetes; vascular access, PCT, C-reactive protein (CRP), albumin, malnutrition inflammatory score (MIS), hematocrit, leukocyte count, and body mass index (BMI). Subsequently, control (G1, n = 36, 43%) vs. non-infected patients (G2, n = 48, 57%) groups were compared. In control subjects (G1), age: 54.3 ± 13.7 years, range (r): 30-81; males: 19 (53%); median PCT 0.034 ng/ml (r: 0.02-0.08); median CRP 0.80 mg/ dl (r: 0.36-3.9); p95 PCT level: 0.063 ng/ml. In G2, age: 60.2 ± 15.2 years; males 32 (67%), time on HD: 27.0 ± 24.4; diabetics: 19 (32%); median PCT: 0.26 ng/ml (r: 0.09-0.82); CRP: 1.1 mg/dl (r: 0.5-6.2); p95 PCT level: 0.8 ng/ml. In control subjects, PCT and CRP were significantly lower than in G2: PCT: 0.034 vs. 0.26 ng/ml, p = 0.0001; CRP: 0.8 vs. 1.1 mg/dl, p = 0.0004. PCT-CRP correlation in G2: p = 0.287, p = 0.048. PCT and CRP concentrations are elevated in chronic non-acutely infected HD subjects, independently of infection, diabetes and vascular access. A p95 PCT level of 0.8 ng/ml may be considered as the upper normal reference value in non-acutely infected HD subjects. The PCT cut-off level in HD is yet to be determined in HD.
The utility of laparoscopy in the diagnosis of acute appendicitis in women of reproductive age

To see whether laparoscopy improves the accuracy of a clinical diagnosis of acute appendicitis in women of reproductive age, and to determine what the long-term sequelae are of not removing an appendix deemed at laparoscopy to be normal.  The initial part of the study was undertaken during 1991–1992. Female patients between 16 and 45 years were eligible for inclusion once a clinical decision had been made to perform an appendicectomy for suspected acute appendicitis. Following consent, patients were randomized into two groups. One group had open appendicectomy, as planned. The other group had laparoscopy, followed by open appendicectomy only if the appendix was seen to be inflamed or was not visualized. The end points for the study were the clinical outcomes of all patients, and the results of histology, where appropriate. An attempt was made to contact all patients at 10 years to determine whether they had had a subsequent appendicectomy, or had been diagnosed with another abdominal condition that might be relevant to the initial presentation in 1991–1992.  Laparoscopic assessment was correct in all cases in which the appendix was visualized. Diagnostic accuracy was improved from 75% to 97%. Laparoscopy was associated with no added complications, no increase in hospital stay in patients who went on to appendicectomy, and a reduction in hospital stay for those who underwent laparoscopy alone. No patients developed a problem over the 10-year follow-up period from having a normal-looking appendix not removed at laparoscopy.  Laparoscopic assessment of the appendix is reliable, and to leave a normal-looking appendix at laparoscopy does not appear to cause any long-term problems.
When do patients and their physicians agree on diabetes treatment goals and strategies, and what difference does it make?

For patients with chronic illnesses, it is hypothesized that effective patient-provider collaboration contributes to improved patient self-care by promoting greater agreement on patient-specific treatment goals and strategies. However, this hypothesis has not been tested in actual encounters of patients with their own physicians.  To assess the extent to which patients with type 2 diabetes agree with their primary care providers (PCPs) on diabetes treatment goals and strategies, the factors that predict agreement, and whether greater agreement is associated with better patient self-management of diabetes.  One hundred twenty-seven pairs of patients and their PCPs in two health systems were surveyed about their top 3 diabetes treatment goals (desired outcomes) and strategies to meet those goals. Using several measures to evaluate agreement, we explored whether patient characteristics, such as education and attitudes toward treatment, and patient-provider interaction styles, such as shared decision making, were associated with greater agreement on treatment goals and strategies. We then examined whether agreement was associated with higher patient assessments of their diabetes care self-efficacy and self-management.  Overall, agreement on top treatment goals and strategies was low (all κ were less than 0.40). In multivariable analyses, however, patients with more education, greater belief in the efficacy of their diabetes treatment, and who shared in treatment decision making with their providers were more likely to agree with their providers on treatment goals or strategies. Similarly, physician reports of having discussed more content areas of diabetes self-care were associated with greater agreement on treatment strategies. In turn, greater agreement on treatment goals and strategies was associated both with higher patient diabetes care self-efficacy and assessments of their diabetes self-management.  Although patients and their PCPs in general had poor agreement on goals and strategies for managing diabetes, agreement was associated with higher patient self-efficacy and assessments of their diabetes self-management. This supports the hypothesis that enhancing patient-provider agreement on both overall treatment goals and specific strategies to meet these goals may lead to improved patient outcomes.
Comparative outcome one year after formal cardiac rehabilitation: the effects of a randomized intervention to improve exercise adherence.

Methods to ensure sustained benefits of cardiac rehabilitation need to be explored. The aim was to assess the effect of a home-based intervention (INT) on exercise adherence and risk factors after cardiac rehabilitation.



Prospective randomized study.



We evaluated patients who were followed for 1 year after either inpatient (ICR) or outpatient cardiac rehabilitation (OCR) by assessment of exercise capacity, physical activity, risk factors and quality of life, both at the completion of rehabilitation, and after 1 year. Patients were randomized to either be instructed how to use a diary of physical activities complemented by quarterly group meetings (INT) or to receive standard treatment (usual care).



Two hundred and sixty-one patients gave consent to be reevaluated after 1 year. Of these patients 33 were lost to follow-up (two deaths); thus 228 patients had complete 1-year follow-up data (195 male and 33 female, 91% with coronary artery disease). At 1-year follow-up significantly more patients of the INT group than of the control group adhered to regular physical activity (73 vs. 40%, P<0.0001). Moreover, INT patients showed a better evolution of body mass index and lipid values. In a stepwise multiple regression analysis the following variables showed a significant impact on regular physical activity at follow-up: study INT [odds ratio (OR): 4.19, P<0.0001], previous cardiac surgery (OR: 2.50, P=0.008), BMI at baseline (OR: 0.89, P=0.018) and quality of life at baseline (OR: 1.58, P=0.041).



Sustained benefits of cardiac rehabilitation can be documented 1 year after both inpatient and outpatient programmes. Self-monitoring of physical activity greatly increased long-term adherence to regular exercise, which in turn was associated with greater improvements of risk factors and quality of life.
The efficacy of lowering glycated haemoglobin with a gliclazide modified release-based intensive glucose lowering regimen in the ADVANCE trial.

The aim of these analyses was to examine the efficacy of the intensive gliclazide MR-based glucose lowering regimen used in the ADVANCE trial in lowering the level of glycated haemoglobin (HbA1c). All 11,140 randomised patients were included in analyses of treatment efficacy. Treatment efficacy was also examined in subgroups defined by baseline characteristics and treatments. At the end of 5 years follow-up, the mean HbA1c was reduced from 7.5% at baseline to 6.5% in those on intensive glucose control and to 7.3% in those on standard glucose control. With intensive glucose lowering greater proportions achieved HbA1c levels of < or =7.0%, < or =6.5% and < or =6.0%. With intensive glucose lowering substantial reductions in HbA1c were observed across subgroups defined by baseline age, sex, duration of diabetes, BMI, HbA1c or treatment regimen (p<0.0001). The main independent predictors of reduction in HbA1c during follow-up were baseline HbA1c, duration of diabetes and BMI. There was no weight gain in the intensive glucose control group and severe hypoglycaemia was uncommon, though more frequent than in the standard control group. Intensive glucose control with a gliclazide MR-based regimen was well tolerated and consistently effective in lowering HbA1c across a broad range of patient with type 2 diabetes.