nils-herrmann/clean_scirepeval huggingface dataset:
Lifestyle intervention in men with advanced prostate cancer receiving androgen suppression therapy: a feasibility study.

Healthy lifestyle behaviors could have a role in ameliorating some of the adverse effects of androgen suppression therapy (AST) in men with prostate cancer. The primary aim of this study was to assess the feasibility of a tapered supervised exercise program in combination with dietary advice in men with advanced prostate cancer receiving AST.



Advanced prostate cancer patients receiving AST for a minimum of 6 months were randomized to a 12-week lifestyle program comprising aerobic and resistance exercise, plus dietary advice (n = 25), or standard care (n = 25). Exercise behavior, dietary macronutrient intake, quality of life, fatigue, functional fitness, and biomarkers associated with disease progression were assessed at baseline, after the intervention, and at 6 months.



The lifestyle group showed improvements in exercise behavior (P < 0.001), dietary fat intake (P = 0.001), total energy intake (P = 0.005), fatigue (P = 0.002), aerobic exercise tolerance (P < 0.001), and muscle strength (P = 0.033) compared with standard care controls. Although a high rate of attrition (44%) was observed at 6 months, the improvements in key health outcomes were sustained. No effects on clinical prostate cancer disease markers were observed.



This preliminary evidence suggests that pragmatic lifestyle interventions have potential to evoke improvements in exercise and dietary behavior, in addition to other important health outcomes in men with advanced prostate cancer receiving AST.



This study shows for the first time that pragmatic lifestyle interventions are feasible and could have a positive impact on health behaviors and other key outcomes in men with advanced prostate cancer receiving AST.
Interaction between current vitamin D supplementation and menopausal hormone therapy use on breast cancer risk: evidence from the E3N cohort.

Experimental studies suggest protective effects of vitamin D on breast carcinogenesis, particularly on estrogen receptor-positive tumors. Epidemiologic data are less conclusive.



Our objective was to investigate the association between postmenopausal breast cancer risk and current or past vitamin D supplementation overall and according to the use of menopausal hormone therapy (MHT).



Between 1995 and 2008, 2482 invasive breast cancer cases were diagnosed among 57,403 postmenopausal women from the E3N prospective cohort during 581,085 person-years. Vitamin D supplementation was assessed from biennially self-administered questionnaires sent in 1995, 2000, 2002, and 2005 and from medico-administrative data on drug reimbursements since 2004. Multivariable HRs for primary invasive breast cancer and 95% CIs were estimated by using Cox models.



A decreased postmenopausal breast cancer risk was associated with current (HR: 0.82; 95% CI: 0.69, 0.97) but not past (HR: 1.10; 95% CI: 0.92, 1.31) vitamin D supplementation (P-homogeneity = 0.02). The association with current vitamin D supplementation differed according to MHT use: ever users (HR: 0.74; 95% CI: 0.60, 0.90) and never users (HR: 1.13; 95% CI: 0.89, 1.56); P-homogeneity = 0.02.



In this observational study, current vitamin D supplementation, mostly taken daily and combined with calcium, was associated with a decreased postmenopausal breast cancer risk in MHT users. These findings should be confirmed before considering vitamin D supplementation to partly balance the MHT-associated increased breast cancer risk.
The CHARMS Study: cardiac patients' experiences of sexual problems following cardiac rehabilitation.

Sexual problems are common among cardiac patients. Further information is required on patients' experiences of sexuality and preferences for sexual counselling.



To characterise sexual dysfunction and related factors among patients following cardiac rehabilitation and examine related treatment delivery.



Telephone interviews with 382 patients (32% response rate) recruited from six hospital rehabilitation centres.



Seventy-nine per cent were male; average age was 64 years (SD 9.8). Forty-seven per cent of the total sample reported no sexual relations in the previous year, and nearly a half of sexually active respondents reported at least one sexual problem. Erectile dysfunction (reported by 33%) and lack of interest in sex (reported by 10%) were the most common problems for men and women respectively. Twenty-three per cent reported that sex had deteriorated for them since their cardiac event, and for half of these this was considered a serious problem. In logistic regression analysis, higher anxiety (Hospital Anxiety and Depression Scale) and being male were associated with reporting a sexual problem (χ(2) = 37.85, p<0.001). Sixty-six per cent reported that sex was never discussed by a health professional and satisfaction with this aspect of care was low. Patients wanted these issues to be addressed and the majority (63%) claimed they would find it easy to discuss sexual problems with a health professional.



Sexual inactivity and sexual problems are common in this group. Health professionals should address sexual issues with their patients, ideally in a private setting and within the broader context of addressing psychological wellbeing.
Maintenance treatment of adolescent bipolar disorder: open study of the effectiveness and tolerability of quetiapine

The purpose of the study was to determine the effectiveness and tolerability of quetiapine as a maintenance treatment preventing against relapse or recurrence of acute mood episodes in adolescent patients diagnosed with bipolar disorder.



Consenting patients meeting DSM-IV lifetime criteria for a bipolar disorder and clinically appropriate for maintenance treatment were enrolled in a 48-week open prospective study. After being acutely stabilized (CGI-S < or = 3 for 4 consecutive weeks), patients were started or continued on quetiapine and other medications were weaned off over an 8-week period. Quetiapine monotherapy was continued for 40-weeks and other mood stabilizers or antidepressants were added if clinically indicated. A neurocognitive test battery assessing the most reliable findings in adult patients was administered at fixed time points throughout the study to patients and matched controls.



Of the 21 enrolled patients, 18 completed the 48-week study. Thirteen patients were able to be maintained without relapse or recurrence in good quality remission on quetiapine monotherapy, while 5 patients required additional medication to treat impairing residual depressive and/or anxiety symptoms. According to symptom ratings and global functioning scores, the quality of remission for all patients was very good.Neurocognitive test performance over treatment was equivalent to that of a matched control group of never ill adolescents. Quetiapine was generally well tolerated with no serious adverse effects.



This study suggests that a proportion of adolescent patients diagnosed with bipolar disorder can be successfully maintained on quetiapine monotherapy. The good quality of clinical remission and preserved neurocognitive functioning underscores the importance of early diagnosis and effective stabilization.
Walk on the bright side: physical activity and affect in major depressive disorder.

Although prescribed exercise has been found to improve affect and reduce levels of depression, we do not know how self-initiated everyday physical activity influences levels of positive affect (PA) and negative affect (NA) in depressed persons. Fifty-three individuals diagnosed with Major Depressive Disorder (MDD) and 53 never-depressed controls participated in a seven-day experience sampling study. Participants were prompted randomly eight times per day and answered questions about their physical activity and affective state. Over the week, the two groups of participants did not differ in average level of physical activity. As expected, participants with MDD reported lower average PA and higher average NA than did never-depressed controls. Both participants with MDD and controls reported higher levels of PA at prompts after physical activity than at prompts after inactive periods; moreover, for both groups of participants, PA increased from a prompt after an inactive period to a subsequent prompt at which activity was reported. Depressed participants in particular showed a dose-response effect of physical activity on affect: longer duration and/or higher intensity of physical activity increased their PA significantly more than did short duration and/or lower intensity physical activity. Physical activity did not influence NA in either group. In contrast to previous treatment studies that examined the effects of prescribed structured exercise, this investigation showed that self-initiated physical activity influences PA. These findings also underscore the importance of distinguishing between PA and NA to gain a more comprehensive understanding of the effects of physical activity on affect in MDD.
Incorporating Uncertainty in Agent Commitments

Commitments play a central role in multi-agent coordinatio n. However, they are inherently uncertain and it is important to ta ke these uncertainties into account during planning and scheduling. This paper add esses the problem of handling the uncertainty in commitments. We propose a new model of commitment that incorporates the uncertainty, the use of continge ncy analysis to reduce the uncertainty, and a negotiation framework for handling c ommitments with uncertainty.
Endurance exercise training during haemodialysis improves strength, power, fatigability and physical performance in maintenance haemodialysis patients.

Endurance training improves cardiopulmonary fitness in maintenance haemodialysis (MHD). Because many MHD patients are profoundly deconditioned and exhibit significant muscle weakness, endurance training may also improve muscle strength and physical performance in these patients. This study assessed this possibility.



Twelve MHD patients performed incremental and constant work rate cycle exercise tests to determine peak work rate, VO(2)peak and endurance time (ET). Lower extremity strength, power and fatigability, stair-climbing time, 10 m walk time and a timed up-and-go were assessed before and after 8.6+/-2.3 weeks of thrice weekly, progressive, semi-recumbent, leg-cycle training during haemodialysis. Initial training intensity and duration targets were set at 50% peak work rate (WR) and 20 min, respectively, with a goal of progressing to 40 min at the highest WR tolerable. Non-exercising MHD patients and healthy volunteers with similar age, gender and race/ethnicity served as comparison groups.



None of the subjects tolerated the initial target intensity. Therefore, WR was reduced to 19+/-9 watts (30% of peak WR) for 19.9 min/session. At end of training, subjects cycled at 29+/-25 watts (46% initial peak WR; P = 0.01) for 38+/-8 min (P<0.001). VO(2)peak and ET improved 22% (P = 0.018) and 144% (P = 0.001), respectively. Quadriceps strength, power and fatigability improved 16% (P = 0.002), 15% (P = 0.115) and 43% (P = 0.029), respectively. The three measures of physical performance improved by 14-17% (P<0.031). Total work performed in training increased by 5.5+/-21.1 kJ/week (17%); a 165% increase during the study period.



Nine weeks of leg-cycling during haemodialysis in MHD patients improves not only cardiopulmonary fitness and endurance but also muscle strength, power, fatigability and physical function. These data underscore the value of endurance training in MHD.
A prospective study evaluating efficacy of polymer free Pronova XR stent in treatment of denovo coronary artery stenosis.

Drug eluting stents have remarkably improved results of percutaneous coronary angioplasty. Most of the currently available drug eluting stents uses a durable polymer as drug carrier which has been implicated in local inflammatory response and continued incidence of late and very late stent thrombosis. The Pronova XR stent is one from those new generation polymer free sirolimus eluting stents in which pharmaceutical excipient is used for the timed release of sirolimus from the XR stent platform instead of a polymeric coating.



We consecutively recruited 121 patients undergoing elective or urgent PCI at our center. All the patients were followed up clinically and mandatory follow up angiogram at 6 months was done for one third of the total patients. An independent core lab analyzed paired angiograms.



The primary efficacy endpoint was death, MI, TVR at 6 months which occurred in 6.66% patients. The QCA analysis showed reference vessel diameter of 2.5 + 0.44 mm at baseline and the minimal luminal diameter was 0.88 + 0.43 mm giving baseline diameter stenosis of 65.26 + 15.89%. The immediate post procedure in-segment diameter stenosis assessed was 23.68 + 8.96% which increased to 36.02 + 24.48% at follow up with a late lumen loss of 0.25 + 0.76 mm at mean of 191 days.



Coronary angioplasty with polymer free Pronova XR stents results in acceptable late lumen loss and very low target lesion revascularisation at short and intermediate term in unselected patients.
Kinematically versus mechanically aligned total knee arthroplasty.

The purpose of this study was to compare 2 alignment methods for total knee arthroplasty (TKA): kinematic alignment with the use of patient-specific guides and mechanical alignment with conventional instruments. A randomized, controlled trial of 41 kinematically aligned and 41 mechanically aligned patients was conducted with the patient, radiographic evaluator, and clinical evaluator blinded to the alignment technique. Radiographic measurements were made from long-leg computer tomography scanograms. Clinical outcome scores and motion were measured preoperatively and 6 months postoperatively. The hip-knee-ankle angle (0.3° difference; P=.693) and anatomic angle of the knee (0.8° difference; P=.131) were similar for both groups. In the kinematically aligned group, the angle of the femoral component was 2.4° more valgus (P<.000) and the angle of the tibial component was 2.3° more varus (P<.000) than the mechanically aligned group. At 6 months postoperatively, the Western Ontario and McMaster Universities Osteoarthritis Index score was 16 points better (P<.000), Oxford Score was 7 points better (P=.001), combined Knee Society Score was 25 points better (P=.001), and flexion was 5.0° greater (P=.043) in the kinematically aligned group than in the mechanically aligned group.Our findings suggest that the risk of early failure related to limb or knee alignment should be similar in kinematic and mechanically aligned TKA. More anatomic alignment of the implant was associated with better flexion and better clinical outcome scores in the kinematically aligned group.
Health status assessment tool for the family member caregiver of patients with bipolar disorder: development and psychometric testing.

The caregivers' health assessment requires the application of a valid instrument that provided based on their experiences about the health concept. The purpose of this study was to develop and test the psychometric properties of the health assessment tool for family member caregivers' of patients with bipolar disorder.



This study utilized mixed research. The specific validation processes used were: content and face validity, construct validity using factor analysis, reliability and internal consistency using test-retest reliability and Cronbach's alpha correlation coefficient.



The exploratory factor analysis revealed ten factors: safe life with peace, maintaining physical health, painful emotions, psychological tolerance, maintaining physical-psychological potency, families and relatives support, health care system support, moral-financial support, maintaining social relationships, and worry over the label. The internal consistency (Cronbach's alpha) was 95. Test-retest reliability of the questionnaire with interval time of two weeks was 0.93 (p < 0.001).



Family caregivers' health assessment questionnaire with 75 items helped to determine family caregivers' health in different settings such as clinical settings, homes and research environments by health care providers.
Transplant-Related Mortality Following Allogeneic Hematopoeitic Stem Cell Transplantation for Pediatric Acute Lymphoblastic Leukemia: 25-Year Retrospective Review

Over the last 25 years, donor source, conditioning, graft-versus-host disease prevention and supportive care for children undergoing hematopoeitic stem cell transplantation (HSCT) have changed dramatically. HSCT indications for acute lymphoblastic leukemia (ALL) now include high-risk patients in first and subsequent remission. There is a large burden of infectious and pre-HSCT morbidities, due to myelosuppressive therapy required for remission induction. We hypothesized that, despite these trends, overall survival (OS) had increased.


PROCEDURE
A retrospective audit of allogeneic pediatric HSCT for ALL was performed in our institution over 25 years. Outcomes for 136 HSCTs were analyzed in three consecutive 8-year periods (Period 1: 1/1/1984-31/8/1992, Period 2: 1/9/1992-30/4/2001, Period 3: 1/5/2001-31/12/2009).



Despite a significant increase in unrelated donor HSCT, event-free and OS over 25 years improved significantly. (EFS 31.6-64.8%, P = 0.0027; OS 41.8-78.9%, P < 0.0001) Concurrently, TRM dropped from 33% to 5% (P = 0.0004) whilst relapse rate was static (P = 0.07). TRM reduced significantly for matched sibling and unrelated cord blood transplantation (UCT) in Period 3 compared with earlier periods (P = 0.036, P = 0.0098, respectively). Factors leading to improved survival in patients undergoing UCT include better matching, higher total nucleated cell doses, and significantly faster neutrophil engraftment. Length of initial HSCT admission was similar over time.



EFS and OS have increased significantly despite heightened HSCT complexity. This survival gain was due to TRM reduction. Contemporary patients have benefited from refined donor selection and improved supportive care. Overall rates of leukemic relapse post-HSCT are unchanged, and remain the focus for improvement.
Aspirin, NSAIDs, and risk of prostate cancer: results from the REDUCE study.

A recent meta-analysis showed that aspirin was associated with reduced prostate cancer risk. As anti-inflammatory medications lower PSA levels, whether these findings reflect reduced prostate cancer detection or lower prostate cancer risk is unknown. We tested the association between aspirin and nonaspirin NSAID use on prostate cancer diagnosis in REDUCE, where all men received biopsies at 2 and 4 years largely independent of PSA. REDUCE tested dutasteride for prostate cancer risk reduction in men with a PSA of 2.5 to 10.0 ng/mL and a negative prestudy biopsy.



We examined the association between aspirin, NSAIDs, or both and total, low-grade (Gleason < 7), or high-grade (Gleason ≥ 7) prostate cancer versus no prostate cancer using multinomial logistic regression among 6,390 men who underwent ≥1 on-study biopsy. Multivariable analyses were adjusted for age, race, geographic region, PSA, prostate volume, digital rectal examination, body mass index, treatment arm, smoking, alcohol, statins, hypertension, diabetes, and cardiovascular disease.



Overall, 3,169 men (50%) were nonusers, 1,368 (21%) used aspirin, 1,176 (18%) used NSAIDs, and 677 (11%) used both. In unadjusted models, aspirin was associated with reduced prostate cancer risk (OR = 0.85, P = 0.036). In multivariable analyses, aspirin was associated with reduced total prostate cancer risk (OR = 0.81, P = 0.015). Use of NSAIDs or NSAIDs and aspirin was not associated with total, low-grade, or high-grade prostate cancer, though all ORs were <1 (all P ≥ 0.08). Therefore, we created a dichotomous variable of aspirin and/or NSAID users versus nonusers. On multivariable analysis, the use of aspirin and/or NSAIDs was significantly associated with decreased total (OR = 0.87, P = 0.030) and high-grade (OR = 0.80, P = 0.040), but not with low-grade, prostate cancer risk (OR = 0.90, P = 0.15). Results were similar in placebo and dutasteride arms.



Among men with a negative biopsy, aspirin and/or NSAID use was associated with decreased prostate cancer risk. Additional studies are warranted.
Continuous positive airway pressure with helmet versus mask in infants with bronchiolitis: an RCT.

Noninvasive continuous positive airway pressure (CPAP) is usually applied with a nasal or facial mask to treat mild acute respiratory failure (ARF) in infants. A pediatric helmet has now been introduced in clinical practice to deliver CPAP. This study compared treatment failure rates during CPAP delivered by helmet or facial mask in infants with respiratory syncytial virus-induced ARF.



In this multicenter randomized controlled trial, 30 infants with respiratory syncytial virus-induced ARF were randomized to receive CPAP by helmet (n = 17) or facial mask (n = 13). The primary endpoint was treatment failure rate (defined as due to intolerance or need for intubation). Secondary outcomes were CPAP application time, number of patients requiring sedation, and complications with each interface.



Compared with the facial mask, CPAP by helmet had a lower treatment failure rate due to intolerance (3/17 [17%] vs 7/13 [54%], P = .009), and fewer infants required sedation (6/17 [35%] vs 13/13 [100%], P = .023); the intubation rates were similar. In successfully treated patients, CPAP resulted in better gas exchange and breathing pattern with both interfaces. No major complications due to the interfaces occurred, but CPAP by mask had higher rates of cutaneous sores and leaks.



These findings confirm that CPAP delivered by helmet is better tolerated than CPAP delivered by facial mask and requires less sedation. In addition, it is safe to use and free from adverse events, even in a prolonged clinical setting.
[Prevalence of chronic kidney disease in subjects consulting in urban primary care clinics].

Chronic kidney disease (CKD) is a major worldwide public health problem and is associated with increased risk of cardiovascular disease and death.



To assess CKD prevalence in urban Primary Care Services (PCS) of Concepcion, Chile.



The clinical records of 27.894 adults aged 55 ± 18 years (66% females), consulting in outpatient clinics and in whom serum creatinine was measured, with or without assessment of urine albumin levels, were reviewed. The glomerular filtration rate (eGFR) was estimated using the Modification of Diet in Renal Disease (MDRD)-4 equation. CKD was defined as an eGFR < 60 ml/min/1.73 m2 and classified according to the National Kidney Foundation Kidney Disease Outcomes Quality Initiative (NFK-KDOQI) guidelines.



Mean eGFR was 77.1 ± 16.3 ml/min/1.73 m2. Twelve percent of subjects had CKD (women, 14.5% and men 7,4%, p < 0,05). The prevalence of stages 3, 4 and 5 of CKD were 11.6, 0.3 and 0.2 % respectively. eGFR was negatively correlated with age ( r = -0,54, p < 0,05). Among patients with an eGFR < 60 ml/min/1.73 m2, 96.3% had eGFR 30-59, 2.3% 15-29 and 1.4 % < of 15. Seventy nine percent were women. 75.1% were aged 65 years or more, 26.8% had a serum creatinine equal or less than 1.0 mg/dL and 40.5% had microalbuminuria. Only 1% of outpatients ascribed to Cardiovascular or Diabetes Programs had the diagnosis of CKD registered. Independent risk predictors of CKD were age > 60 years, female sex and microalbuminuria.



This study showed a high prevalence of CKD in ambulatory patients, mainly among women and older people. The low level of diagnosis of CKD in cardiovascular and diabetes programs is of concern.