nils-herrmann/clean_scirepeval huggingface dataset:
A Comparative Study Between Deep Inferior Epigastric Artery Perforator and Thoracoacromial Venous Supercharged Deep Inferior Epigastric Artery Perforator Flaps.

Nowadays, microvascular breast reconstruction with abdominal perforator flap is a popular and widespread technique. However, venous congestion is a recurrent problem in deep inferior epigastric artery perforator (DIEP) flap survival. We present a venous supercharging technique using the thoracoacromial vein in DIEP free flap for breast reconstruction.



A prospective randomized study was conducted in 52 patients undergoing a free DIEP flap breast reconstruction. Classical DIEP flap using 1 venous anastomosis (DIEP group) was compared with thoracoacromial venous supercharged DIEP flap using the ipsilateral superficial epigastric vein as a supercharging vein (DIEP-TAsc group). The endpoint was to assess the equivalence or the superiority of each technique. Statistical analysis was made with the t test and the χ test.



Venous congestion occurred in 16 (55.1%) patients in the DIEP group, and 3 (13%) patients in the DIEP-TAsc group (P = 0.001). The venous congestion rate was 36.5%. Fat necrosis was experienced by 14 (48.2%) patients in the DIEP group, and 4 (17.4%) patients in the DIEP-TAsc group (P = 0.020). The fat necrosis rate was 34.6%. Partial flap necrosis occurred in 13 (44.8%) patients in the DIEP group, and 2 (8.7%) patients in the DIEP-TAsc group (P = 0.004). The partial flap necrosis rate was 28.8%. Total flap necrosis occurred in 5 (17.2%) patients in the DIEP group, but no (0%) patient in the DIEP-TAsc group (P = 0.036). The total flap necrosis rate was 9.6%. The mean operative time was 405 minutes (range, 355-460) in the DIEP group, and 510 minutes (range, 405-590) in the DIEP-TAsc group (P < 0.001).



Thoracoacromial venous supercharging using the ipsilateral superficial inferior epigastric vein is a valuable method which considerably secures the DIEP free flap in breast reconstruction although it lengthens the operative procedure.
Impact of functional mitral regurgitation on right ventricular function and outcome in patients with right ventricular infarction.

Right ventricular (RV) infarction is associated with increased mortality. Functional mitral regurgitation (FMR) may complicate inferoposterior infarction with RV involvement leading to pulmonary hypertension and increased RV afterload, potentially exacerbating RV remodeling and dysfunction. We studied 179 patients with inferior wall left ventricular (LV) ST-elevation myocardial infarction and RV infarction. The presence and severity of FMR and RV function were assessed by echocardiography. FMR was diagnosed based on echocardiographic criteria and when the severity of regurgitation was ≥moderate. Eighteen patients (10.0%) had ≥moderate FMR. Estimated pulmonary artery systolic pressure was higher in patients with FMR than in patients without FMR (43 ± 10 vs 34 ± 10 mmHg, respectively, p = 0.002). RV systolic dysfunction was present in 76 patients (42.5%). FMR was a strong predictor of RV dysfunction (odds ratio 5.35, 95% confidence interval [CI] 1.65 to 17.48, p = 0.005) independent of reperfusion therapy. During a median follow-up of 4.1 years, 20 (12.4%) and 10 (55.6%) deaths occurred in patients with and without FMR, respectively (p <0.001). In a multivariable Cox regression model, compared with patients without FMR and with normal RV function, the adjusted hazard ratio for mortality was 1.02 in patients without FMR and with RV dysfunction (95% CI 0.39 to 2.69, p = 0.97) and 3.62 in patients with FMR with RV dysfunction (95% CI 1.33 to 9.85, p = 0.01). In conclusion, in patients with RV infarction, the development of concomitant hemodynamically significant FMR is associated with RV dysfunction. The risk for mortality is increased predominantly in patients with both RV dysfunction and FMR.
Testing versus guessing blood glucose values: impact on self-care behaviors in type 2 diabetes.

To assess differences between estimated blood glucose values and those measured on a blood glucose meter and the impact on self-care behavior in type 2 diabetes.



Subjects ≥18 years with type 2 diabetes (N = 297) attending a Taking Control of Your Diabetes conference were asked questions about diabetes management and to estimate their current blood glucose. Study staff tested subjects' blood glucose on a meter. After seeing the result, subjects were again asked questions on diabetes management.



The percentage of subject blood glucose estimations that were outside ISO 15197:2003 accuracy criteria (>±15 mg/dL or >±20% of meter glucose values).



Nearly half (46%) of subjects estimated blood glucose values outside ISO 15197:2003 accuracy criteria. Time since last blood glucose test, time since last meal, testing frequency, and A1C did not have an effect on differences between estimated blood glucose values and meter results. In the questionnaire before blood glucose testing, most subjects strongly agreed, agreed, or neither agreed nor disagreed that 'I make decisions about my diabetes, such as my food intake or my insulin dose even when I do not test my blood sugar' (71%) and 'My body tells me without testing if my blood sugar is low or high' (77%). After blood glucose testing, 99% of subjects strongly agreed, agreed, or neither agreed nor disagreed that 'Knowing my blood sugar by checking could help me make different diabetes decisions'.



Self-monitoring of blood glucose is an important component of diabetes self-management. Testing rather than guessing blood glucose values is important to obtain accurate results and inform people with type 2 diabetes to make effective, appropriate diabetes management decisions. A potential limitation of this study is that the subject population may not be representative of the general population of people with diabetes; however, the conference setting may attract a more motivated population, which could underestimate the magnitude of the results.
Contributions Effects of Raloxifene on Serum Lipids and Coagulation Factors in Healthy Postmenopausal Women

Raloxifene is a selective estrogen receptor modulator that has estrogen-agonistic effects on bone and estrogen-antagonistic effects on breast and uterus.  To identify the effects of raloxifene on markers of cardiovascular risk in postmenopausal women, and to compare them with those induced by hormone replacement therapy (HRT).  Double-blind, randomized, parallel trial.  Eight sites in the United States.  390 healthy postmenopausal women recruited by advertisement.  Participants were randomized to receive 1 of 4 treatments: raloxifene, 60 mg/d; raloxifene, 120 mg/d; HRT (conjugated equine estrogen, 0.625 mg/d, and medroxyprogesterone acetate, 2.5 mg/d); or placebo.  Change and percent change from baseline of lipid levels and coagulation parameters after 3 months and 6 months of treatment.  At the last visit completed, compared with placebo, both dosages of raloxifene significantly lowered low-density lipoprotein cholesterol (LDL-C) by 12% (P , .001), similar to the 14% reduction with HRT (P , .001). Both dosages of raloxifene significantly lowered lipoprotein(a) by 7% to 8% (P , .001), less than the 19% decrease with HRT (P , .001). Raloxifene increased high-density lipoprotein-2 cholesterol (HDL2-C) by 15% to 17% (P , .05), less than the 33% increase with HRT (P , .001). Raloxifene did not significantly change high-density lipoprotein cholesterol (HDL-C), triglycerides, or plasminogen activator inhibitor-1 (PAI-1); whereas HRT increased HDL-C by 11% and triglycerides by 20%, and decreased PAI-1 by 29% (for all, P , .001). Raloxifene significantly lowered fibrinogen by 12% to 14% (P , .001), unlike HRT, which had no effect. Neither treatment changed fibrinopeptide A or prothrombin fragment 1 and 2.  Raloxifene favorably alters biochemical markers of cardiovascular risk by decreasing LDL-C, fibrinogen, and lipoprotein(a), and by increasing HDL2-C without raising triglycerides. In contrast to HRT, raloxifene had no effect on HDL-C and PAI-1, and a lesser effect on HDL2-C and lipoprotein(a). Further clinical trials are necessary to determine whether these favorable biochemical effects are associated with protection against cardiovascular disease. JAMA. 1998;279:1445-1451
A pilot study to assess the efficacy of biofeedback-assisted relaxation training as an adjunct treatment for pediatric functional dyspepsia associated with duodenal eosinophilia.

To conduct a pilot study examining whether adding biofeedback-assisted relaxation training (BART) to medication treatment results in better clinical outcomes than medication treatment alone for children with functional dyspepsia (FD) associated with duodenal eosinophilia, a subgroup of children with recurrent abdominal pain.



Twenty children were randomly assigned to receive a standardized medication treatment or medication plus 10 sessions of BART. Children and parents completed psychosocial functioning and quality of life measures at baseline, posttreatment, and 6 months. Children rated pain daily via PDA. Physicians provided biweekly assessments of clinical improvement.



Children receiving medication plus BART demonstrated better outcomes on pain intensity, duration of pain episodes, and clinical improvement than children receiving medication alone.



BART is a promising adjunctive treatment for pediatric FD associated with duodenal eosinophilia. Electronic daily diaries appear to be a useful approach to assessing changes in self-reported pain ratings in this population.
Outcomes of complete vs targeted approaches to endoscopic sinus surgery.

Functional endoscopic sinus surgery (FESS) was historically predicated on targeted widening of narrow anatomic structures that caused postobstructive persistent sinus inflammation. It is now clear that chronic rhinosinusitis (CRS) is a multifactorial disease with subsets of patients which may require a more extensive surgical approach. This study compares quality-of-life (QOL) and disease severity outcomes after FESS based on the extent of surgical intervention.



Participants with CRS were prospectively enrolled into an ongoing, multi-institutional, observational, cohort study. Surgical extent was determined by physician discretion. Participants undergoing bilateral frontal sinusotomy, ethmoidectomy, maxillary antrostomy, and sphenoidotomy were considered to have undergone "complete" surgery, whereas all other participants were categorized as receiving "targeted" surgery. Improvement was evaluated between surgical subgroups with at least 6-month follow-up using the 22-item Sino-Nasal Outcome Test (SNOT-22) and the Brief Smell Inventory Test (B-SIT).



A total of 311 participants met inclusion criteria with 147 subjects undergoing complete surgery and 164 targeted surgery. A higher prevalence of asthma, acetylsalicylic acid (ASA) sensitivity, nasal polyposis, and a history of prior sinus surgery (p ≤ 0.002) was present in participants undergoing complete surgery. Mean improvement in SNOT-22 (28.1 ± 21.9 vs 21.9 ± 20.6; p = 0.011) and B-SIT (0.8 ± 3.1 vs 0.2 ± 2.4; p = 0.005) was greater in subjects undergoing complete surgery. Regression models demonstrated a 5.9 ± 2.5 greater relative mean improvement on SNOT-22 total scores with complete surgery over targeted approaches (p = 0.016).



Complete surgery was an independent predictor of greater postoperative SNOT-22 score improvement, yet did not achieve clinical significance. Further study is needed to determine the optimal surgical extent.
The utility of supplemental oxygen during emergency department procedural sedation with propofol: a randomized, controlled trial.

We determine whether supplemental oxygen reduces the incidence of hypoxia by 20% compared with breathing room air in adult study patients receiving propofol for emergency department procedural sedation.



Patients were randomized to receive either supplemental oxygen or compressed air by nasal cannula at 3 L per minute. Physicians were blinded to the gas used and end tidal CO(2) (etco(2)) data. Respiratory depression was defined a priori as oxygen saturation less than or equal to 93%, an etco(2) level of greater than or equal to 50 mm Hg, an absolute etco(2) change from baseline of greater than or equal to 10 mm Hg, or loss of the etco(2) waveform.



Of the 110 patients analyzed, 56 received supplemental oxygen and 54 received room air. Ten (18%) patients in the supplemental oxygen group and 15 (28%) patients in the compressed air group experienced hypoxia (P=.3, effect size=10%, 95% confidence interval -24% to 7%). Twenty-seven patients (20 supplemental oxygen; 7 room air) met etco(2) criteria for respiratory depression but did not become hypoxic. Physicians identified respiratory depression in 23 of 25 patients who developed hypoxia compared with only 1 of 27 patients who met etco(2) criteria for respiratory depression but who did not have hypoxia. One patient in the supplemental oxygen group experienced a transient arrhythmia and had a short apneic episode, both of which resolved spontaneously. The patient was admitted for observation.



Supplemental oxygen (3 L/minute) trended toward reducing hypoxia in adult study patients; however, the 10% difference observed was not statistically significant and was below our a priori 20% threshold. Blinded capnography frequently identified respiratory depression undetected by the treating physicians.
Meta-analysis of microarray data using a pathway-based approach identifies a 37-gene expression signature for systemic lupus erythematosus in human peripheral blood mononuclear cells

A number of publications have reported the use of microarray technology to identify gene expression signatures to infer mechanisms and pathways associated with systemic lupus erythematosus (SLE) in human peripheral blood mononuclear cells. However, meta-analysis approaches with microarray data have not been well-explored in SLE.



In this study, a pathway-based meta-analysis was applied to four independent gene expression oligonucleotide microarray data sets to identify gene expression signatures for SLE, and these data sets were confirmed by a fifth independent data set.



Differentially expressed genes (DEGs) were identified in each data set by comparing expression microarray data from control samples and SLE samples. Using Ingenuity Pathway Analysis software, pathways associated with the DEGs were identified in each of the four data sets. Using the leave one data set out pathway-based meta-analysis approach, a 37-gene metasignature was identified. This SLE metasignature clearly distinguished SLE patients from controls as observed by unsupervised learning methods. The final confirmation of the metasignature was achieved by applying the metasignature to a fifth independent data set.



The novel pathway-based meta-analysis approach proved to be a useful technique for grouping disparate microarray data sets. This technique allowed for validated conclusions to be drawn across four different data sets and confirmed by an independent fifth data set. The metasignature and pathways identified by using this approach may serve as a source for identifying therapeutic targets for SLE and may possibly be used for diagnostic and monitoring purposes. Moreover, the meta-analysis approach provides a simple, intuitive solution for combining disparate microarray data sets to identify a strong metasignature.
Quantitative characterization of circadian rhythm of pulmonary function in asthmatic patients treated with inhaled corticosteroids

The aim of this study was to characterize the circadian rhythm observed for forced expiratory volume in 1 s (FEV1) in patients with persistent asthma being treated with inhaled corticosteroids. The database included 3379 FEV1 measurements from 189 patients with mild to moderate asthma. A model using the sum of two Sine functions with periods of 12 and 24 h and a constant component of mean circadian rhythm adequately described the circadian rhythm in FEV1 measurements over time. The model adequateness was evaluated by various approaches including visual predictive check (VPC), prediction-corrected VPC, standardized VPC and normalized prediction distribution error. Covariates tested included age, body weight, height, body mass index, baseline FEV1, and sex. Age and height were found to have significant effects on the mean FEV1 level and no covariate was found to have an effect on the magnitude and timing of circadian rhythm. The model predicted that a minimum FEV1 occurred in the early morning and maximum FEV1 occurred in the early afternoon, with a population mean fluctuation of 170 mL, which is consistent with the finding that asthma symptoms usually exacerbate in the early morning for patients with persistent asthma. This developed model provides the first quantitative approach to describing FEV1 circadian rhythm with ICS background treatment and provided insight in designing future registration trials for asthma drug development.
TAR DNA-binding protein 43 immunohistochemistry reveals extensive neuritic pathology in FTLD-U: a midwest-southwest consortium for FTLD study.

TAR DNA-binding protein 43 (TDP-43) is a major component of the inclusions in frontotemporal lobar degeneration with ubiquitinated inclusions (FTLD-U). We studied TDP-43 pathology in the hippocampus and frontal cortex of autopsy brains from patients with FTLD-U (n = 68), dementia lacking distinctive histopathology (n = 4), other neurodegenerative diseases (n = 23), and controls (n = 12) using a sensitive immunohistochemistry protocol. Marked enhancement of staining of TDP-43-positive dystrophic neurites (DNs) was obtained, and we observed 2 previously unrecognized pathologic patterns (i.e. frequent long DNs in the CA1 region and frequent dot-like DNs in the neocortical layer 2) in 39% and 15% of the FTLD-U cases, respectively. Frequent long DNs, but not dot-like DNs, were significantly associated with progranulin mutations. Based on this evaluation, 4 FTLD-U cases showed no TDP-43 pathology and were reclassified as "FTLD-U, non-TDP-43 proteinopathy," and 3 cases of dementia lacking distinctive histopathology were reclassified as FTLD-U. Of the cases with other neurodegenerative diseases, 43% showed TDP-43 pathology in the hippocampus, but only 4% showed TDP-43 pathology in the frontal cortex. No TDP-43 pathology was seen in controls. These results indicate that the sensitivity of the TDP-43 immunohistochemistry method affects both the extent and type of abnormalities detected. Moreover, assessment of abnormalities in both the hippocampus and frontal cortex may be diagnostically important in FTLD-U.
A pragmatic community-based intervention of multimodal physiotherapy plus deep water running (DWR) for fibromyalgia syndrome: a pilot study

Evidence-based recommendations support the use of multimodal therapy and hydrotherapy for fibromyalgia syndrome; however, there is little standardisation of such programmes. The aim of the study was to assess the effectiveness of a pool-based exercise using deep water running (DWR) as part of a multimodal physiotherapy programme for patients with fibromyalgia syndrome. For a non-randomised clinical study, 44 patients diagnosed with fibromyalgia were recruited from primary care. Patients in the experimental group received a multimodal programme incorporating pool-based exercise using DWR three times a week for an 8-week period. The control group received a leaflet containing advice and continued with normal activities. Patients were evaluated for physical function (Fibromyalgia Impact Questionnaire, FIQ), pain, general health (Short Form-12 Health Survey) and quality of life (European Quality of Life Scale-5D) pre- and post intervention. Statistically significant results were found for the experimental group for FIQ total score, incorporating physical function, pain, fatigue, stiffness and psychological variables (p < 0.05). Statistically significant differences between the experimental group and control were also found for general health (p < 0.05) and quality of life (p < 0.05). The results of this pilot study and the high level of compliance and adherence and low level of attrition suggest that this multimodal programme incorporating DWR is a safe and effective intervention for fibromyalgia syndrome that is acceptable to patients.
Comparison in Clinical Outcome of Two Surgical Treatments in Degenerative Scoliosis

To evaluate the clinical outcome of two different surgical treatments in treating degenerative scoliosis. Forty patients with degenerative scoliosis hospitalized in our department from June 2010 to June 2012 were selected. They were randomly divided into two groups. The first group was performed on the points with nerve or spinal compression for decompression, bone grafting, and short-segmental fixation in situ; The second group was treated with sufficient decompression, long-segmental fixation, and short-segmental fusion to operate orthopedic on scoliosis in three dimensions. All patients completed the follow-up period for more than 1 year, with the average of 18 months. Bone grafting fusion was achieved in all of the patients. The second group showed significantly better result in remission rate of postoperative pain and ODI improvement rate than the first group. Long-segmental internal fixation orthopedic is a better surgical option for patients with degenerative scoliosis to achieve sufficient decompression and three-dimensional orthopedic; therefore, it is a better solution for biomechanical reconstruction of spine.
Borderline hypotension: how does it influence cerebral regional tissue oxygenation in preterm infants?

To monitor cerebral regional tissue oxygenation (crSO2) of preterm infants continuously and to analyze the influence of arterial hypotension on crSO2.



In this prospective, observational study crSO2, peripheral oxygen saturation (SpO2), heart rate (HR) and mean arterial blood pressure (MABP) were monitored continuously for 24 h, starting within the first 6 h after birth. Furthermore, cerebral fractional tissue oxygen extraction (cFTOE) was calculated. Preterm neonates with and without arterial hypotension (MABP below the gestational age in weeks) were compared to each other.



Forty-six preterm infants could be analyzed, 17 with (33.4 ± 1.9 weeks, 2016.5 ± 548.5 g) and 29 without arterial hypotension (33.3 ± 1.3 weeks, 1924.7 ± 451.9 g). Altogether, we detected 30 episodes of hypotension, with a mean duration of 1.6 ± 1.2 h per infant and a mean decrease in MABP of 2.2 ± 0.9 mmHg. During hypotension mean crSO2 was 7 5 ± 11%, 2 h prior to that 76 ± 10% and 2 h after the hypotension 7 7 ± 10%, therefore no significant alterations could be observed. Moreover, there was no significant difference in mean 24-h crSO2, SpO2 and cFTOE between the two groups.



Mild short-term hypotensive episodes in preterm infants did not affect crSO2. This suggests that cerebral autoregulation is maintained in case of borderline-hypotension and may protect infants from cerebral injury.