nils-herrmann/clean_scirepeval huggingface dataset:
Lumbar segmental instability: a criterion-related validity study of manual therapy assessment

Musculoskeletal physiotherapists routinely assess lumbar segmental motion during the clinical examination of a patient with low back pain. The validity of manual assessment of segmental motion has not, however, been adequately investigated.



In this prospective, multi-centre, pragmatic, diagnostic validity study, 138 consecutive patients with recurrent or chronic low back pain (R/CLBP) were recruited. Physiotherapists with post-graduate training in manual therapy performed passive accessory intervertebral motion tests (PAIVMs) and passive physiological intervertebral motion tests (PPIVMs). Consenting patients were referred for flexion-extension radiographs. Sagittal angular rotation and sagittal translation of each lumbar spinal motion segment was measured from these radiographs, and compared to a reference range derived from a study of 30 asymptomatic volunteers. Motion beyond two standard deviations from the reference mean was considered diagnostic of rotational lumbar segmental instability (LSI) and translational LSI. Accuracy and validity of the clinical assessments were expressed using sensitivity, specificity, and likelihood ratio statistics with 95% confidence intervals (CI).



Only translation LSI was found to be significantly associated with R/CLBP (p < 0.05). PAIVMs were specific for the diagnosis of translation LSI (specificity 89%, CI 83-93%), but showed poor sensitivity (29%, CI 14-50%). A positive test results in a likelihood ratio (LR+) of 2.52 (95% CI 1.15-5.53). Flexion PPIVMs were highly specific for the diagnosis of translation LSI (specificity 99.5%; CI 97-100%), but showed very poor sensitivity (5%; CI 1-22%). Likelihood ratio statistics for flexion PPIVMs were not statistically significant. Extension PPIVMs performed better than flexion PPIVMs, with slightly higher sensitivity (16%; CI 6-38%) resulting in a likelihood ratio for a positive test of 7.1 (95% CI 1.7 to 29.2) for translation LSI.



This study provides the first evidence reporting the concurrent validity of manual tests for the detection of abnormal sagittal planar motion. PAIVMs and PPIVMs are highly specific, but not sensitive, for the detection of translation LSI. Likelihood ratios resulting from positive test results were only moderate. This research indicates that manual clinical examination procedures have moderate validity for detecting segmental motion abnormality.
Efficacy of combined local mechanical vibrations, continuous passive motion and thermotherapy in the management of osteoarthritis of the knee.

We evaluated the efficacy of combined mechanical vibrations, continuous passive motion (CPM) and heat on the severity of pain in management of osteoarthritis of the knee (OA-K).



In this controlled, double crossover study, 71 OA-K patients were randomized in Phase 1 to receive 4 weeks active treatment consisting of two 20-min sessions per day (34 patients, Group AB) or treatment with a sham device (37 patients, Group BA). This was followed by a 2-week washout period (Phase 2). In Phase 3, patients crossed over so that Group AB was treated with the sham device and Group BA received active treatment for an additional 4 weeks. Patient assessments of pain (visual analog scale, VAS) and Western Ontario and McMaster Universities (WOMAC) OA index were performed at baseline and at study weeks 2, 4, 6, and 10. Net treatment effects were estimated by comparing outcomes between active and sham treatment study phases.



Treatment benefits were noted for both of the trial's two pre-specified primary endpoints, VAS and WOMAC. VAS was reduced at all follow-up time points for patients receiving active treatment compared to sham treatment with a net treatment effect of 14.4+/-4.1 mm (P=0.001). Similarly, the WOMAC score was reduced significantly with active treatment at all measured points with a net effect of 8.8+/-1.9 points (P<0.001). The secondary endpoints, range of motion (ROM) and treatment satisfaction, also improved with active vs sham treatment.



Four weeks treatment with combined CPM, vibration and local heating significantly decreases pain, improves ROM and the quality of life in patients with OA-K (
Development and validation of the functional assessment of cancer therapy nasopharyngeal cancer subscale.

We aimed to develop a quality-of-life subscale for nasopharyngeal carcinoma (NPC) and validate the functional assessment of cancer therapy-nasopharyngeal (FACT-NP).



The FACT-NP was tested cross-sectionally in survivors of postirradiated NPC (n = 357) and was administered to newly diagnosed patients (n = 160) before, at the end of, and 3 months after radiotherapy (RT).



Each FACT-NP domain was internally consistent (Cronbach's alpha = 0.87-0.90). The test-retest reliability for each subscale was satisfactory (intraclass correlation coefficient = .73-.88). Concurrent validity was suggested by the moderate to strong correlations between the FACT-NP and the Quality of Life-Radiation Therapy Instrument-Head and Neck (QOL-RTI-H&N) subscales (Pearson r = .39-.84). The FACT-NP was responsive to clinical changes from pretreatment to 3 months after RT (effect sizes > 0.6 for clinically relevant subscales). The pooled data for multitrait scaling analysis showed satisfactory item internal consistency and item discriminant validity (100% and 90% scaling success, respectively).



The FACT-NP is a reliable and valid instrument for measuring QOL in patients with NPC.
Are Foot and Ankle Characteristics Associated With Falls in People With Rheumatoid Arthritis? A Prospective Study.

To determine whether foot and ankle characteristics are associated with falls in people with rheumatoid arthritis (RA).



A total of 201 adults with RA were recruited from rheumatology outpatient clinics in Auckland, New Zealand. Clinical characteristics, common fall risk factors, and foot and ankle variables were measured. Participants were prospectively studied for 12 months to record the occurrence of falls using falls diaries. Logistic regression analysis identified baseline variables that were independent predictors of falls over the 12 months.



Eighty-four participants (42%) fell at least once and 39 (19%) experienced multiple (>1) falls over the 12-month followup period. In logistic regression analysis, including age and significant baseline variables in bivariate analysis but not baseline fall history, presence of foot or ankle tender joints (odds ratio [OR] 1.95, P = 0.034) and psychotropic medication (OR 2.35, P = 0.025) were independent predictors of prospective falls. However, when baseline fall history was included in the analysis, psychotropic medication (OR 2.34, P = 0.025) and baseline fall history (over the preceding 12 months) (OR 2.27, P = 0.008) were independent predictors of prospective falls.



Foot and ankle characteristics are not associated with falls in people with RA, independent of prior falls. Inquiry about prior falls and psychotropic medications may assist in identifying patients with RA who are at high risk of future falls.
EFFECT OF PHYLLANTHUS AMARUS ON CHRONIC CARRIERS OF HEPATITIS B VIRUS

In a preliminary study, carriers of hepatitis B virus were treated with a preparation of the plant Phyllanthus amarus for 30 days. 22 of 37 (59%) treated patients had lost hepatitis B surface antigen when tested 15-20 days after the end of the treatment compared with only 1 of 23 (4%) placebo-treated controls. Some subjects have been followed for up to 9 months. In no case has the surface antigen returned. Clinical observation revealed few or no toxic effects. The encouraging results of this preliminary study recommend continued evaluation of this plant and the active principles isolated from it.
The management of severe agoraphobia: A comparison of iproniazid and systematic desensitization

Sixty out-patients with severe agoraphobia took part in a controlled prospective clinical trial of combinations of methohexitone-assisted and standard systematic desensitization and monoamine oxidase inhibitor. Severity of agoraphobia in terms of avoidance and anxiety was rated both by the patients themselves and by an independent assessor during the eight weeks of treatment. The monoamine oxidase inhibitor produced a significant reduction in severity of anxiety but not of avoidance. Methohexitone-assisted systematic desensitization appeared to produce significantly greater improvement than either standard systematic desensitization or no systematic desensitization in both anxiety and avoidance. Assessors' ratings showed that the monoamine oxidase inhibitor used in conjunction with methohexitone-assisted systematic desnsitization produced slightly greater clinical improvement than the other treatment combinations.
Hydrocele of the canal of Nuck: a case report with magnetic resonance hydrography findings

Hydrocele of the canal of Nuck, also called the "female hydrocele," is a rare developmental disorder in females. This entity is now believed to be more common now in comparison with previous reports; however, it is still an unfamiliar problem for physicians. The processus vaginalis accompanies the round ligament through the inguinal canal into the labium majus. This evagination of the parietal peritoneum forms the canal of Nuck in the female. The canal of Nuck normally loses its connection with the peritoneal cavity during the first year of life, but can result in a hernia or hydrocele when the connection of the canal of Nuck fails to close. Here, we present the case of a 43-year-old female who complained of swelling in the right inguinal region. Coronal and axial magnetic resonance imaging (MRI) revealed a cystic mass lesion with an irregular shape in the right inguinal region, and smaller cystic lesions extending alongside the right round ligament were also identified in the right side of the pelvic cavity. Magnetic resonance (MR) hydrography revealed the uninterrupted cystic lesion from the inguinal region to the pelvic cavity, with constrictions at the internal and external inguinal rings. These MR findings proved to be incredibly useful for surgical planning.
The assessment of osteoporosis risk factors in Iranian women compared with Indian women

Osteoporosis is an important public health problem in older adults. It is more common in postmenopausal women and not only gives rise to morbidity but also markedly diminishes the quality of life in this population. There is lack of information about the risk factor of osteoporosis in developing countries. In this study we aimed to assess the risk factors for osteoporosis in postmenopausal women from selected BMD centers of two developing Asian countries (Iran and India).



This study is a multicenter interview-based study conducted in selected hospitals and health centers from urban areas in Iran and India. The case group included postmenopausal osteoporotic women who were identified as patients with bone density higher than 2.5 SD below average of young normal bone density (in L1-L4) spine region interest and/or total femoral region) by using DEXA method. The controls were chosen from postmenopausal women with normal bone density (in L1-L4 spine and total femoral regions using DEXA method) matching in age groups was strategy of choice.The sample sizes included from Iran a total of 363 subjects (178 osteoporotic and 185 normal) and from India a total of 354 subjects (203 osteoporotic and 151 normal).



The significant (p < 0.05) risk factors in present study population with their Odds Ratios (in parenthesis, respectively in Iran and India) were as follow:Lower education defined as less than class 12 or nil college (2.1) (2.7), duration of menopause greater than 5 years: (2.2) (1.4), Menarche age (after 14 years): (1.9) (1.6), Menopause age (before 45 years): (1.1) (2), Parity more than 3: (1.1) (1), Bone and joint problem (2.3) (2.2). Calcium supplementation (0.6) and HRT (0.4) were shown as protective factors and steroid therapy (3.3) was found as a risk factor in Iran. Calcium supplementation more than 1 year (0.3) was shown as a protective factor in India.Pure vegetarianism: (2.2) and Red meat consumption more than 4 times per week (1.4) was shown as a risk factor in Indian and Iranian subjects respectively. Regular consumption of Soya (0.3), almond (0.5), fish (0.5), fruits (0.4) and milk tea 4 cups per day and more (0.4) appeared to be significant protective factors in India. Regular consumption of cheese (0.5), milk (0.5), chicken (0.4), egg (0.6), fruit (0.4), tea 7 cups per day and more (0.3) were found to be significant protective factors in Iran. Exercises were shown as protective factor in Iran (0.4) and India (0.4). There were no significant differences in association of risk factors and osteoporosis between Iranian and Indian subjects.



Osteoporosis in Iranian and Indian subjects also appears to be associated with several known risk factors that well described in the literature. There were no significant differences in association of risk factors and osteoporosis between Iranian and Indian subjects. It was shown a protective role of certain nutritional dietary components and also exercises in both populations and can be exploited in preventive educational strategies on osteoporosis in these populations.
[Initial results of robotic esophagectomy for esophageal cancer].

There is scant experience with robot-assisted esophagectomy in cases of esophageal and gastro-esophageal junction cancer. Our aim is to report our current experience.



Observational cohort study of the first 32 patients who underwent minimally invasive esophagectomy for esophageal cancer from September 2011 to June 2014. The gastric tube was created laparoscopically. In the thoracic field, a robot-assisted thoracoscopic approach was performed in the prone position with intrathoracic robotic hand-sewn anastomosis. Patient and tumour characteristics, surgical technique, short-term outcomes (morbidity and mortality) and oncological results (radicality and number of removed nodes) were evaluated.



Thirty-two patients, with a mean age of 58 years (34-74) were treated by a totally minimally invasive esophagectomy: robotic laparoscopy and thoracoscopy (11 McKeown and 21 Ivor-Lewis). Twenty-nine received neoadjuvant chemoradiotherapy. There were no conversions to open surgery. Console time was 218minutes (190-285). Blood loss was 170ml (40-255). One patient died from cardiac disease. Nine patients had a major complication (Dindo-Clavien grade II or higher). There was no case of respiratory complication or recurrent laryngeal nerve palsy. Five patients had intrathoracic fistula, 4 radiological and one clinical. Three had chylothorax, 2 cervical fistula and one gastric tube necrosis. The median hospital stay was 12 days (8-50). All the resections were R0 and the median of removed lymph nodes was 16 (2-23).



Our results suggest that minimally invasive esophagectomy with robot-assisted thoracoscopy is safe and achieves oncological standards.
In Vivo quantitative imaging of angiogenesis-targeted PFOB nanoparticles in a hypercholesterol rabbit model using 19F-MRI with ultra-short echo time balanced SSFP

-integrin targeted nanoparticle (NP) emulsions have been shown to detect and quantify angiogenesis and anti-angiogenic therapy in small animal models of atherosclerosis. While these NP were visualized in high resolution preand post-injection H-MRI via a Gadolinium (Gd) chelate, we seek to image the perfluoro-octyl bromide (PFOB) core directly via F MR. Early in vivo successes of F MR molecular imaging exploited the single resonance peak of perfluoro-crown-ether. However, PFOB, which is the more clinically-relevant NP with a better-understood human safety profile, has a more complex spectrum with seven F resonance peaks and multiple relaxation conditions, leading to chemical shift artifact and intra-voxel destructive interference. We hypothesize that a new technique—simultaneous dualfrequency F/H ultra-short echo time (UTE) balanced steady state free precession (b-SSFP) sequence with 3D radial readout—will allow efficient, sensitive imaging of the complex PFOB signal without the need for Gd and in sufficient resolution to discern the anatomy even in the presence of cardiac and respiratory motion.
Versatile roles of brassinosteroid in plants in the context of its homoeostasis, signaling and crosstalks

Brassinosteroids (BRs) are a class of steroidal plant hormones that play diverse roles in plant growth and developmental processes. Recently, the easy availability of biological resources, and development of new molecular tools and approaches have provided the required impetus for deeper understanding of the processes involved in BRs biosynthesis, transport, signaling and degradation pathways. From recent studies it is also evident that BRs interact with other phytohormones such as auxin, cytokinin, ethylene, gibberellin, jasmonic acid, abscisic acid, salicylic acid and polyamine in regulating wide range of physiological and developmental processes in plants. The inputs from these studies are now being linked to the versatile roles of BRs. The present review highlights the conceptual development with regard to BR homeostasis, signaling and its crosstalk with other phytohormones. This information will assist in developing predictive models to modulate various useful traits in plants and address current challenges in agriculture.
Cerebral Venous Thrombosis : Diagnostic Accuracy of Combined , Dynamic and Static , Contrast-Enhanced 4 D MR Venography

S. Meckel C. Reisinger J. Bremerich D. Damm M. Wolbers S. Engelter K. Scheffler S.G. Wetzel  MR including MRV is an established method to diagnose CVT. However, it remains unsettled which MR imaging modalities offer the highest diagnostic accuracy. We evaluated the accuracy of a combined, dynamic (1.5 seconds per dataset) and static (voxel size, 1.1 0.9 1.5 mm), contrast-enhanced MRV method (combo-4D MRV) relative to other established MR/MRV modalities.
Low plasma coenzyme Q(10) levels and breast cancer risk in Chinese women.

Low circulating levels of coenzyme Q(10) (CoQ(10)) have been associated with increased cancer incidence and poor prognosis for a number of cancer types, while a recent prospective study observed a positive association for CoQ(10) with breast cancer risk.



We prospectively examined the association of plasma CoQ(10) with breast cancer risk in a nested case-control study of Chinese women within the Shanghai Women's Health Study (SWHS). Prediagnostic plasma samples were obtained from 340 cases and 653 age-matched controls and analyzed for total CoQ(10).



A borderline significant inverse association for breast cancer incidence with plasma CoQ(10) level was observed by a conditional logistic regression model adjusted for age and age at first live birth, which became significant after elimination of cases diagnosed within 1 year of blood draw (P(trend) = 0.03). This association was independent of menopausal status. Plasma CoQ(10) levels were also observed to be significantly associated with circulating γ-tocopherol (r = 0.50; P < 0.0001) and α-tocopherol (r = 0.38; P < 0.0001) levels.



Circulating levels of CoQ(10) were generally low in this population and the observed association with breast cancer risk may be limited to those women with exceptionally low values.



This study reports an inverse relationship between circulating CoQ(10) and breast cancer risk, while the only other prospective study of CoQ(10) and breast cancer to date found a positive association. Lower levels of CoQ(10) in the SWHS population suggest that the 2 studies may not be contradictory and indicate a possible nonlinear (U-shaped) association of CoQ(10) with risk.
Effect of low doses of corticosteroids in septic shock patients with or without early acute respiratory distress syndrome.

We investigated the efficacy of low doses of corticosteroids in septic shock patients with or without early acute respiratory distress syndrome (ARDS) by post hoc analysis of a previously completed clinical trial.



Retrospective analysis of a placebo-controlled, randomized, double-blind trial of low doses of corticosteroids in septic shock.



Nineteen intensive care units in France.



Among the 300 septic shock patients enrolled, we selected those meeting standard criteria for ARDS at inclusion.



Seven-day treatment with 50 mg of hydrocortisone every 6 hrs and 50 microg of 9-alpha-fludrocortisone once a day.



There were 177 patients with ARDS (placebo, n = 92; corticosteroids, n = 85) including 129 (placebo, n = 67; corticosteroids, n = 62) nonresponders and 48 (placebo, n = 25; corticosteroids, n = 23) responders. In nonresponders, there were 50 deaths (75%) in the placebo group and 33 deaths (53%) in the steroid group (hazard ratio 0.57, 95% confidence interval 0.36-0.89, p = .013; relative risk 0.71, 95% confidence interval 0.54-0.94, p = .011). The number of days alive and off the ventilator was 2.6 +/- 6.6 in the placebo group and 5.7 +/- 8.6 in the steroid group (p = .006). There was no significant difference between groups in responders. There was no significant difference between groups in the two subsets of patients without ARDS. Adverse events rates were similar in the two groups.



This post hoc analysis shows that a 7-day treatment with low doses of corticosteroids was associated with better outcomes in septic shock-associated early ARDS nonresponders, but not in responders and not in septic shock patients without ARDS.
Combined detrusor-trigone BTX-A injections for urinary incontinence secondary to neurogenic detrusor overactivity

The objective of this study was to evaluate the effect and safety of trigonal injection of botulinum toxin A (BTX-A) for patients with neurological detrusor overactivity (NDO) with incontinence.A prospective, multicenter, single-blind and randomized controlled trial was conducted between June 2011 and June 2014. Spinal cord injury patients with urinary incontinence secondary to NDO overactivity were recruited. At a 1:1 ratio, patients randomly received 200 U BTX-A intradetrusor injections excluding the trigone (the control group) or 160 U intradetrusor and 40 U intratrigonal injections (the experimental group). Patients were evaluated at baseline and at 4 and 12 weeks after injection. The efficacy and safety outcomes included Incontinence-Specific-Quality-of-Life Instrument (I-QoL), voiding volume, urinary incontinence episodes, complete dryness, maximum detrusor pressure (Pdetmax) and volume at first involuntary detrusor contraction (VFIDC). Vesicoureteral reflux (VUR) and other adverse events were recorded.Ninety-six patients were recruited and 91 of them completed the trial. Among the 91 patients, 47 were randomized to the experimental group and 44 to the control group. There were no significant differences in baseline evaluation items (gender, age, duration of spinal cord injury, level of neurological injury, AIS (the American Social Injury Association) scores) between the two groups. At 12 weeks, the improvement was significantly better in the experimental group compared with that in the control group for I-QoL (26.01 vs 18.75, P=0.01), mean urinary incontinence episodes (−5.22 vs −4.68 per day, P=0.01), complete dryness (13 vs 5, P=0.03), mean voiding volume (159.72 vs 139.07 ml, P=0.02), Pdetmax (−33.34 vs −28.02 cmH2O, P=0.04) and VFIDC (106.81 vs 97.86 ml, P=0.02), duration of first detrusor contraction (−41.54 vs −18.65 s, P=0.03) and the number of patients with detrusor contraction (−20 vs −9, P=0.02). In both the groups, no patients developed VUR.Conclusions:BTX-A intradetrusor and intratrigonal injections are more effective compared with those excluding the trigone for patients with NDO with incontinence. Intratrigonal injections do not induce VUR.