nils-herrmann/clean_scirepeval huggingface dataset:
Analysis of chronic low back pain with magnetic resonance imaging T2 mapping of lumbar intervertebral disc.

Magnetic resonance imaging (MRI) T2 mapping utilizes the T2 values for quantification of moisture content and collagen sequence breakdown. Recently, attempts at quantification of lumbar disc degeneration through MRI T2 mapping have been reported. We conducted an analysis of the relationship between T2 values of degenerated intervertebral discs (IVD) and chronic low back pain (CLBP).



The subjects who had CLBP comprised 28 patients (15 male, 13 female; mean age 48.9 ± 9.6 years; range 22-60 years). All subjects underwent MRI and filled out the low back pain visual analog scale (VAS) and Japanese Orthopaedic Association Back Pain Evaluation Questionnaire (JOABPEQ). The disc was divided into the anterior annulus fibrosus (AF), the nucleus pulposus (NP), and the posterior AF, and each T2 value was measured. This study involved 25 asymptomatic control participants matched with the CLBP group subjects for gender and age (13 male, 12 female; mean age 43.8 ± 14.5 years; range 23-60 years). These subjects had no low back pain, and constituted the control group.



T2 values for IVD tended to be lower in the CLBP group than in the control group, and these values were significantly different within the posterior AF. The correlation coefficients between the VAS scores and T2 values of anterior AF, NP and posterior AF were r = 0.30, -0.15 and -0.50. The correlation coefficient between the JOABPEQ scores (low back pain) and T2 values of anterior AF, NP and posterior AF were r = -0.0041, 0.11 and 0.42. Similarly, the JOABPEQ scores (lumbar function) were r = -0.22, -0.12 and 0.57.



The results indicated a correlation between posterior AF degeneration and CLBP. This study suggests that MRI T2 mapping could be used as a quantitative method for diagnosing discogenic pain.
Energy titration strategies with the endoscopic ablation system: lessons from the high-dose vs. low-dose laser ablation study.

To assess the effects of low-dose (LD) and high-dose (HD) ablation on acute and chronic success in patients with atrial fibrillation (AF). While the concept of visually guided pulmonary vein isolation (PVI) has been established little is known on energy titration using laser ablation.



In 60 patients with AF, PVI using the endoscopic ablation system (EAS) was performed in two groups. Visually guided ablation was carried out after obtaining optimal tissue contact with 5.5-8.5 W in the LD group and with >8.5 W in the HD group. Acute PVI after a single visually guided circular lesion set was achieved in 89% (HD) and 69% (LD), respectively, (P = 0.0004). In 70 and 39% of patients all PVs were isolated after a single ablation circle in the HD and LD group, respectively, (P = 0.009). After gap ablation all PVs were isolated with the EAS. More energy was deployed (6483 ± 1834 vs. 5306 ± 2258 Ws; P ≤ 0.0001) with less applications (31.6 ± 8 vs. 35.2 ± 15 applications per PV; P = 0.03) leading to shorter procedure times (128 ± 17 vs. 154 ± 38 min; P = 0.001). During median follow-up of 311 days (261-346) recurrence rate was 17 and 40% in the HD and LD group, respectively. In both groups one phrenic nerve palsy was observed.



For the first time, it was demonstrated that high ablation power affects acute and chronic outcomes. High-dose laser balloon ablation allows for an acute PVI rate of 89% solely by visually guided circular ablation and is associated with a chronic success rate of 83% after a single procedure.
Inter-Segmental Coordination Pattern in Patients with Anterior Cruciate Ligament Deficiency during a Single-Step Descent

Anterior cruciate ligament injury is a debilitating pathology which may alter lower limb coordination pattern in both intact and affected lower extremities during activities of daily living. Emerging evidence supports the notion that kinematic variables may not be a good indicator to differentiate patients with anterior cruciate ligament deficiency during step descent task. The aim of the present study was to examine alterations in kinematics as well as coordination patterns and coordination variability of both limbs of these patients during a single step descent task. Continuous relative phase technique was used to measure coordination pattern and coordination variability between a group of anterior cruciate ligament deficient (n = 23) and a healthy control group (n = 23). A third order polynomial Curve fitting was utilized to provide a curve that best fitted to the data points of coordination pattern and coordination variability of the healthy control group. This was considered as a reference to compare to that of patient group using nonlinear regression analysis. The results of the present study demonstrated an altered coordination pattern of the supporting shank-thigh and the stepping foot-shank couplings in anterior cruciate ligament deficient subjects. It was further noticed that there was an increased coordination variability in foot-shank and shank-thigh couplings of both supporting and stepping legs. There was no significant difference in the hip, knee and ankle joints kinematics in either side of these patients. Anterior cruciate ligament deficient individuals showed altered strategies in both intact and affected legs, with increased coordination variability. Kinematic data did not indicate any significant difference between the two groups. It could be concluded that more sophisticated dynamic approach such as continuous relative phase would uncover discrepancies between the healthy and anterior cruciate ligament deficient individuals.
Intervening before the onset of Type 1 diabetes: baseline data from the European Nicotinamide Diabetes Intervention Trial (ENDIT)

To set up a clinical trial to establish whether nicotinamide can prevent or delay clinical onset of Type 1 diabetes. The European Nicotinamide Diabetes Intervention Trial is a randomised, double-blind, placebo-controlled intervention trial undertaken in 18 European countries, Canada and the USA. Entry criteria were a first-degree family history of Type 1 diabetes, age 3–40 years, confirmed islet cell antibody (ICA) levels greater than or equal to 20 JDF units, and a non-diabetic OGTT; the study group was further characterised by intravenous glucose tolerance testing, measurement of antibodies to GAD, IA-2 and insulin and HLA class II genotyping. ICA screening was carried out in approximately 30,000 first-degree relatives. A total of 1004 individuals fulfilled ICA criteria for eligibility, and 552 (288 male) were randomised to treatment. Of these, 331 were aged less than 20 years (87% siblings and 13% offspring of the proband with diabetes) and 221 were 20 years of age or more (76% parents, 21% siblings and 3% offspring). Oral glucose tolerance was normal in 500 and impaired in 52 (9.4%), and first phase insulin response in the IVGTT was below the 10th centile in 34%. Additional islet autoantibodies were identified in 354 trial entrants. Diabetes-associated HLA class II haplotypes were found in 84% of the younger age group and 80% of the older group. The protective haplotype HLA-DQA1*0102-DQB1*0602 was found in 10% overall. ENDIT has shown that a trial of an intervention designed to halt or delay progression to Type 1 diabetes can be carried out on a multinational collaborative basis, as and when potentially safe and effective forms of intervention become available. Primary screening with biochemically defined autoantibodies will substantially reduce the number of lower risk individuals to be included in future intervention trials
Course and prognosis of recovery for chronic non-specific low back pain: design, therapy program and baseline data of a prospective cohort study

There has been increasing focus on factors predicting the development of chronic musculoskeletal disorders. For patients already experiencing chronic non-specific low back pain it is also relevant to investigate which prognostic factors predict recovery. We present the design of a cohort study that aims to determine the course and prognostic factors for recovery in patients with chronic non-specific low back pain.



All participating patients were recruited (Jan 2003-Dec 2008) from the same rehabilitation centre and were evaluated by means of (postal) questionnaires and physical examinations at baseline, during the 2-month therapy program, and at 5 and 12 months after start of therapy. The therapy protocol at the rehabilitation centre used a bio-psychosocial approach to stimulate patients to adopt adequate (movement) behaviour aimed at physical and functional recovery. The program is part of regular care and consists of 16 sessions of 3 hours each, over an 8-week period (in total 48 hours), followed by a 3-month self-management program. The primary outcomes are low back pain intensity, disability, quality of life, patient's global perceived effect of recovery, and participation in work. Baseline characteristics include information on socio-demographics, low back pain, employment status, and additional clinical items status such as fatigue, duration of activities, and fear of kinesiophobia. Prognostic variables are determined for recovery at short-term (5 months) and long-term (12 months) follow-up after start of therapy.



In a routine clinical setting it is important to provide patients suffering from chronic non-specific low back pain with adequate information about the prognosis of their complaint.
Volumetric measurement of pulmonary nodules at low-dose chest CT: effect of reconstruction setting on measurement variability

To assess volumetric measurement variability in pulmonary nodules detected at low-dose chest CT with three reconstruction settings. The volume of 200 solid pulmonary nodules was measured three times using commercially available semi-automated software of low-dose chest CT data-sets reconstructed with 1 mm section thickness and a soft kernel (A), 2 mm and a soft kernel (B), and 2 mm and a sharp kernel (C), respectively. Repeatability coefficients of the three measurements within each setting were calculated by the Bland and Altman method. A three-level model was applied to test the impact of reconstruction setting on the measured volume. The repeatability coefficients were 8.9, 22.5 and 37.5% for settings A, B and C. Three-level analysis showed that settings A and C yielded a 1.29 times higher estimate of nodule volume compared with setting B (P = 0.03). The significant interaction among setting, nodule location and morphology demonstrated that the effect of the reconstruction setting was different for different types of nodules. Low-dose CT reconstructed with 1 mm section thickness and a soft kernel provided the most repeatable volume measurement. A wide, nodule-type-dependent range of agreement between volume measurements with different reconstruction settings suggests strict consistency is required for serial CT studies.
Obesity paradox in cancer: new insights provided by body composition.

Obesity, defined by body mass index (BMI), appears to have a paradoxical protective effect in several chronic diseases.



We investigated the obesity paradox in cancer patients by using body composition.



The study was an observational study of 175 cancer patients assessed before chemotherapy. Obesity was defined as BMI (in kg/m(2)) ≥30 or fat mass index (FMI; fat mass divided by the square of height) ≥5.2 (men) and ≥8.2 (women) measured by using a bioelectrical impedance analysis. Low muscle mass (sarcopenia) was defined as fat-free mass index (fat-free mass divided by the square of height) <17.5 (men) and <15.1 (women).



Most patients were women (65.7%) and had a mean (±SD) age of 56.9 ± 12.8 y. According to BMI criteria, 60% of patients were overweight or obese. The median survival time for overweight (2.64 y; range: 0.23-3.16 y) and obese (2.61 y; range: 0.26-3.20 y) patients was significantly higher than for patients with a normal (2.04 y; range: 0.06-3.05 y) or low (0.52 y; range: 0.19-0.98 y) BMI (P < 0.001). Sarcopenic patients had shorter survival, regardless of their FMI. Obesity predicted higher survival rates only when sarcopenia was absent. In a multivariate Cox regression model, sarcopenia was an independent predictor of higher mortality (HR: 5.19; 95% CI: 2.58, 10.43) after we controlled for BMI, age, and tumor stage.



The obesity paradox is present in cancer patients only when obesity is defined by BMI. Patients with sarcopenic obesity had the poorest prognosis. Cancer patients with high mortality risk can be identified by a body-composition assessment.
Effects of acute glucocorticoid blockade on metabolic dysfunction in patients with Type 2 diabetes with and without fatty liver

To investigate the potential of therapies which reduce glucocorticoid action in patients with Type 2 diabetes we performed a randomized, double-blinded, placebo-controlled crossover study of acute glucocorticoid blockade, using the glucocorticoid receptor antagonist RU38486 (mifepristone) and cortisol biosynthesis inhibitor (metyrapone), in 14 men with Type 2 diabetes. Stable isotope dilution methodologies were used to measure the rates of appearance of glucose, glycerol, and free fatty acids (FFAs), including during a low-dose (10 mU·m⁻² ·min⁻¹) hyperinsulinemic clamp, and subgroup analysis was conducted in patients with high or low liver fat content measured by magnetic resonance spectroscopy (n = 7/group). Glucocorticoid blockade lowered fasting glucose and insulin levels and improved insulin sensitivity of FFA and glycerol turnover and hepatic glucose production. Among this population with Type 2 diabetes high liver fat was associated with hyperinsulinemia, higher fasting glucose levels, peripheral and hepatic insulin resistance, and impaired suppression of FFA oxidation and FFA and glycerol turnover during hyperinsulinemia. Glucocorticoid blockade had similar effects in those with and without high liver fat. Longer term treatments targeting glucocorticoid action may be useful in Type 2 diabetes with and without fatty liver.
Estimation of prevalence of DSM-IV and latent class-defined ADHD subtypes in a population-based sample of child and adolescent twins.

The goal of this study is to determine the prevalence and age of onset of Diagnostic and Statistical Manual of Mental Disorders and latent class-derived attention deficit/hyperactivity disorder (ADHD) subtypes in a population-based twin sample of boys and girls. Missouri birth records identified families with a twin pair 7 to 18 years of age. Telephone screening interviews for ADHD symptoms were completed for 5007 families. Diagnostic assessments were administered to 564 families with at least one twin meeting screening criteria, plus 183 control families. Prevalence and age of onset for both ADHD nosologies were calculated by sex and zygosity from parent report data. The prevalence of any DSM-IV ADHD was 6.2% overall, 7.4% in boys and 3.9% in girls. The inattentive subtype was most common in boys; the combined subtype was most common in girls. The mean age of onset of symptoms in children with any DSM-IV ADHD was 3.5 years, with no significant differences between boys and girls. Prevalences of latent class defined ADHD subtypes also varied by sex with the severe inattentive and combined classes more common in boys than girls. The age of onset of symptoms did not differ between boys and girls but were higher than in the DSM-IV subtypes. Findings in this twin sample showed that clinically significant ADHD, defined by either DSM-IV or latent class criterion, has an early age of onset and is more common in boys than girls. As clinical samples are most commonly composed of male combined subtypes, the inattentive subtype of both sexes in the general population is an under-treated segment of the general population.
Treatment of hyperhomocysteinemia in children on dialysis by folic acid

Adult patients with renal failure have a high total homocysteine concentration in plasma. Hyperhomocysteinemia is an independent risk factor for cardiovascular diseases. Folic acid lowers the homocysteine concentrations in plasma in hyperhomocysteinemia. Whether this results in a reduced risk for cardiovascular diseases remains to be proven by intervention studies. In the present study we investigated: (1) if homocysteine concentrations are elevated in the plasma of children with renal failure and (2) the influence of folic acid administration on the plasma homocysteine concentration. The plasma homocysteine concentration was measured in 21 children, 9 on hemodialysis and 12 on peritoneal dialysis, before and 4 weeks after treatment with 2.5 mg folic acid daily. Healthy children (234) constituted the control group. In controls the median homocysteine concentration was 9.1 µmol/l (range 4.3–20.0 µmol/l). The median plasma homocysteine concentration in patients before folic acid treatment was 20.0 µmol/l (Q1-Q3 13.7–26.0; Q, quartile). After 4 weeks of folic acid treatment the median plasma homocysteine concentration was 12.0 µmol/l [Q1-Q3 9.8–14.3 (P<0.0001 Wilcoxon signed rank test)]. There was no significant difference between hemodialysis and peritoneal dialysis patients. Children with renal failure treated with hemodialysis or peritoneal dialysis have elevated plasma homocysteine concentrations, but this is significantly reduced after administration of 2.5 mg folic acid daily for 4 weeks. It is suggested that folic acid be added to the treatment of children with renal failure, although a beneficial effect still has to be proven. The required dose needs further study.
[Effects of a home-based exercise program for patients with stomach cancer receiving oral chemotherapy after surgery].

The purpose of this study was to identify the effects of a home based exercise program for patients with stomach cancer who were undergoing oral chemotherapy.



The home-based exercise program was developed from the study findings of Winningham (1990) and data from the Korea Athletic Promotion Association (2007). The home-based exercise program consisted of 8 weeks of individual exercise education and exercise adherence strategy. Participants were 24 patients with stomach cancer who were undergoing oral chemotherapy following surgery in 2007 or 2008 at a university hospital in Seoul. Patients were randomly assigned to either the experimental group (11) or control group (13). The effects of the home-based exercise program were measured by level of cancer related fatigue, NK cell ratio, anxiety, and quality of life. Data were analyzed using SPSS/WIN 13.0 version.



The degree of cancer related fatigue and anxiety in the experimental group decreased compared to the control group. The NK cell ratio and the degree of quality of life of experimental group increased while that of the control group decreased.



This study result indicate the importance of exercise and provide empirical evidence for continuation of safe exercise for patients with cancer during their chemotherapy.
Pain course in conservatively treated patients with back pain and a VCF on the spine radiograph (VERTOS III)

Little is known about the natural course of pain from vertebral compression fractures (VCF). In this study we evaluated the pain course in conservatively treated patients with back pain and a VCF on the spine radiograph. Between May 2007 and November 2008, 169 patients with back pain referred by the general practitioner for spine radiographs and with a VCF were requested to participate in this follow-up study. Base line questionnaires about visual analogue scale (VAS) score, type of treatment and use of osteoporosis medication were filled in by 82 patients. Questionnaires were repeated at 6 weeks, and at 3, 6 and 12 months. Significant pain relief was defined as a decrease in VAS score of 50 % or more from baseline. At baseline, mean VAS score in 82 patients was 6.9 (SD 2.0). Significant pain relief at 12 months was reported by 44 patients (54 %) while in 38 patients (46 %) pain relief was insufficient. No predictors for pain relief could be identified. Patients with insufficient pain relief at 12 months used significantly more analgesics and in these patients physiotherapy did better than other types of therapy. More than half of conservatively treated patients with back pain and VCF had sufficient pain relief at 12 months with most pain decrease in the first 3 months. However, a substantial proportion of patients still reported disabling pain. There were no predictors for the development of chronic pain. Patients with continuing pain ≥3 months after diagnosis of VCF may be candidates for vertebroplasty.
Short-term intravenous antimicrobial prophylaxis for elective rectal cancer surgery: results of a prospective randomized non-inferiority trial

To investigate the non-inferiority of postoperative single-dose intravenous antimicrobial prophylaxis to multiple-dose intravenous antimicrobial prophylaxis in terms of the incidence of surgical site infections (SSIs) in patients undergoing elective rectal cancer surgery by a prospective randomized study. Patients undergoing elective surgery for rectal cancer were randomized to receive a single intravenous injection of flomoxef (group 1) or five additional doses (group 2) of flomoxef after the surgery. All the patients had received preoperative oral antibiotic prophylaxis (kanamycin and erythromycin) after mechanical cleansing within 24 h prior to surgery, and had received intravenous flomoxef during surgery. A total of 279 patients (including 139 patients in group 1 and 140 in group 2) were enrolled in the study. The incidence of SSIs was 13.7 % in group 1 and 13.6 % in group 2 (difference [95 % confidence interval]: −0.2 % [−0.9 to 0.7 %]). The incidence of SSIs was not significantly different in patients undergoing elective rectal surgery who were treated using a single dose of postoperative antibiotics compared to those treated using multiple-dose antibiotics when preoperative mechanical and chemical bowel preparations were employed.
CT prediction of contusion evolution after closed head injury: the role of pericontusional edema.

Cerebral contusions have a 51% incidence of evolution in the first hours after injury. Evolution is associated with clinical deterioration and is the reason for ICP monitoring or surgical intervention. We sought to define CT features that predict cerebral contusion evolution.



Patients treated for cerebral contusion who had 2 CT scans within 24 hours after injury were evaluated (n = 21). CT scans were analyzed for area of contusion, hemorrhagic components, and edema. Increase (%) in contusion size was recorded. Contusion evolution was defined as > 5% size increase. Ratios of hemorrhagic components to surrounding edema were calculated.



Ten patients (47.6%) showed contusion evolution and 11 (52.4%) did not. Age, sex ratio, or injury severity between the 2 groups did not differ. Eight of 10 patients with evolving contusions had minimal or no perilesional edema on first CT; only 2 of 11 nonevolution patients had perilesional edema (p < 0.005). Mean ratio of area of surrounding edema to area of hemorrhagic products on first CT was 0.770 in evolution group versus 2.22 in non-evolution group (p = 0.055).



A higher proportion of patients without contusion evolution had perilesional edema present on first CT scan. The absence of pericontusional edema on early CT may be a useful marker to predict contusion evolution.