nils-herrmann/clean_scirepeval huggingface dataset:
Nonlinear Imputation of PaO2/FIO2 From SpO2/FIO2 Among Mechanically Ventilated Patients in the ICU: A Prospective, Observational Study.

In the contemporary ICU, mechanically ventilated patients may not have arterial blood gas measurements available at relevant timepoints. Severity criteria often depend on arterial blood gas results. Retrospective studies suggest that nonlinear imputation of PaO2/FIO2 from SpO2/FIO2 is accurate, but this has not been established prospectively among mechanically ventilated ICU patients. The objective was to validate the superiority of nonlinear imputation of PaO2/FIO2 among mechanically ventilated patients and understand what factors influence the accuracy of imputation.



Simultaneous SpO2, oximeter characteristics, receipt of vasopressors, and skin pigmentation were recorded at the time of a clinical arterial blood gas. Acute respiratory distress syndrome criteria were recorded. For each imputation method, we calculated both imputation error and the area under the curve for patients meeting criteria for acute respiratory distress syndrome (PaO2/FIO2 ≤ 300) and moderate-severe acute respiratory distress syndrome (PaO2/FIO2 ≤ 150).



Nine hospitals within the Prevention and Early Treatment of Acute Lung Injury network.



We prospectively enrolled 703 mechanically ventilated patients admitted to the emergency departments or ICUs of participating study hospitals.



None.



We studied 1,034 arterial blood gases from 703 patients; 650 arterial blood gases were associated with SpO2 less than or equal to 96%. Nonlinear imputation had consistently lower error than other techniques. Among all patients, nonlinear had a lower error (p < 0.001) and higher (p < 0.001) area under the curve (0.87; 95% CI, 0.85-0.90) for PaO2/FIO2 less than or equal to 300 than linear/log-linear (0.80; 95% CI, 0.76-0.83) imputation. All imputation methods better identified moderate-severe acute respiratory distress syndrome (PaO2/FIO2 ≤ 150); nonlinear imputation remained superior (p < 0.001). For PaO2/FIO2 less than or equal to 150, the sensitivity and specificity for nonlinear imputation were 0.87 (95% CI, 0.83-0.90) and 0.91 (95% CI, 0.88-0.93), respectively. Skin pigmentation and receipt of vasopressors were not associated with imputation accuracy.



In mechanically ventilated patients, nonlinear imputation of PaO2/FIO2 from SpO2/FIO2 seems accurate, especially for moderate-severe hypoxemia. Linear and log-linear imputations cannot be recommended.
Correlation of pretreatment clinical parameters and PSA nadir after high-intensity focused ultrasound (HIFU) for localised prostate cancer

To determine which pretreatment clinical parameters were predictive of a low prostate-specific antigen (PSA) nadir following high-intensity focused ultrasound (HIFU) treatment. Retrospective study of patients with clinically localised prostate cancer undergoing HIFU at a single centre between December 1997 and September 2009. Whole-gland treatment was applied. Patients also included if they had previously undergone transurethral resection of the prostate (TURP). TURP was also conducted simultaneously to HIFU. Biochemical failure based on Phoenix definition (PSA nadir + 2). Univariate and multivariate analysis of pretreatment clinical parameters conducted to assess those factors predictive of a PSA nadir ≤0.2 and >0.2 ng/ml. Mean (SD) follow-up was 6.2 (2.8) years; median (range) was 6.3 (1.1–12.2) years. Kaplan–Meier estimate of biochemical disease-free survival rate at 8 years was 83 and 48 % for patients achieving a PSA nadir of ≤0.2 and >0.2 ng/ml, respectively. Prostate volume and incidental finding of cancer were significant predictors of low PSA nadir (≤0.2 ng/ml). Prostate volume and incidental finding of cancer could be predictors for oncologic success of HIFU based on post-treatment PSA nadir.
Body weight dynamics and their association with physical function and mortality in older adults: the Cardiovascular Health Study.

To estimate the associations of weight dynamics with physical functioning and mortality in older adults.



Longitudinal cohort study using prospectively collected data on weight, physical function, and health status in four U.S. Communities in the Cardiovascular Health Study. Included were 3,278 participants (2,013 women and 541 African Americans), aged 65 or older at enrollment, who had at least five weight measurements. Weight was measured at annual clinic visits between 1992 and 1999, and summary measures of mean weight, coefficient of variation, average annual weight change, and episodes of loss and gain (cycling) were calculated. Participants were followed from 1999 to 2006 for activities of daily living (ADL) difficulty, incident mobility limitations, and mortality.



Higher mean weight, weight variability, and weight cycling increased the risk of new onset of ADL difficulties and mobility limitations. After adjustment for risk factors, the hazard ratio (95% confidence interval) for weight cycling for incident ADL impairment was 1.28 (1.12, 1.47), similar to that for several comorbidities in our model, including cancer and diabetes. Lower weight, weight loss, higher variability, and weight cycling were all risk factors for mortality, after adjustment for demographic risk factors, height, self-report health status, and comorbidities.



Variations in weight are important indicators of future physical limitations and mortality in the elderly and may reflect difficulties in maintaining homeostasis throughout older ages. Monitoring the weight of an older person for fluctuations or episodes of both loss and gain is an important aspect of geriatric care.
Fluconazole vs low-dose amphotericin B for the prevention of fungal infections in patients undergoing bone marrow transplantation: a study of the North American Marrow Transplant Group

systemic fungal infections are a major problem in bone marrow transplant recipients who have prolonged neutropenia or who receive high-dose corticosteroids. prophylaxis with fluconazole or low-dose amphotericin b reduces, but does not eliminate these infections. to determine which prophylactic agent is better, we performed a prospective randomized study. patients undergoing allogeneic (related or unrelated) or autologous marrow or peripheral stem cell transplantation were randomized to receive fluconazole (400 mg/day p.o. or i.v.) or amphotericin b (0.2 mg/kg/day i.v.) beginning 1 day prior to stem cell transplantation and continuing until recovery of neutrophils to >500/μl. patients were removed from their study drug for drug-associated toxicity, invasive fungal infection or suspected fungal infection (defined as the presence of fever >38°C without positive culture while on broad-spectrum anti-bacterial antibiotics). Proven or suspected fungal infections were treated with high-dose amphotericin B (0.5–0.7 mg/kg/day). Patients were randomized at each institution and stratified for the type of transplant. The primary end-point of the study was prevention of documented fungal infection; secondary endpoints included fungal colonization, drug toxicity, duration of hospitalization, duration of fever, duration of neutropenia, duration and total dose of high-dose amphotericin B and overall survival to hospital discharge. From July 1992 to October 1994, a total of 355 patients entered into the trial with 159 patients randomized to amphotericin B and 196 to Fluconazole. Patient groups were comparable for diagnosis, age, sex, prior antibiotic or antifungal therapy, use of corticosteroids prior to transplantation and total duration of neutropenia. Amphotericin B was significantly more toxic than Fluconazole especially in related allogeneic transplantation where 19% of patients developed toxicity vs 0% of Fluconazole recipients (p < 0.05). approximately 44% of all patients were removed from prophylaxis for presumed fungal infection. proven fungal infections occurred in 4.1% and 7.5% of fluconazole and amphotericin-treated patients, respectively. proven fungal infections occurred in 9.1% and 14.3% of related allogeneic marrow recipients receiving fluconazole or amphotericin b, respectively, and 2.1% and 5.6% of autologous marrow recipients receiving fluconazole or amphotericin b, respectively (P > 0.05). In this prospective trial, low-dose amphotericin B prophylaxis was as effective as Fluconazole prophylaxis, but Fluconazole was significantly better tolerated. Bone Marrow Transplantation (2000) 25 , 853–859.
A prospective, cluster-randomized controlled trial of exercise program to prevent low back pain in office workers

The objective of this study was to evaluate the effects of an exercise program focusing on muscle stretching and endurance training on the 12-month incidence of low back pain (LBP) in office workers. A 12-month prospective cluster-randomized controlled trial was conducted in healthy office workers with lower-than-normal trunk extension flexibility or trunk muscle endurance. Healthy office workers (n = 563) were randomly assigned at the cluster level into either intervention (n = 282) or control (n = 281) groups. Participants in the intervention group received an exercise program that included daily stretching exercise and twice-a-week muscle endurance training. Those in the control group received no intervention. The 12-month incidence of LBP was the primary outcome. Secondary outcome were pain intensity, disability level, and quality of life and health status. Analyses were performed using the Cox proportional hazard models. Over the 12-month follow-up, 8.8 % of participants in the intervention group and 19.7 % in the control group developed incidence of LBP. Hazard rate ratios showed a protective effect of the exercise program for LBP (HR = 0.37, 95 % CI 0.22–0.64) after adjusting for biopsychosocial factors. There was no significant difference in pain intensity, disability, and quality of life and health status between those who reported incidence of LBP in the intervention and control groups. An exercise program consisting of muscle stretching and endurance training is an effective intervention to reduce incident LBP for office workers with lower-than-normal trunk extension flexibility or trunk muscle endurance.
A randomized, double-blind, placebo-controlled trial of oral montelukast in acute asthma exacerbation

Leukotriene receptor antagonists (LTRAs) are well established in the management of outpatient asthma. However, there is very little information as to their role in acute asthma exacerbations. We hypothesized that LTRAs may accelerate lung function recovery when given in an acute exacerbation.



A randomized, double blind, placebo-controlled trial was conducted at the Aga Khan University Hospital to assess the efficacy of oral montelukast on patients of 16 years of age and above who were hospitalized with acute asthma exacerbation. The patients were given either montelukast or placebo along with standard therapy throughout the hospital stay for acute asthma. Improvements in lung function and duration of hospital stay were monitored.



100 patients were randomized; their mean age was 52 years (SD +/- 18.50). The majority were females (79%) and non-smokers (89%). The mean hospital stay was 3.70 ± 1.93 days with 80% of patients discharged in 3 days. There was no significant difference in clinical symptoms, PEF over the course of hospital stay (p = 0.20 at day 2 and p = 0.47 at day 3) and discharge (p = 0.15), FEV1 at discharge (p = 0.29) or length of hospital stay (p = 0.90) between the two groups. No serious adverse effects were noted during the course of the study.



Our study suggests that there is no benefit of addition of oral montelukast over conventional treatment in the management of acute asthma attack.
Individual music therapy for agitation in dementia: an exploratory randomized controlled trial

Agitation in nursing home residents with dementia leads to increase in psychotropic medication, decrease in quality of life, and to patient distress and caregiver burden. Music therapy has previously been found effective in treatment of agitation in dementia care but studies have been methodologically insufficient. The aim of this study was to examine the effect of individual music therapy on agitation in persons with moderate/severe dementia living in nursing homes, and to explore its effect on psychotropic medication and quality of life.



In a crossover trial, 42 participants with dementia were randomized to a sequence of six weeks of individual music therapy and six weeks of standard care. Outcome measures included agitation, quality of life and medication.



Agitation disruptiveness increased during standard care and decreased during music therapy. The difference at -6.77 (95% CI (confidence interval): -12.71, -0.83) was significant (p = 0.027), with a medium effect size (0.50). The prescription of psychotropic medication increased significantly more often during standard care than during music therapy (p = 0.02).



This study shows that six weeks of music therapy reduces agitation disruptiveness and prevents medication increases in people with dementia. The positive trends in relation to agitation frequency and quality of life call for further research with a larger sample.
Effects of high-velocity resistance training on muscle function, muscle properties, and physical performance in individuals with hip osteoarthritis: a randomized controlled trial.

To investigate the effects of high-velocity resistance training on muscle function, muscle properties, and physical performance in patients with hip osteoarthritis by comparison with those of low-velocity resistance training.



Single-blind randomized controlled trial.



Home-based exercise programmes.



A total of 46 women with hip osteoarthritis were randomly assigned to the high-velocity (n = 23) or low-velocity (n = 23) training group.



Both groups underwent an eight-week daily home-based resistance training programme using an elastic band. Exercises involved hip abduction, extension, and flexion and knee extension. Participants in the high-velocity group performed the concentric phase of each repetition as rapidly as possible and returned to the initial position eccentrically in 3 s. Participants in the low-velocity group performed both the concentric and eccentric phases in 3 s.



The following outcome measures were evaluated: isometric muscle strength, muscle power, muscle thickness, muscle echo intensity, maximum walking speed, Timed Up and Go test, 3-minute walking test, Harris Hip Score, and hip pain.



Decreases in the time for performing the Timed Up and Go test (mean changes: high-velocity group -0.46 s, low-velocity group -0.23 s) and echo intensity of the gluteus maximus (mean changes: high-velocity group -6.8, low-velocity group -1.0) were significantly greater in the high-velocity group than in the low-velocity group. No significant difference was observed in changes of other outcome measures between the groups.



This study revealed that high-velocity training for patients with hip osteoarthritis has partially a greater effect on muscle properties and physical performance than low-velocity training.
Performance of EuroSCORE II in Hungary: a single-centre validation study.

The efficacy of the updated cardiac surgical risk stratification system, EuroSCORE II, needs widespread assessment in the cardiac surgical centres where it is intended to be used. The present paper is a single-centre validation study carried out in Hungary.



An adult cardiac surgical cohort of 2287 patients was investigated. The general levels of performance of the logistic EuroSCORE and that of EuroSCORE II were compared using the Hosmer-Lemeshow test, ROC analysis and calculation of the Brier score. The calibrations were visualised by smoothed curves derived with the help of local polynomial regression. The efficacy of EuroSCORE II was analysed in different operation types and urgency subgroups.



The old EuroSCORE over-estimated the risk (O:E ratio: 0.66, HL test, p < 0.01), while EuroSCORE II slightly under-predicted mortality (O:E ratio:1.19, HL test, p = 0.0084). Comparing the ROC AUCs, we did not find a significant difference between the accuracy of the old and new versions of EuroSCORE (0.8017, 95% CI: 0.7596-0.8438 vs. 0.8177 95% CI: 0.7786-0.8569). EuroSCORE II performed well among CABG patients (O:E ratio: 0.75, HL test, p = 0.5789) and in those who underwent elective surgery (O:E ratio: 1.1, HL test, p = 0.1396), but failed in the emergency (O:E ratio: 1.71, HL test, p = 0.0055) and salvage (O:E ratio:1.36, HL test, p = 0.0245) categories.



EuroSCORE II proved to be more suitable for cardiac surgical risk prediction compared with its previous version, but its reliability can be questioned among patients who need emergency and salvage surgery, as well as in the case of combined operations.
Early hepatitis C viral kinetics correlate with long-term outcome in patients receiving high dose induction followed by combination interferon and ribavirin therapy.

The majority of patients with genotype 1 do not respond to interferon (IFN) plus ribavirin. Limited data exist on the use of induction followed by combination therapy.



In this prospective study of 28 patients infected with genotype 1, randomization involved either daily or twice daily high dose IFN for 6 weeks, followed by standard therapy of 3 million units three times a week in combination with ribavirin for an additional 42 weeks. Hepatitis C virus (HCV) RNA was quantitated before and frequently during treatment.



The best correlate of response was delta (the infected cell loss rate). Sixteen patients continued on the study because they had at least a 2 log drop in their HCV RNA levels by week 12; all but one were PCR negative for HCV RNA at 48 weeks, and 14 of these 16 patients continued to be PCR negative at 72 weeks. Both African-Americans in our trial failed to respond to therapy, and differences were evident during the induction phase.



This randomized study of induction IFN therapy followed by combination IFN plus ribavirin yielded the highest rate of sustained response (50%) reported to date in chronically HCV-infected patients with genotype 1. The predictive value of the infected cell loss rate needs to be evaluated prospectively in larger studies, particularly in patients receiving pegylated IFN.
Isolating the benefits of fluid restriction in patients with heart failure: A pilot study.

Fluid restriction (FR) in persons with heart failure (HF) is often prescribed, yet self-regulation and the troublesome symptom of thirst are difficult for patients to manage.



The purpose of this pilot study was to test an educational and behavioral intervention (EBI) on adherence with prescribed FR and outcome measures of fluid congestion, symptom distress, and health related quality of life (HRQL). Secondary aims were to describe the relationships between self-reported and objectively measured determinants of fluid status and symptoms, and assess the psychometric properties of piloted instruments, and intervention effect sizes.



NYHA Class II-IV (n=25, 44-83 years, 56% male, 20% minority, mean EF 23.0+11.7%) participants were randomized to the EBI or attention control (AC) and evaluated at baseline, 3 and 6 months.



EBI patients trended toward decreasing fluid ingestion (p=0.08), experienced less HF symptom frequency (p=0.13) and severity (p=0.06), and increased symptoms of thirst (p<0.01) across time. Whereas HRQL remained stable in the EBI group, it improved in the AC group over time (p=0.01). There were no significant differences in clinical measures of fluid congestion between groups.



These outcomes suggest that patients receiving the EBI drank slightly less fluid, experienced less typical HF symptoms, greater thirst distress and stable HRQOL. Moderate to large effect sizes for the measures used were observed, and outcomes suggest that a randomized trial of various levels of FR would not potentiate fluid congestion but should specifically address preservation of HRQOL and thirst symptoms.
Coated mesalazine ( 5-aminosalicylic acid ) versus sulphasalazine in the treatment of active ulcerative colitis : a randomised trial

B infection interferon probably exerts its beneficial effect through the immune system, in chronic non-A non-B infection the interferon acts directly on the virus infected hepatocytes. These initial results are encouraging, and longer term study of these patients is being undertaken to see whether the histological picture of the liver improves in parallel to biochemical values and also whether the improvement persists after interferon has been discontinued. Preliminary studies suggest that, certainly in some patients, one year of continuous treatment may be successful in bringing about a permanent biochemical and histological remission.' Even if relapse does occur on stopping treatment, continuous low dose interferon, which is accompanied by comparatively minor side effects, may be an acceptable inconvenience in view of the high risk of cirrhosis that untreated patients run.term follow up of acute and chronic non-A non-B hepatitis: evidence of progression to liver cirrhosis. A non-B hepatitis with acyclovir: a pilot study. Treatment of chronic non-A non-B hepatitis with recombinant human alpha-interferon. Alpha-interferon therapy for non-A non-B hepatitis transmitted by gammaglobulin replacement therapy. male homosexual chronic hepatitis B carriers with HTLV-III antibodies to recombinant alpha-interferon. hepato vte membrane during recovery from acute hepatitis B virus infection and during interferon therapy in chronic hepatitis B infection. delta hepatitis with recombinant human alpha-interferon [Abstract]. Coated mesalazine (5-aminosalicylic acid) versus sulphasalazine in the treatment of active ulcerative colitis: a randomised trial D Rachmilewitz on behalf of an international study group professor ofmedicine and head ofdepartment The investigators making up the international study group are listed at the end of this paper. To assess the safety and efficacy of a preparation of mesalazine (5-aminosalicylic acid) coated with a pH dependent resin (Eudragit L) as compared with sulphasalazine in patients with active mild to moderate ulcerative colitis. Eight week randomised double blind parallel group study. Forty six gastroenterology outpatient clinics in seven countries. Two hundred and twenty patients aged 18-70 who met the following criteria: clinical activity index-6 and endoscopic index-4; no concomitant treatment for ulcerative colitis; no hypersensitivity to salicylates or sulphonamides. Of the 164 patients eligible for efficacy analysis, 87 received the coated preparation of mesalazine and 77 sulphasalazine. Most of the remaining patients (28 in each group) were ineligible for the efficacy analysis because of treatment with steroid enemas. All pretrial characteristics were comparable in the two treatment groups. Coated mesalazine (Mesasal) 1-5 g daily or sulphasalazine 3 0 g daily …