nils-herrmann/clean_scirepeval huggingface dataset:
Emerging risk factors and the dose–response relationship between physical activity and lone atrial fibrillation: a prospective case–control study

The role of high-intensity exercise and other emerging risk factors in lone atrial fibrillation (Ln-AF) epidemiology is still under debate. The aim of this study was to analyse the contribution of each of the emerging risk factors and the impact of physical activity dose in patients with Ln-AF.



Patients with Ln-AF and age- and sex-matched healthy controls were included in a 2:1 prospective case-control study. We obtained clinical and anthropometric data transthoracic echocardiography, lifetime physical activity questionnaire, 24-h ambulatory blood pressure monitoring, Berlin questionnaire score, and, in patients at high risk for obstructive sleep apnoea (OSA) syndrome, a polysomnography. A total of 115 cases and 57 controls were enrolled. Conditional logistic regression analysis associated height [odds ratio (OR) 1.06 [1.01-1.11]], waist circumference (OR 1.06 [1.02-1.11]), OSA (OR 5.04 [1.44-17.45]), and 2000 or more hours of cumulative high-intensity endurance training to a higher AF risk. Our data indicated a U-shaped association between the extent of high-intensity training and AF risk. The risk of AF increased with an accumulated lifetime endurance sport activity ≥ 2,000 h compared with sedentary individuals (OR 3.88 [1.55-9.73]). Nevertheless, a history of <2000 h of high-intensity training protected against AF when compared with sedentary individuals (OR 0.38 [0.12-0.98]).



A history of ≥ 2,000 h of vigorous endurance training, tall stature, abdominal obesity, and OSA are frequently encountered as risk factors in patients with Ln-AF. Fewer than 2000 total hours of high-intensity endurance training associates with reduced Ln-AF risk.
Further studies on a male monozygotic triplet with schizophrenia: cytogenetical and neurobiological assessments in the patients and their parents

We previously described a Swedish set of male schizophrenic monozygotic triplets. In this study the patients as well as their parents were further characterized. By high-resolution chromosomal analysis an extra band at chromosome 15p was found in all the triplets and the father. Microdissection, degenerate oligonucleotide-primed PCR (DOP-PCR) amplification and reverse painting indicates that the extra band probably contains only repetitive DNA sequences with no known effect on the phenotype. Magnetic resonance imaging (MRI) showed similar borderline ventricular enlargement and widened subarachnoid spaces over frontoparietal and basal regions as well as around the pituitary gland (empty sella) in all the triplets. The father also had widened subarachnoid spaces over the frontal and basal regions. The mother had an empty sella indicating widened subarachnoid spaces. All the boys also had a right-sided conductive hearing defect, probably due to malformation and fixation of the ossicular chain. The parents did not present any otological abnormalities. Neuropsychological assessment demonstrated similar marked reductions of attentional, mnestic, and executive functions in all the triplets, but the mother showed a normal pattern. Possible joint etiological mechanisms for the psychological and somatic abnormalities recorded in the triplets are discussed.
A German multicenter, randomized phase III trial comparing irinotecan-carboplatin with etoposide-carboplatin as first-line therapy for extensive-disease small-cell lung cancer.

This trial was designed to prove superiority of irinotecan over etoposide combined with carboplatin in extensive-disease small-cell lung cancer.



Patients were randomly assigned to receive carboplatin area under the curve 5 mg x min/ml either in combination with irinotecan 50 mg/m2 on days 1, 8, and 15 (IP) or etoposide 140 mg/m2 on days 1-3 (EP). Primary end point was progression-free survival (PFS) at 6 months. Secondary end points were overall survival (OS), response rate, and toxicity.



Of 226 patients, 216 were eligible. Median PFS was 6.0 months [95% confidence interval (CI) 5.0-7.0] in the IP arm and 6.0 months (95% CI 5.2-6.8) in EP arm (P = 0.07). Median survival was 10.0 months (95% CI 8.4-11.6) and 9.0 months (95% CI 7.6-10.4) in the IP and EP arm (P = 0.06), respectively. Hazard ratios for disease progression and OS were 1.29 (95% CI 0.96-1.73, P = 0.095) and 1.34 (95% CI 0.97-1.85, P = 0.072), respectively. No difference in response rates was observed. Grade 3 and 4 hematologic toxicity favored the IP arm, whereas diarrhea was significantly more frequent in the IP arm.



This trial failed to show superiority of irinotecan over etoposide in combination with carboplatin.
The impact of ruxolitinib treatment on inflammation-mediated comorbidities in myelofibrosis and related neoplasms

The inflammation-mediated comorbidities in myelofibrosis (MF) and related neoplasms (MPNs) likely reflect the concurrent immune deregulation and systemic inflammatory nature of the MPNs, emphasizing the link between chronic systemic inflammation, immune deregulation, and the malignant clone. JAK1-2 inhibitors in MF-patients reduce constitutional symptoms and splenomegaly, but also taget autoimmune and inflammation-mediated comorbidities.
Multicenter study of clinical features of sudden-onset versus slower-onset asthma exacerbations requiring hospitalization.

Asthma exacerbations differ in their speed of symptom onset.



To characterize and compare demographic factors, clinical risk factors, and clinical outcomes among hospitalized patients who presented with sudden-onset (<or= 3 h) versus slower-onset asthma exacerbations, across a wide age range.



We reviewed the medical records of a random sample of 1,294 patients, ages 2-54 years, admitted in 30 United States hospitals, for acute asthma from January 1999 to May 2000.



Data on duration of symptoms were available for 1,260 (97%) of the patients. Seventy-two patients (6%) had sudden-onset exacerbations. Sudden-onset patients were older than slower-onset patients (30 y vs 19 y, p = 0.03) but did not differ by other sociodemographic characteristics. Markers of chronic asthma severity were similar between the groups. The sudden-onset patients were more likely to present to the emergency department between midnight and 8:00 am, to require intubation, and to be admitted to the intensive care unit (all p < 0.01). The higher risk of intensive care unit admission remained significant even after adjustment for 6 potential confounders (odds ratio 2.5, 95% confidence interval 1.3-4.9). However, hospital stay was shorter in the sudden-onset patients (2.0 d vs 2.7 d, p = 0.01). There was no difference in peak expiratory flow at hospital discharge.



The sudden-onset patients were older and they more commonly presented to the emergency department between midnight and 8:00 am with severe exacerbations that required intubation and intensive care unit admission. However, the sudden-onset group was discharged from the hospital earlier.
Rapid virological response and treatment duration for chronic hepatitis C genotype 1 patients: a randomized trial.

Recommended treatment for hepatitis C virus genotype 1 (HCV-1) patients is peginterferon plus ribavirin for 48 weeks. We assessed whether treatment duration of 24 weeks is as effective as standard treatment in HCV-1 patients with a rapid virological response (RVR; seronegative for hepatitis C virus [HCV] RNA at 4 weeks). Two hundred HCV-1 patients were randomized (1:1) to either 24 or 48 weeks of peginterferon-alpha-2a (180 microg/week) and ribavirin (1000-1200 mg/day) with a 24-week follow-up. The primary endpoint was a sustained virological response (SVR; seronegative for HCV RNA at 24-week follow-up). Overall, the 48-week arm had a significantly higher SVR rate (79%) than the 24-week arm (59%, P = 0.002). For 87 (43.5%) patients with an RVR, the 24-week arm had a lower SVR rate [88.9%; 95% confidence interval (CI): 80%-98%] than the 48-week arm (100%, P = 0.056). For 52 patients with low baseline viremia (<400,000 IU/mL) and an RVR, the 24-week arm had rates (CI) of relapse and SVR of 3.6% (-3%-11%) and 96.4% (89%-103%), respectively, which were comparable to those of the 48-week arm (0% and 100%) with difference (CI) of 3.6% (-7.2%-6.6%) and -3.6% (-14.3% to -0.6%), respectively. Multivariate analysis in all patients showed that RVR was the strongest independent factor associated with an SVR, followed by treatment duration, mean weight-based exposure of ribavirin, and baseline viral load.



HCV-1 patients derive a significantly better SVR from 48 weeks versus 24 weeks of peginterferon/ribavirin even if they attain an RVR. Both 24 and 48 weeks of therapy can achieve high SVR rates (>96%) in HCV-1 patients with low viral loads and an RVR.
Effects of ionized waterfall aerosol on pediatric allergic asthma.

Ionized water aerosols have been suggested to exert beneficial health effects on pediatric allergic asthma. Their effect was evaluated in a randomized controlled clinical trial as part of a summer asthma camp.



Asthmatic allergic children (n = 54) spent 3 weeks in an alpine asthma camp; half of the group was exposed to water aerosol of an alpine waterfall for 1 hour per day, whereas the other half spent the same time at a "control site". Immunological analysis, lung function testing, and fractional exhaled nitric oxide (FeNO) testing were performed during the stay, and sustaining effects were evaluated 2 months later. Symptom score testing was done over a period of 140 days.



The water aerosol group showed a significant improvement in all lung function parameters, whereas only the peak expiratory flow improved in the control group. All patients showed a significant improvement in symptom score and a significant decrease in FeNO after the camp. Only the water aerosol group exhibited a long-lasting effect on asthma symptoms, lung function, and inflammation in the follow-up examination. Induction of interleukin (IL)-10 and regulatory T (Treg) cells was measured in both groups, with a pronounced increase in the water aerosol group. IL-13 was significantly decreased in both groups, whereas IL-5 and eosinophil cationic protein were decreased only in the water aerosol group.



Our findings confirm the induction of Treg cells and reduction in inflammation by climate therapy. They indicate a synergistic effect of water aerosols resulting in a long-lasting beneficial effect on asthma symptoms, lung function, and airway inflammation.
Myocardial sympathetic innervation in patients with symptomatic coronary artery disease: follow-up after 1 year with neurostimulation.

In both diabetic and nondiabetic patients, there is a loose correlation between coronary flow reserve (CFR) and sympathetic innervation in viable myocardial segments. The loose correlation implies that sympathetic innervation may be preserved even with major impairment of myocardial blood supply. In some patients, denervation is due to repetitive episodes of ischemia in areas with severely reduced CFR. We investigated the long-term effect of reduced CFR on myocardial sympathetic innervation in diabetic and nondiabetic patients with spinal cord stimulation.



We analyzed 23 patients (10 diabetic and 13 nondiabetic) with coronary artery disease and without known cardiac autonomic neuropathy. At baseline, we determined quantitative myocardial blood flow using (13)N-ammonia PET, myocardial viability using (18)F-FDG PET, and cardiac innervation using (11)C-hydroxyephedrine (HED) PET. At the 1-y follow-up we measured CFR and (11)C-HED retention. During follow-up, no cardiac intervention was performed and no myocardial infarction occurred. In all patients, spinal cord stimulation was performed for relief of angina.



There was no significant difference in segmental (11)C-HED retention between baseline and follow-up in the whole patient group. In diabetic patients, as well as in segments with severely reduced CFR (<1.5), (11)C-HED retention showed a small but significant decrease (P<0.05). Linear regression of segmental (11)C-HED retention between baseline and follow-up was high (r(2)=0.81), confirming good reproducibility of the investigation on the one hand and little change in regional sympathetic innervation on the other hand.



In patients with stable chronic coronary artery disease, sympathetic innervation of the myocardium is almost unchanged in both diabetic and nondiabetic patients in a 1-y follow-up. In myocardial segments with severely altered blood supply, a small but significant decrease in (11)C-HED retention most probably reflects ischemic neuronal damage. The prognostic relevance of sympathetic denervation in viable myocardium still has to be determined.
Adherence to cancer prevention guidelines and cancer incidence, cancer mortality, and total mortality: a prospective cohort study.

Several health agencies have issued guidelines promoting behaviors to reduce chronic disease risk; however, little is known about the impact of such guidelines, particularly on cancer incidence.



The objective was to determine whether greater adherence to the American Cancer Society (ACS) cancer prevention guidelines is associated with a reduction in cancer incidence, cancer mortality, and total mortality.



The NIH-AARP Diet and Health Study, a prospective cohort study of 566,401 adults aged 50-71 y at recruitment in 1995-1996, was followed for a median of 10.5 y for cancer incidence, 12.6 y for cancer mortality, and 13.6 y for total mortality. Participants who reported a history of cancer or who had missing data were excluded, yielding 476,396 subjects for analysis. We constructed a 5-level score measuring adherence to ACS guidelines, which included baseline body mass index, physical activity, alcohol intake, and several aspects of diet. Cox proportional hazards models were used to compute HRs and 95% CIs for the association of the adherence score with cancer incidence, cancer mortality, and total mortality. All analyses included fine adjustment for cigarette smoking.



Among 476,396 participants, 73,784 incident first cancers, 16,193 cancer deaths, and 81,433 deaths from all causes were identified in the cohort. Adherence to ACS guidelines was associated with reduced risk of all cancers combined: HRs (95% CIs) for the highest compared with the lowest level of adherence were 0.90 (0.87, 0.93) in men and 0.81 (0.77, 0.84) in women. Fourteen of 25 specific cancer sites showed a reduction in risk associated with increased adherence. Adherence was also associated with reduced cancer mortality [HRs (95% CIs) were 0.75 (0.70, 0.80) in men and 0.76 (0.70, 0.83) in women] and reduced all-cause mortality [HRs (95% CIs) were 0.74 (0.72, 0.76) in men and 0.67 (0.65, 0.70) in women].



In both men and women, adherence to the ACS guidelines was associated with reductions in all-cancer incidence and the incidence of cancer at specific sites, as well as with reductions in cancer mortality and total mortality. These data suggest that, after accounting for cigarette smoking, adherence to a set of healthy behaviors may have considerable health benefits.
Validity of clinical measures of frontal plane knee alignment: data from the Osteoarthritis Initiative.

Clinicians frequently assess frontal plane knee alignment of patients suspected of having knee osteoarthritis. However, there is little data to indicate whether simple to obtain clinical measures frontal plane alignment indicate the actual bony alignment of the knee or the extent and type of knee osteoarthritis. The purpose of this study was to assess the validity of goniometric measures of frontal plan knee position as a simple clinical tool to assess lower limb alignment and tibiofemoral OA status. Data from the Osteoarthritis Initiative were used to assess concurrent and diagnostic validity of goniometric measures. Data from 142 persons with symptomatic knee OA were used to examine concurrent validity, based on comparison to whole limb radiographs. Diagnostic validity was examined using data from 1390 persons with symptomatic knee OA, based on comparison to tibiofemoral joint space narrowing obtained from standardized radiographs. Associations between goniometric measures and whole limb radiographs were moderate (r = 0.43 for right knee and r = 0.46 for left knee). Goniometric measurements explained approximately 20% of the variation in lower limb alignment as measured by whole limb radiography suggesting that simple clinical measures of lower limb alignment contain too much error for inferring actual lower limb alignment. Diagnostic validity indicated positive likelihood ratios of 3.3 or less for detecting isolated severe medial or lateral joint space narrowing and a high rate of misclassification. Simple clinical assessments of frontal plane lower limb alignment or tibiofemoral OA status, in isolation, contain substantial error and likely do not inform clinical practice.
Randomized trial of MST and ARC in a two-level evidence-based treatment implementation strategy.

A randomized trial assessed the effectiveness of a 2-level strategy for implementing evidence-based mental health treatments for delinquent youth.



A 2 x 2 design encompassing 14 rural Appalachian counties included 2 factors: (a) the random assignment of delinquent youth within each county to a multisystemic therapy (MST) program or usual services and (b) the random assignment of counties to the ARC (for availability, responsiveness, and continuity) organizational intervention for implementing effective community-based mental health services. The design created 4 treatment conditions (MST plus ARC, MST only, ARC only, control). Outcome measures for 615 youth who were 69% male, 91% Caucasian, and aged 9-17 years included the Child Behavior Checklist and out-of-home placements.



A multilevel, mixed-effects, regression analysis of 6-month treatment outcomes found that youth total problem behavior in the MST plus ARC condition was at a nonclinical level and significantly lower than in other conditions. Total problem behavior was equivalent and at nonclinical levels in all conditions by the 18-month follow-up, but youth in the MST plus ARC condition entered out-of-home placements at a significantly lower rate (16%) than youth in the control condition (34%).



Two-level strategies that combine an organizational intervention such as ARC and an evidence-based treatment such as MST are promising approaches to implementing effective community-based mental health services. More research is needed to understand how such strategies can be used effectively in a variety of organizational contexts and with other types of evidence-based treatments.
Diffusion Tensor Imaging to Predict Long-term Outcome after Cardiac Arrest

Prognostication in comatose survivors of cardiac arrest is a major clinical challenge. The authors’ objective was to determine whether an assessment with diffusion tensor imaging, a brain magnetic resonance imaging sequence, increases the accuracy of 1 yr functional outcome prediction in cardiac arrest survivors.  Prospective, observational study in two intensive care units. Fifty-seven comatose survivors of cardiac arrest
DreamScope: Evaluating Interactive 360° Virtual Reality in a Physical Narrative Art Installation

The widespread affordability of digital technologies is encouraging artists to experiment and make use of them in their artworks. This paper describes the design and in-the-wild evaluation of DreamScope, a bespoke 360° mobile virtual reality (VR) interface designed for immersive interaction in the Lucid Peninsula physical narrative art installation. We evaluated the VR interface by means of a questionnaire based on the Positive and Negative Affect Scale (PANAS) and individual items related with the interaction within the exhibition. Results extracted from 53 subjects highlight how the interface supported engagement, positive affect and reflections on the narrated scenario of the art installation. The study reported in this paper provides evidence of the positive role of 360° mobile VR in strengthening the narrative and the artist's intent in the Lucid Peninsula artistic installation.
Comparison of short- and long-term dynamic group psychotherapy: randomised clinical trial.

There are no randomised clinical trials comparing the outcomes of short- with long-term psychodynamic group psychotherapy.



To compare differences in outcome during and after short- and long-term group psychotherapy.



In total, 167 out-patients with mood, anxiety and personality disorders were randomised to short- or long-term group therapy (20 or 80 weekly, 90 min sessions). Outcome measures were: symptoms (Symptom Checklist 90 - Revised), interpersonal problems (Inventory of Interpersonal Problems - Circumplex) and psychosocial functioning (Global Assessment of Functioning (GAF) split version: GAF-Symptom and GAF-Function). Change over the 3-year study period was assessed using linear mixed models. The study was registered in clinicalTrials.gov as NCT00521417.



Patients in both groups made significant gains. A significantly larger symptomatic change over time was found for long-term compared with short-term therapy, but no significant differences were detected for the three remaining outcome variables. There was a higher number of premature terminations in the long-term (33.3%) compared with the short-term group (8.6%).



Short- and long-term therapy seem equally effective for typical out-patients seeking group psychotherapy, except for symptomatic distress.
Aortic annulus sizing: echocardiographic versus computed tomography derived measurements in comparison with direct surgical sizing.

The precise sizing of the aortic annulus is crucial in order to select the most appropriate valve size for transcatheter aortic valve implantation (TAVI). Owing to the closed heart situation in TAVI, sizing has to be performed based on preoperative imaging when compared with direct sizing during conventional procedures. The aim of the study was to evaluate valve sizing performed either by CT-scan or by echocardiography by comparing these imaging-based measurements with direct intraoperative sizing.



Prior to the standard conventional aortic valve replacement, 26 patients underwent cardiac CT-scan and echocardiographic examination. Maximal annular diameter was measured by echocardiography at end-diastole and end-systole, including the leaflet calcifications. The CT-scan maximal, minimal and mean diameters were measured as well as the 'effective' diameter (CT(eff)). CT(eff) represents the diameter of a circle with the exact same area as the measured area of the annular circumference reconstructed from the CT-data set. Direct intraoperative diameters were measured after decalcification using metric sizers.



CT(eff) and end-systolic echocardiographic diameters showed best agreement with intraoperative direct sizing (intraop) in the Bland-Altman analysis [mean difference for transoesophageal echocardiography (TEE) vs intraop 0.5 mm (limits of agreement -2.5-3.5); mean difference for transthoracic echocardiography (TTE) vs intraop 0.38 mm (limits of agreement -3.28-4.03) and CT(eff) vs intraop -0.56 (limits of agreement -3.16-2.05)]. In patients with an oval-shaped annulus, CT(eff) demonstrated the best agreement with intraop [mean difference -0.32 (limits of agreement -2.29 to 1.66)].



Both the 'effective' CT diameter and end-systolic TEE values are the most reliable approaches for preoperative aortic annulus sizing. In patients with a pronounced oval-shaped annulus, the 'effective' CT diameter seems to be the method of choice. Therefore, aortic annulus measurement using 'effective' CT diameters should be included into current recommendations for TAVI sizing.