nils-herrmann/clean_scirepeval huggingface dataset:
Wherefrom and whereabouts of an alien: the American liver fluke Fascioloides magna in Austria: an overview

We performed a single center analysis of 60 adult patients (33 males and 27 females) with myelodysplastic syndromes (MDS) or secondary acute myeloid leukemia (AML) who underwent allogeneic hematopoietic stem cell transplantation (HCT) at our institution. Allogeneic stem cell in patients were transplanted between 1988 and 2010, 28 had an human leukocyte antigen (HLA)-identical sibling donor, 23 had an HLA-identical unrelated donor, and 9 had an 1 allele mismatched donor. The median age at time of HCT was 44 (range: 18–68) years. Conditioning therapy was myeloablative in 36 patients and consisted of a reduced-intensity conditioning (RIC) regimen in 24 patients. Graft-versus-host disease (GvHD) prophylaxis was performed with a combination of methotrexate and cyclosporine A in 36 patients, and cyclosporine A plus mycophenolate mofetil in 24 patients. The 10-year probability of overall survival was 46 %. In a multivariate analysis, we identified pretransplantation serum ferritin as the only independent adverse prognostic variable predicting survival in our patients. In dieser Arbeit wurden das Überleben und potentiell prognostische Faktoren von Patienten mit Myelodysplastischem Syndrom (MDS) bzw. sekundärer akuter myeloischer Leukämie (sAML) nach allogener Stammzelltransplantation von 1988 bis 2010 an der Medizinischen Universität Wien untersucht. Es wurden insgesamt 60 Patienten ausgewertet. Das mediane Alter zum Zeitpunkt der Transplantation lag bei 44 Jahren. Die Vorbereitung zur Transplantation bestand bei 36 Patienten aus hochdosierter – „myeloablativer“ – Chemotherapie und Ganzkörperbestrahlung, 24 Patienten sind „nicht-myeloablativ“, also dosisreduziert, konditioniert worden. Das Gesamtüberleben nach 10 Jahren lag bei 46 %. In einem weiteren Schritt wurden diverse potentiell prognostische Risikofaktoren für das Überleben untersucht. Interessanterweise konnte als einziger Faktor, der signifikant mit dem Überleben korrelierte, in diesen Patienten das Serumferrtin, das vor der Transplantation bestimmt wurde, identifiziert werden. Zusammenfassend konnten wir zeigen, dass doch eine respektable Anzahl von jenen Hochrisiko-MDS/sek. AML-Patienten durch die Stammzelltransplantation ein Langzeit-krankheitsfreies Überleben erreichen kann. Um eine Risikostratifizierung bei der Patientenauswahl vornehmen zu können, bewerten wir die Transfusionsabhängigkeit und den Ferritinspiegel als wichtigen prognostischen Parameter.
Regular consumption of vitamin D-fortified yogurt drink (Doogh) improved endothelial biomarkers in subjects with type 2 diabetes: a randomized double-blind clinical trial

Endothelial dysfunction has been proposed as the underlying cause of diabetic angiopathy that eventually leads to cardiovascular disease, the major cause of death in diabetes. We recently demonstrated the ameliorating effect of regular vitamin D intake on the glycemic status of patients with type 2 diabetes (T2D). In this study, the effects of improvement of vitamin D status on glycemic status, lipid profile and endothelial biomarkers in T2D subjects were investigated.



Subjects with T2D were randomly allocated to one of the two groups to receive either plain yogurt drink (PYD; containing 170 mg calcium and no vitamin D/250 mL, n1 = 50) or vitamin D3-fortified yogurt drink (FYD; containing 170 mg calcium and 500 IU/250 mL, n2 = 50) twice a day for 12 weeks. Anthropometric measures, glycemic status, lipid profile, body fat mass (FM) and endothelial biomarkers including serum endothelin-1, E-selectin and matrix metalloproteinase (MMP)-9 were evaluated at the beginning and after the 12-week intervention period.



The intervention resulted in a significant improvement in fasting glucose, the Quantitative Insulin Check Index (QUICKI), glycated hemoglobin (HbA1c), triacylglycerols, high-density lipoprotein cholesterol (HDL-C), endothelin-1, E-selectin and MMP-9 in FYD compared to PYD (P < 0.05, for all). Interestingly, difference in changes of endothelin-1, E-selectin and MMP-9 concentrations in FYD compared to PYD (-0.35 ± 0.63 versus -0.03 ± 0.55, P = 0.028; -3.8 ± 7.3 versus 0.95 ± 8.3, P = 0.003 and -2.3 ± 3.7 versus 0.44 ± 7.1 ng/mL, respectively, P < 0.05 for all), even after controlling for changes of QUICKI, FM and waist circumference, remained significant for endothelin-1 and MMP-9 (P = 0.009 and P = 0.005, respectively) but disappeared for E-selectin (P = 0.092). On the contrary, after controlling for serum 25(OH)D, the differences disappeared for endothelin-1(P = 0.066) and MMP-9 (P = 0.277) but still remained significant for E-selectin (P = 0.011).



Ameliorated vitamin D status was accompanied by improved glycemic status, lipid profile and endothelial biomarkers in T2D subjects. Our findings suggest both direct and indirect ameliorating effects of vitamin D on the endothelial biomarkers.
Validity and reliability of the caregiver contribution to self-care of heart failure index.

Caregivers make an important contribution to the self-care of patients with heart failure (HF), but few instruments are available to measure this contribution.



The objective of this study was to test the psychometric properties of the Caregiver Contribution to Self-care of Heart Failure Index (CC-SCHFI), an instrument derived from the Self-care of Heart Failure Index version 6.2. The CC-SCHFI measures the contribution of caregivers to the self-care maintenance and self-care management of HF patients, as well as their confidence in their ability to contribute to the patients' HF self-care.



A cross-sectional design was used to study 291 Italian caregivers whose HF patients were cared for in 17 cardiovascular centers across Italy. Caregivers completed the CC-SCHFI and a sociodemographic questionnaire. Caregivers were retested on the CC-SCHFI 2 weeks later to assess test-retest reliability.



Most caregivers were women (66%) with a mean age of 59 years. First- and second-order confirmatory factor analysis (CFA) for each CC-SCHFI scale showed good model fit: χ2 = 37.22, P = .08, Comparative Fit Index (CFI) = 0.97, Non-Normed Fit Index (NNFI) = 0.96 for caregiver contribution to self-care maintenance (second-order CFA); χ2 = 14.05, P = .12, CFI = 0.96, NNFI = 0.93 for caregiver contribution to self-care management (first-order CFA); and χ2 = 10.63, P = .15, CFI = 0.99, NNFI = 0.98 for caregiver confidence in contributing to self-care (second-order CFA). The CC-SCHFI was able to discriminate statistical and clinical differences between 2 groups of caregivers who had received or not received HF self-care education. Internal consistency reliability measured by factor score determinacy was more than .80 for all factors and scales except for 1 factor in the caregiver contribution to self-care management scale (.65). Test-retest reliability computed by intraclass correlation coefficient was high (>0.90) for most factors and scales.



The CC-SCHFI showed good psychometric properties of validity and reliability and can be used to measure the contribution of caregiver to HF patient self-care.
Hypoxia, not the frequency of sleep apnea, induces acute hemodynamic stress in patients with chronic heart failure.

This study was conducted to evaluate whether brain (B-type) natriuretic peptide (BNP) changes during sleep are associated with the frequency and severity of apneic/hypopneic episodes, intermittent arousals, and hypoxia.



Sleep apnea is strongly associated with heart failure (HF) and could conceivably worsen HF through increased sympathetic activity, hemodynamic stress, hypoxemia, and oxidative stress. If apneic activity does cause acute stress in HF, it should increase BNP.



Sixty-four HF patients with New York Heart Association functional class II and III HF and ejection fraction <40% underwent a baseline sleep study. Five patients with no sleep apnea and 12 with severe sleep apnea underwent repeat sleep studies, during which blood was collected every 20 min for the measurement of BNP. Patients with severe sleep apnea also underwent a third sleep study with frequent BNP measurements while they were administered oxygen. This provided 643 observations with which to relate apnea to BNP. The association of log BNP with each of 6 markers of apnea severity was evaluated with repeated measures regression models.



There was no relationship between BNP and the number of apneic/hypopneic episodes or the number of arousals. However, the burden of hypoxemia (the time spent with oxygen saturation <90%) significantly predicted BNP concentrations; each 10% increase in duration of hypoxemia increased BNP by 9.6% (95% confidence interval: 1.5% to 17.7%, p = 0.02).



Hypoxemia appears to be an important factor that underlies the impact of sleep abnormalities on hemodynamic stress in patients with HF. Prevention of hypoxia might be especially important for these patients.
Using collaborative learning to improve diabetes care and outcomes: the VIDA project.

The prevalence of diabetes in Mexico among those 20-64 years of age has increased from 7.2% in 1993 to 10.7% in 2000. National population-based surveys in Mexico demonstrated that 50% of the total population with diabetes had blood glucose levels of 200mg/dl or higher. Thus, diabetes care has become one of the most important public health challenges in this country. The aim of the study was to improve the quality of diabetes care in primary health care centers using the chronic care model and the breakthrough series (BTS) collaborative methodology.



Ten public health centers in the cities of Xalapa and Veracruz were randomly selected to participate in the project. Five of the health centers were randomly assigned to receive the intervention (intervention group) and the other five followed usual care (usual care group). The intervention was evaluated by A1c test before and after the intervention in both groups of patients. Patients were followed for 18 months from November 2002 to May 2004. Results were adjusted for the clustering of patients within practices and baseline measure.



The proportion of people with good glycemic control (A1c<7%) among those in the intervention group increased from 28% before the intervention to 39% after the intervention. The proportion of patients achieving three or more quality improvement goals increased from 16.6% to 69.7% (p<0.001) among the intervention group while the usual care group experienced a non-significant decrease from 12.4% to 5.9% (p=0.118). The focus on the primary care team and the participation of people with diabetes were strategic elements incorporated into the methodology, expected to ensure sustainability of continued improvement of health outcomes.



The intervention introduced modifications to solve problems identified by health teams in their practice and improved process and outcome measures of quality diabetes care. Most of the actions were directed at four components of the chronic care model: self-management support, decision support, delivery system design, and clinical information systems.
Feasibility study of an optimised person-centred intervention to improve mental health and reduce antipsychotics amongst people with dementia in care homes: study protocol for a randomised controlled trial

People living in care homes often have complex mental and physical health problems, disabilities and social needs which are compounded by the use of psychiatric and other drugs. In the UK dementia care is a national priority with a vast impact on services. WHELD combines the most effective elements of existing approaches to develop a comprehensive but practical intervention. This will be achieved by training care staff to provide care that is focused on an understanding of the individual and their needs; and by using additional components such as exercise, activities and social interaction to improve mental health and quality of life (QoL) and reduce the use of sedative drugs.



Work Package 3 (WP3) is the pilot randomised trial and qualitative evaluation to help develop a future definitive randomised controlled clinical trial. The study design is a cluster randomised 2x2x2 factorial design with two replications in 16 care homes. Each care home is randomized to receive one of the eight possible permutations of the four key interventions, with each possible combination delivered in two of the 16 homes. Each cluster includes a minimum of 12 participants (depending upon size of the care home, the number of people with dementia and the number consenting).



The overarching goal of the programme is to provide an effective, simple and practical intervention which improves the mental health of, and reduces sedative drug use in, people with dementia in care homes and which can be implemented nationally in all UK care homes as an NHS intervention.
Metabolic determinants of the course of coronary artery disease in men.

We examined associations between metabolic variables and changes in coronary artery disease (CAD) in the St. Thomas' Atherosclerosis Regression Study (STARS). The course of CAD over 3 years was measured continually by quantitative coronary angiography, i.e., as the per patient change in the mean absolute width of coronary segments (delta MAWS). The decrease in MAWS (progression of CAD) was significantly correlated with in-trial plasma concentrations of cholesterol (P = 0.002), low-density lipoprotein (LDL) cholesterol (P = 0.001), apolipoprotein B (apoB) (P = 0.008), and lipoprotein(a) [Lp(a)] (P = 0.004); no significant associations were found with high-density lipoprotein (HDL) cholesterol, apoA-I, vitamin E, thyroid hormones, fibrinogen, von Willebrand factor, or post-load plasma glucose and insulin concentrations. By multiple regression analysis, LDL cholesterol was the best predictor of delta MAWS, the adjusted model explaining 22% of the variance (P = 0.04). Thus, in men with symptomatic CAD the most important metabolic predictor of change in CAD is plasma LDL cholesterol, there being no advantage in measuring other variables, in particular, apoB or Lp(a).
Specific antinuclear antibodies are associated with clinical features in systemic lupus erythematosus.

To study associations between antinuclear antibodies (ANA) and signs/symptoms in patients with systemic lupus erythematosus (SLE).



A consecutive cohort of 289 patients with SLE was included; 235 fulfilled ACR criteria for SLE and were further analysed. ANA profiles were determined by line immunoassay and by indirect immunofluorescence on Crithidia luciliae. An extensive list of signs/symptoms was evaluated.



Five clusters of antibodies were defined by cluster analysis: 1-antibodies to SmB, SmD, RNP-A, RNP-C, and RNP-70k; 2-antibodies to Ro52, Ro60, and SSB; 3, 4, and 5-antibodies to ribosomal P, histones and dsDNA, respectively. Significant associations (p< or =0.01) were found between anti-RNP-70k, anti-RNP-A, anti-RNP-C and Raynaud's phenomenon, between anti-RNP-A, anti-RNP-70k and leucopenia, and between anti-RNP-A, anti-RNP-C and a lower prevalence of urine cellular casts. Anti-SSA, anti-SSB were associated with xerostomia, and anti-SSB with pericarditis. Antibodies to ribosomal P were associated with haemolytic anaemia, leucopenia, and alopecia. Patients with anti-dsDNA antibodies had a higher risk for cellular casts and a lower risk for photosensitivity. Antihistone antibodies were associated with arthritis.



In a large and consecutive cohort of patients with SLE, clusters of antibodies were identified. Previously reported associations of antibodies with symptoms were confirmed and new associations found.
Impact of a high loading dose of atorvastatin on contrast-induced acute kidney injury.

The role of statins in the prevention of contrast-induced acute kidney injury (CIAKI) is controversial.



First, we investigated the in vivo effects of atorvastatin on CIAKI. Patients with chronic kidney disease enrolled in the Novel Approaches for Preventing or Limiting Events (NAPLES) II trial were randomly assigned to (1) the atorvastatin group (80 mg within 24 hours before contrast media [CM] exposure; n=202) or (2) the control group (n=208). All patients received a high dose of N-acetylcysteine and sodium bicarbonate solution. Second, we investigated the in vitro effects of atorvastatin pretreatment on CM-mediated modifications of intracellular pathways leading to apoptosis or survival in renal tubular cells. CIAKI (ie, an increase >10% of serum cystatin C concentration within 24 hours after CM exposure) occurred in 9 of 202 patients in the atorvastatin group (4.5%) and in 37 of 208 patients in the control group (17.8%) (P=0.005; odds ratio=0.22; 95% confidence interval, 0.07-0.69). CIAKI rate was lower in the atorvastatin group in both diabetics and nondiabetics and in patients with moderate chronic kidney disease (estimated glomerular filtration rate, 31-60 mL/min per 1.73 m(2)). In the in vitro model, pretreatment with atorvastatin (1) prevented CM-induced renal cell apoptosis by reducing stress kinases activation and (2) restored the survival signals (mediated by Akt and ERK pathways).



A single high loading dose of atorvastatin administered within 24 hours before CM exposure is effective in reducing the rate of CIAKI. This beneficial effect is observed only in patients at low to medium risk.
Fast Detection and Processing of Arbitrary Contrast Agent Injections in Coronary Angiography and Fluoroscopy

Percutaneous transluminal coronary angioplasty (PTCA) requires both pre-interventional cine-angiograms showing the contrasted vessel tree over several heart cycles, and live X-ray monitoring (fluoroscopy) during the catheterization. Navigation during the intervention can be facilitated by fusing the automatically synchronized cineangiogram with the interventional images, e.g. by overlaying the synchronized angiogram over the interventional images. Clearly, this fusion should be limited to those frames of the angiogram which show the full contrasted vessel tree. Conversely, if contrast agent appears in the fluoroscopy images, overlay is not required and should be switched off. To these ends, we describe approaches for the detection and processing of contrast agent injections in cardiac X-ray image sequences.
Animal-assisted activity among patients with cancer: effects on mood, fatigue, self-perceived health, and sense of coherence.

To identify to what extent an animal-assisted activity (i.e., visits with a dog) affects the mood, self-perceived health, and sense of coherence among patients undergoing radiation therapy.



Pretest/post-test between and within groups.



Radiation oncology units of two hospitals in a mid-sized, midwestern city.


SAMPLE
30 adult patients undergoing nonpalliative radiation therapy.



After giving informed consent, participants were randomly assigned to receive 12 dog visits, 12 human visits, or 12 quiet reading sessions over a four-week period.



No statistically significant differences were found; however, compared with others their age, patients receiving dog visits viewed their health as improved over the four-week period. Participants described each of the three activities as beneficial. The study is primarily useful as a basis for planning additional research.



The study warrants replication with a larger sample to determine applicability of animal-assisted activity in patients with cancer who are undergoing radiation therapy.



Patients may want and express benefit from animal-assisted activity dog visits, but the outcomes of the visits may not be measureable. Nurses should assess to what extent patients believe that such visits are beneficial by asking them. The visits may be valued by patients as helping to relieve their anxiety and as distractions from their disease and therapy.
Direct transapical aortic valve implantation: a modified transcatheter approach avoiding balloon predilatation.

Transcatheter aortic valve implantation (T-AVI) is an accepted alternative treatment option for patients with aortic stenosis seen inoperable or high risk for aortic valve (AV) replacement. However, a significant risk of stroke and cerebrovascular complications raises concern. Cerebral embolizations during T-AVI are frequent and recent data demonstrates that balloon aortic valvuloplasty during transcatheter procedures causes nearly as many high-intensity transient signals and microembolic signals as the deployment of the transcatheter heart valve itself. Omitting predilatation, therefore, may reduce the incidence of microembolizations and a possible stroke. We have developed a novel technique of 'Direct Transapical Aortic Valve Implantation', which enables surgeons to avoid predilatation of the native AV. So far, a total of six consecutive patients were treated using the Edwards SAPIEN XT™ transcatheter heart valve (Edwards Lifesciences, Irvine, CA, USA). Compared with conventional transapical implantations using the same device, procedure time was shorter, less contrast used and duration of fluoroscopy reduced. Procedural success was achieved in all patients, and all were discharged home without greater than or equal to moderate paravalvular leakage observed. Direct transapical implantation is technically safe and effective, with shorter radiation/procedure times. It is the next logical step in the direction of a full percutaneous transapical approach and potentially can result in reduced microembolizations.
Unexpectedly high recanalization rate in patients with pulmonary embolism treated with anticoagulants alone.

The rate of residual thrombosis, defined as the long-term persistence of thrombotic material in the pulmonary artery tree after pulmonary embolism (PE), is uncertain. Although a systematic review reported low recanalization rates (43% at 6 mo) (1), most studies used perfusion or ventilation–perfusion lung scanning or older generation computed tomography (CT) scanners. In a prospective study we determined the rate of residual thrombosis in a cohort of consecutive patients with acute PE as detected by 64-row multidetector CT (MDCT), treated with anticoagulants alone and reassessed 6 months later with the same high-technology procedure.
Oral alendronate can suppress bone turnover but not fracture in kidney transplantation recipients with hyperparathyroidism and chronic kidney disease

Post-transplantation bone diseases negatively affect the quality of life of solid organ recipients. Secondary or tertiary hyperparathyroidism is a frequent complication in kidney transplantation (KTx) recipients. Treatment with immunosuppressive agents including glucocorticoids can lead to deterioration in bone metabolism in these patients. In the present study, we explored the effects of a three-year treatment period with oral alendronate (ALN) in long-term KTx recipients. Post-KTx recipients were recruited (n = 24, M/F = 12/12, mean age 52.0 ± 7.8 years) into this study. All patients were prescribed methylprednisolone (4.07 ± 0.86 mg/day) with various immunosuppressive agents. Before treatment with oral ALN (35 mg/week), the mean concentrations of intact parathyroid hormone (iPTH) and 25-hydroxyvitamin D were 139.2 ± 71.4 pg/mL and 20.8 ± 4.1 ng/mL, respectively. After 36 months of ALN treatment, mean iPTH levels increased slightly (+20.9 %). Treatment with ALN reduced bone-specific alkaline phosphatase (−35.4 %), serum type I collagen N-terminal telopeptide (−31.2 %) and osteocalcin (−55.6 %) levels. ALN did not increase bone mass after 24 months. Four patients with the highest baseline iPTH levels suffered a clinical osteoporotic fracture during the 36-month ALN treatment period. Higher iPTH levels with chronic kidney disease (CKD) at baseline were associated with the incidence of new clinical fractures during ALN treatment. In conclusion, anti-resorptive therapy with ALN can suppress bone turnover even when iPTH concentration is elevated in long-term KTx recipients. However, hyperparathyroidism with CKD seems to be associated with new clinical fractures during ALN treatment.