nils-herrmann/clean_scirepeval huggingface dataset:
Mediators of physical activity change in a behavioral modification program for type 2 diabetes patients

Many studies have reported significant behavioral impact of physical activity interventions. However, few have examined changes in potential mediators of change preceding behavioral changes, resulting in a lack of information concerning how the intervention worked. Our purpose was to examine mediation effects of changes in psychosocial variables on changes in physical activity in type 2 diabetes patients.



Ninety-two patients (62 ± 9 years, 30, 0 ± 2.5 kg/m(2), 69% males) participated in a randomized controlled trial. The 24-week intervention was based on social-cognitive constructs and consisted of a face-to-face session, telephone follow-ups, and the use of a pedometer. Social-cognitive variables and physical activity (device-based and self-reported) were collected at baseline, after the 24-week intervention and at one year post-baseline. PA was measured by pedometer, accelerometer and questionnaire.



Post-intervention physical activity changes were mediated by coping with relapse, changes in social norm, and social modeling from family members (p ≤ 0.05). One-year physical activity changes were mediated by coping with relapse, changes in social support from family and self-efficacy towards physical activity barriers (p ≤ 0.05)



For patients with type 2 diabetes, initiatives to increase their physical activity could usefully focus on strategies for resuming regular patterns of activity, on engaging family social support and on building confidence about dealing with actual and perceived barriers to activity.
Effect of interval training programme on pulse pressure in the management of hypertension: a randomized controlled trial.

Pulse pressure (PP), might be a stronger determinants of cardiovascular risk.



To investigate the effect of interval training program on PP in subjects with hypertension.



Two hundred and forty five male patients with mild to moderate (Systolic Blood Pressure [SBP] between 140-179 & Diastolic Blood Pressure [DBP] between 90-109 mmHg) essential hypertension were age-matched and grouped into exercise and control groups. The exercise (work: rest ratio of 1:1) groups involved in an 8-weeks interval training programs of between 45-60 minutes, at intensities of 60-79% of HR max (maximum heart rate), while the control group remained sedentary during this period. SBP, DBP, VO2max and PP were assessed.



Findings of the study revealed significant correlation between PP and blood pressure; correlation of PP with SBP was much stronger (95% variance). Also, there was significant effect of the exercise training program on SBP, DBP and PP. Changes in VO2max also negatively correlated with changes in PP (r= -.285) at p<0.05.



Moderate intensity interval training programs is effective in the non-pharmacological management of hypertension and may prevent cardiovascular event through the down regulation of PP in hypertension.
Derivation and validation of REASON: a risk score identifying candidates to screen for peripheral arterial disease using ankle brachial index.

The recommendation of screening with ankle brachial index (ABI) in asymptomatic individuals is controversial. The aims of the present study were to develop and validate a pre-screening test to select candidates for ABI measurement in the Spanish population 50-79 years old, and to compare its predictive capacity to current Inter-Society Consensus (ISC) screening criteria.



Two population-based cross-sectional studies were used to develop (n = 4046) and validate (n = 3285) a regression model to predict ABI < 0.9. The validation dataset was also used to compare the model's predictive capacity to that of ISC screening criteria. The best model to predict ABI < 0.9 included age, sex, smoking, pulse pressure and diabetes. Assessment of discrimination and calibration in the validation dataset demonstrated a good fit (AUC: 0.76 [95% CI 0.73-0.79] and Hosmer-Lemeshow test: χ(2): 10.73 (df = 6), p-value = 0.097). Predictions (probability cut-off value of 4.1) presented better specificity and positive likelihood ratio than the ABI screening criteria of the ISC guidelines, and similar sensitivity. This resulted in fewer patients screened per diagnosis of ABI < 0.9 (10.6 vs. 8.75) and a lower proportion of the population aged 50-79 years candidate to ABI screening (63.3% vs. 55.0%).



This model provides accurate ABI < 0.9 risk estimates for ages 50-79, with a better predictive capacity than that of ISC criteria. Its use could reduce possible harms and unnecessary work-ups of ABI screening as a risk stratification strategy in primary prevention of peripheral vascular disease.
Time patterns of adherence and long-term virological response to non-nucleoside reverse transcriptase inhibitor regimens in the Stratall ANRS 12110/ESTHER trial in Cameroon.

Although treatment adherence is a major challenge in sub-Saharan Africa, it is still unknown which longitudinal patterns of adherence are the most detrimental to long-term virological response to non-nucleoside reverse transcriptase inhibitor (NNRTI) regimens. This analysis aimed to study the influence of different time patterns of adherence on virological failure after 24 months of treatment in Cameroon.



Antiretroviral therapy (ART) adherence data were collected using face-to-face questionnaires administered at months 1, 3, 6, 12, 18 and 24. Virological failure was defined as viral load >40 copies/ml at month 18 and/or 24. Two combined indicators of early adherence (months 1, 3 and 6) and adherence during the maintenance phase (months 12, 18 and 24) were designed to classify patients as always adherent during the early or maintenance phase, non-adherent at least once and having interrupted ART for >2 days at least once at any visit during either of these two phases.



Virological failure occurred in 107 (42%) of the 254 patients included in the analysis. In the early and maintenance phases, 84% and 76%, respectively, were always adherent, 5% and 5% were non-adherent and 11% and 20% experienced ≥ 1 treatment interruption. Early non-adherence was independently associated with virological failure (adjusted OR 7.2 [95% CI 1.5, 34.6]), while only treatment interruptions had a significant impact on virological failure during the maintenance phase (adjusted OR 2.1 [95% CI 1.1, 4.4]).



ART NNRTI-regimens used in sub-Saharan Africa seem to 'forgive' deviations from good adherence during the maintenance phase. Optimizing adherence in the early months of treatment remains crucial, especially in a setting of poor health care infrastructure and resources.
Moderate-intensity aerobic training program improves insulin sensitivity and inflammatory markers in a pilot study of morbidly obese minority teens.

We initiated a pilot study to investigate the effects of 8 wks of aerobic exercise training (ET) on insulin sensitivity and inflammatory markers in obese and insulin-resistant minority adolescents. Eleven morbidly obese (BMI 41.4 ± 1.8 kg/m2) minority adolescents were entered into a supervised ET intervention (~180 min/wk at 40-55%VO2PeakR [(VO2Peak-VO2Rest)/VO2Rest]). The effects of training on insulin sensitivity (SI), inflammation and other metabolic syndrome features were examined.



Insulin action improved in response to training, as indicated by a ~37% increase in SI (p = .018). Plasma levels of several proinflammatory cytokines were reduced in response to ET, as indicated by significant decrements in sTNF-R, CCL2, MPO, IL-6, resistin, and leptin, with no significant changes in hsCRP. ET induced reductions in BMI and percent total body fat.



The present study supports the efficacy of ET interventions on metabolic syndrome features in morbidly obese minority youth.
Self-selected unrefined and refined carbohydrate diets do not affect metabolic control in pump-treated diabetic patients

This study investigated whether unrefined or refined carbohydrate diets have any effect on metabolic control and on insulin requirement in near-normoglycaemic Type 1 (insulin-dependent) diabetic out-patients on continuous subcutaneous insulin infusion therapy. Two females and 8 males (aged 27±9 years; diabetes duration 13±8 years; duration of insulin pump therapy 22±5 months; means±SD) participated in a randomised cross-over study with two 6-week periods on self-selected refined and unrefined carbohydrate diets respectively. As a result, energy intake differed between the experimental diets (2372±669 kcal/day on unrefined diet vs 2757±654 kcal/day on refined diet, p= 0.04), as did the fibre intake (18±5 g/day with the refined carbohydrate diet vs 35±13 g/day with the unrefined carbohy drate diet, p = 0.02). The composition of nutrients was approximately 40% carbohydrate, 45% fat, and 13% protein with both diets. Body weight, HbA1c, daily mean blood glucose (7.2±0.6 mmol/l) and serum lipids remained virtually unchanged during the entire study. Insulin requirement varied between 40.1±7.9 U/day with the unrefined carbohydrate diet, and 42.5±10.1 U/day with the refined carbohydrate diet (NS). Thus, neither the refined nor the unrefined carbohydrate diet affected insulin requirement and metabolic control in these near-normoglycaemic, normolipaemic, nonobese, insulin-pump-treated Type 1 diabetic patients.
White rice, brown rice, and risk of type 2 diabetes in US men and women.

Because of differences in processing and nutrients, brown rice and white rice may have different effects on risk of type 2 diabetes mellitus. We examined white and brown rice consumption in relation to type 2 diabetes risk prospectively in the Health Professionals Follow-up Study and the Nurses' Health Study I and II.



We prospectively ascertained and updated diet, lifestyle practices, and disease status among 39,765 men and 157,463 women in these cohorts.



After multivariate adjustment for age and other lifestyle and dietary risk factors, higher intake of white rice (> or =5 servings per week vs <1 per month) was associated with a higher risk of type 2 diabetes: pooled relative risk (95% confidence interval [CI]), 1.17 (1.02-1.36). In contrast, high brown rice intake (> or =2 servings per week vs <1 per month) was associated with a lower risk of type 2 diabetes: pooled relative risk, 0.89 (95% CI, 0.81-0.97). We estimated that replacing 50 g/d (cooked,equivalent to one-third serving per day) intake of white rice with the same amount of brown rice was associated with a 16% (95% CI, 9%-21%) lower risk of type 2 diabetes,whereas the same replacement with whole grains as a group was associated with a 36% (30%-42%) lower diabetes risk [corrected].



Substitution of whole grains, including brown rice, for white rice may lower risk of type 2 diabetes. These data support the recommendation that most carbohydrate intake should come from whole grains rather than refined grains to help prevent type 2 diabetes.
Memantine Improves Attentional Processes in Fragile X-Associated Tremor/Ataxia Syndrome: Electrophysiological Evidence from a Randomized Controlled Trial

Progressive cognitive deficits are common in patients with fragile X-associated tremor/ataxia syndrome (FXTAS), with no targeted treatment yet established. In this substudy of the first randomized controlled trial for FXTAS, we examined the effects of NMDA antagonist memantine on attention and working memory. Data were analyzed for patients (24 in each arm) who completed both the primary memantine trial and two EEG recordings (at baseline and follow-up) using an auditory "oddball" task. Results demonstrated significantly improved attention/working memory performance after one year only for the memantine group. The event-related potential P2 amplitude elicited by non-targets was significantly enhanced in the treated group, indicating memantine-associated improvement in attentional processes at the stimulus identification/discrimination level. P2 amplitude increase was positively correlated with improvement on the behavioral measure of attention/working memory during target detection. Analysis also revealed that memantine treatment normalized the P2 habituation effect at the follow-up visit. These findings indicate that memantine may benefit attentional processes that represent fundamental components of executive function/dysfunction, thought to comprise the core cognitive deficit in FXTAS. The results provide evidence of target engagement of memantine, as well as therapeutically relevant information that could further the development of specific cognitive or disease-modifying therapies for FXTAS.
Reflexology and progressive muscle relaxation training for people with multiple sclerosis: a crossover trial.

To compare the effects of reflexology and progressive muscle relaxation training for people with multiple sclerosis, provided by nurse therapists, on psychological and physical outcomes.



A crossover design was chosen with a 4-week break between treatment phases. The Short Form 36 and General Health Questionnaire 28 were completed by patients (n=50) pre and post each of the 6-week treatment phases. Salivary cortisol levels, State Anxiety Inventory, systolic and diastolic blood pressure and heart rate data were collected pre and post the weekly sessions.



All of the chosen measures except for three SF-36 scales recorded significant changes, however, despite the 4-week break (washout period), most outcome measures did not return to their pre-treatment baseline levels. This meant that the analysis of the data was complicated by significant effects involving ordering of treatment occurring for eight of the variables (one from SF-36, two from the GHQ, SAI, Salivary Cortisol, Systolic BP and HR). However, there was a difference in the State Anxiety Inventory values between the treatments of the order of 1.092 units (95%CI 0.211-1.976) (p=0.016, Wilks lambda=0.885, df=1, 48) in favour of reflexology. Changes in salivary cortisol comparing levels pre 1st to post 6th session favoured reflexology (95%CI 0.098-2.644) (p=0.037, Wilks lambda=0.912, df=1, 48). A significant difference was found in the way the treatments affected change in systolic blood pressure following sessions; this favoured progressive muscle relaxation training (p=0.002, Wilks lambda=0.812, df=1, 48).



Positive effects of both treatments following sessions and over the 6 weeks of treatment are reported, with limited evidence of difference between the two treatments, complicated by ordering effects.
Chronic vitamin E administration improves brachial reactivity and increases intracellular magnesium concentration in type II diabetic patients.

Vascular disease accounts for the majority of the clinical complications in diabetes mellitus. As an exaggerated oxidative stress degree has been postulated as the link between diabetes mellitus and endothelial function, a possible positive effect of plasma vitamin E (Vit.E) administration on brachial reactivity could be postulated. Our study aims at investigating the possible effect of chronic Vit.E administration on brachial reactivity, oxidative stress indexes, and intracellular magnesium and calcium content in type II diabetic patients free of diabetic complications. Forty adult, type II diabetic patients were enrolled in the study, which was deigned as a double blind, randomized vs. placebo trial. At baseline all patients underwent the following tests: 1) anthropometric and metabolic examinations, 2) evaluation of oxidative stress indexes, 3) intracellular magnesium and calcium measurements, and 4) determination of arterial compliance and distensibility. Then, all patients were randomly assigned to Vit.E treatment at a dose of 600 mg/day (Evion Forte; n = 20) or placebo (n = 20) over 8 weeks. At the end of this treatment period, a complete reevaluation of the patients was made. Vit.E treatment was associated with a significant improvement in the percent change in brachial artery diameter (P<0.03) and oxidative stress indexes (P< 0.005). In the Vit.E group, the percent change in brachial artery diameter correlated positively with the percent change in oxidative stress indexes (oxidized/reduced glutathione, Trolox-equivalent antioxidant capacity, thiobarbituric acid reaction products, lipid peroxides) and intracellular cation content (magnesium and calcium). After adjustment for age, sex, body mass index, and wait/hip ratio, all of these correlations remained significant (P<0.03 for all). Furthermore, adjusting for glycosylated hemoglobin, plasma total cholesterol, and homeostatic model index, brachial artery diameter was still correlated with the percent change in oxidative stress indexes (P<0.04 for all). Nevertheless, the relationship between the percent change in brachial artery diameter and oxidative stress indexes was no longer significant after adjustment for intracellular Mg and Ca2+. In conclusion, our study demonstrates that chronic administration of Vit.E improves brachial artery reactivity in patients with type II diabetes mellitus. Such an effect seems mediated by a reduction in oxidative stress and a regulation of intracellular calcium and magnesium contents.
Managerial control over IT projects: control, forms, commitment, and dominant coalitions

This research in progress addresses how managers engage in controlling IT projects, which can be seen as an instance of a classical problem in organizational control: managing sensibly in situations where subordinates have superior task knowledge. Theories used in the study include control theory, theories on commitment and escalation, and theories on IS implementation. An in-depth, retrospective, interpretive case study forms the empirical basis of the study. Preliminary results include the importance of input control as a control form and the role of a dominant coalition of controllers. The functioning of the dominant coalition, as it evolves, is closely associated with the organizational commitment to an IT project. Findings on the influence of the project leader (controllee) over managers (controllers) indicate limitations of management control.
Phase I trial of doxorubicin-containing low temperature sensitive liposomes in spontaneous canine tumors.

To determine the maximum tolerated dose, dose-limiting toxicities, and pharmacokinetic characteristics of doxorubicin encapsulated in a low temperature sensitive liposome (LTSL) when given concurrently with local hyperthermia to canine solid tumors.



Privately owned dogs with solid tumors (carcinomas or sarcomas) were treated. The tumors did not involve bone and were located at sites amenable to local hyperthermia. LTSL-doxorubicin was given (0.7-1.0 mg/kg i.v.) over 30 minutes during local tumor hyperthermia in a standard phase I dose escalation study. Three treatments, given 3 weeks apart, were scheduled. Toxicity was monitored for an additional month. Pharmacokinetics were evaluated during the first treatment cycle.



Twenty-one patients were enrolled: 18 with sarcomas and 3 with carcinomas. Grade 4 neutropenia and acute death secondary to liver failure, possibly drug related, were the dose-limiting toxicities. The maximum tolerated dose was 0.93 mg/kg. Other toxicities, with the possible exception of renal damage, were consistent with those observed following free doxorubicin administration. Of the 20 dogs that received > or = 2 doses of LTSL-doxorubicin, 12 had stable disease, and 6 had a partial response to treatment. Pharmacokinetic variables were more similar to those of free doxorubicin than the marketed liposomal product. Tumor drug concentrations at a dose of 1.0 mg/kg averaged 9.12 +/- 6.17 ng/mg tissue.



LTSL-doxorubicin offers a novel approach to improving drug delivery to solid tumors. It was well tolerated and resulted in favorable response profiles in these patients. Additional evaluation in human patients is warranted.
[Reliability and validity of the Turkish version of the Chronic Heart Failure Questionnaire].

Any disease specific Health Related Quality of Life Instrument for Chronic Heart Failure (CHF) is lacking in Turkey. The aim of this study is to adapt the Chronic Heart Failure Questionnaire (CHQ) into Turkish and probe the reliability and validity of this questionnaire.



There are four dimensions of this 20 items scale. These dimensions are: dyspnea (5 items), fatigue (4 items), emotional status (7 items) and mastery (4 items). Response options were evaluated using a 7 -point Likert type scale. Quality of life (QOL) improves as the score increases. A total of 205 CHF patients hospitalized in the Department of Cardiology of Ege University hospital were enrolled in this study. The CHQ was applied to the patients twice with a wash-out period of 15 days. Confirmatory approach was used during the reliability and validity analysis. Cronbach alpha test was used for the reliability analysis. Confirmatory factor analysis (CFA) was used for the construct validity testing. NYHA classification for testing the criterion validity; SF-36 and WHOQOL-100 General Health and QOL facet for convergent validity testing of the Turkish version of the CHQ were used. Responsiveness to change was evaluated by Effect Size analysis by using test-retest data.



The range of Cronbach alpha values is 0.72-0.94. A considerable ceiling and floor effects were observed for the dyspnea dimension of the scale but no problematic items were observed for the entire scale. The CFA results supported the original four factors scale structure. Criterion and construct validity rebuts were satisfactory. Effect sizes obtained among dimensions of the CHQ were between 0.13 and 0.56.



Overall results revealed that Turkish version of the CHQ is a reliable and valid instrument to be used for the evaluation of CHF patients.
EXERCISE TRAINING IMPROVES ENDOTHELIAL FUNCTION IN RESISTANCE ARTERIES OF YOUNG PREHYPERTENSIVES

Prehypertension is associated with reduced conduit artery endothelial function and perturbation of oxidant/antioxidant status. It is unknown whether endothelial dysfunction persists to resistance arteries and whether exercise training affects oxidant/antioxidant balance in young prehypertensives. We examined resistance artery function using venous occlusion plethysmography measurement of forearm (FBF) and calf blood flow (CBF) at rest and during reactive hyperaemia (RH), as well as lipid peroxidation (8-iso-PGF2α) and antioxidant capacity (Trolox-equivalent antioxidant capacity; TEAC) before and after exercise intervention or time control. Forty-three unmedicated prehypertensive and 15 matched normotensive time controls met screening requirements and participated in the study (age: 21.1±0.8 years). Prehypertensive subjects were randomly assigned to resistance exercise training (PHRT; n=15), endurance exercise training (PHET; n=13) or time-control groups (PHTC; n=15). Treatment groups exercised 3 days per week for 8 weeks. Peak and total FBF were lower in prehypertensives than normotensives (12.7±1.2 ml min−1 per100 ml tissue and 89.1±7.7 ml min−1 per 100 ml tissue vs 16.3±1.0 ml min−1 per 100 ml tissue and 123.3±6.4 ml min−1 per 100 ml tissue, respectively; P<0.05). Peak and total CBF were lower in prehypertensives than normotensives (15.3±1.2 ml min−1 per 100 ml tissue and 74±8.3 ml min−1 per 100 ml tissue vs 20.9±1.4 ml min−1 per 100 ml tissue and 107±9.2 ml min−1 per 100 ml tissue, respectively; P<0.05). PHRT and PHET improved humoral measures of TEAC (+24 and +30%) and 8-iso-PGF2α (−43 and −40%, respectively; P⩽0.05). This study provides evidence that young prehypertensives exhibit reduced resistance artery endothelial function and that short-term (8 weeks) resistance or endurance training are effective in improving resistance artery endothelial function and oxidant/antioxidant balance in young prehypertensives.