nils-herrmann/clean_scirepeval huggingface dataset:
Facet joints infiltration: a viable alternative treatment to physiotherapy in patients with low back pain due to facet joint arthropathy.

There is a paucity of information on treatment options and outcome of treatment of patients that have MRI findings of FJA presenting with low back pain in the developing country. This prospective cohort study conducted mainly in the University of Abuja Teaching Hospital Gwagwalada, Abuja Nigeria is to compare the short-term clinical outcome between two groups, one having undergone facet joints infiltration (FJI) and the other physiotherapy for facet joint arthropathy (FJA).



All patients with clinical lower back pain (LBP) and MRI features of FJA were recruited into this prospective study randomly. All the FJI patients had depot methylprednisolone and the physiotherapy patients had McKenzie regimen. Outcome questionnaires comprising Oswentry disability index scores (ODI), visual analogue scores (VAS), and patient satisfaction scores (PSS) were completed at all clinic visits. Follow-up was for 6 months for both groups. The results were analyzed using SPSS 17.0.



There were 10 FJI patients and 8 physiotherapy patients (1.25: 1). The outcome scores comprised the following ODI, VAS, and PSS. The FJI group had a better score compared to the physiotherapy group at short-term evaluation and this difference was statistically significant. The female patients in both groups fare better compared to the male counterparts.



FJI offered added benefit over physiotherapy in LBPs diagnosed with FJA. Patients with FJI have a significant reduction in pain symptom than the patients in the physiotherapy group. Though majority of the patients reported satisfactory outcome, the FJI patients group had a better outcome.
Seizure clustering during drug treatment affects seizure outcome and mortality of childhood-onset epilepsy.

To provide evidence of whether seizure clustering is associated with drug resistance and increased mortality in childhood-onset epilepsy, a prospective, long-term population-based study was performed. One hundred and twenty patients who had been followed since disease onset (average age 37.0 years, SD 7.1, median 40.0, range 11-42; incident cases) were included. At the end of the follow-up period, 26 (11 boys) of these patients (22%) had recorded clusters of seizures. Fourteen recorded pre-treatment clusters, including 10 patients with clusters as first seizures; and in 12 patients, clusters occurred during treatment. In these 12 patients, first clustering began after 16 (range 0-35; median 15) years of treatment. Compared with the patients without clusters, those with clusters more often had at least one seizure per week at the initial stage (63% versus 32%, P = 0.0178) and during the follow-up period (P-value varied from 0.0464 to 0.0064). Patients having seizure clusters during drug therapy were more likely to have drug resistant epilepsy compared to those not experiencing seizure clusters (42% versus 13%; P = 0.0102) and had a lower rate of entering 5-year terminal remission (P = 0.0039) and 5-year remission (P = 0.0230). In addition, the risk of death was significantly increased among patients with seizure clusters during drug therapy compared with those who had not experienced any clustering (42% versus 14%; P = 0.0299 two-sided Fisher's exact test). The risk ratio for patients with clusters was 3.49 (95%CI 1.25-9.78). In contrast, patients with seizure clustering prior to, but not during, treatment versus those with no clustering showed no difference in seizure outcome or mortality risk. In conclusion, clustering of seizures during treatment, but not prior to treatment, is associated with a poorer long-term seizure and mortality outcome.
Beneficial effects of the CorCap cardiac support device: five-year results from the Acorn Trial.

The CorCap cardiac support device (Acorn Cardiovascular, Inc, St Paul, Minn) is the first device that specifically addresses ventricular remodeling in heart failure by reducing wall stress. We previously reported outcomes from the Acorn randomized trial to a common closing date (22.9 months of follow-up). This report summarizes results of extended followup to 5 years.



A total of 107 patients were enrolled in the no-mitral valve repair/replacement stratum including 57 in the CorCap treatment group and 50 in the control (optimal medical therapy alone) group. Patients were assessed every year, until completing 5 years of follow-up, for survival, adverse events, major cardiac procedures, New York Heart Association (NYHA) functional status, and echocardiograms, which were read at a core laboratory.



Overall survivals were similar between the treatment and control groups, demonstrating no late adverse effect on mortality. The treatment group had significant reductions in left ventricular end-diastolic volume (P = .029) as well as a small increase in sphericity index. More patients in the treatment group improved by at least 1 NYHA functional class (P = .0005). There was no difference in rates of adverse events. In a subgroup of patients with an intermediate left ventricular end-diastolic dimension, there was a significant reduction in the Kaplan-Meier estimate of the freedom from the composite end point of death and major cardiac procedures (P = .04).



These cumulative data demonstrate the sustained reverse remodeling of the left ventricle and the long-term safety and efficacy of the CorCap cardiac support device as an adjunctive therapy for patients with heart failure who remain symptomatic despite optimal medical therapy.
Ergometry as a Basis for Judging the Antihypertensive Effect

The duration and degree of blood pressure reduction produced by antihypertensive drugs is usually assessed by measuring blood pressure at rest; however, these measurements are strongly influenced by the time ofday and the subject's physical and emotional state (Kronig 1976; Schulte et aI. 1978;  1978). Moreover, arterial hypertension is characterised both by an elevated resting blood pressure and, especially, by an excessive pressure response to physical and emotional stress (Franz 1986).There is a close correlation between systolic pressure during exercise and the degree of left ventricular hypertropy (Nathwani et aI. 1975; Ren et aI. 1985).Therefore, it may be appropriate to assess antihypertensive efficacy during standardised exercise testing. In a double-blind controlled study, we evaluated the effect ofurapidil and nitrendipine on blood pressure at rest and also during and after standardised ergometric exercise. This method of exercise testing is reported to provide reproducible data regarding the blood pressure response to physical activity (Franz 1982, 1987).
Local muscle injection of botulinum toxin type a synergistically improves the beneficial effects of repetitive transcranial magnetic stimulation and intensive occupational therapy in post-stroke patients with spastic upper limb hemiparesis.

The purpose of this study was to determine whether local injection of botulinum toxin type A (BoNT-A) into the spastic muscles has any added benefits to repetitive transcranial magnetic stimulation (RTMS)/occupational therapy (OT) in patients with spastic upper limb hemiparesis.



The study subjects of 80 post-stroke patients with spastic upper limb hemiparesis (age: 60.2 ± 13.0 years, time after stroke: 55.3 ± 43.0 months), were divided into the BoNT-A plus RTMS/OT group and RTMS/OT group. BoNT-A was injected into the spastic muscles (total dose: 240 units) before RTMS/OT. The latter included 12 sessions of 40 min RTMS over the non-lesional hemisphere and 240-min intensive OT daily over 15 days. Spasticity was evaluated by the modified Ashworth scale (MAS) and the motor function of the affected upper limb was evaluated serially with Fugl-Meyer Assessment and Wolf Motor Function Tests.



Both groups showed significant improvements in spasticity and motor function. The addition of BoNT-A resulted in better improvement in FMA score and MAS of finger flexor muscles (p < 0.05).



The triple-element protocol of local injection of BoNT-A into spastic finger muscles, RTMS and intensive OT, is a promising therapeutic program for post-stroke spastic upper limb hemiparesis, although its significance should be confirmed in randomized, placebo-controlled trials.
Loss of Pace Capture on the Ablation Line During Pulmonary Vein Isolation versus "Dormant Conduction": Is Adenosine Expendable?

Permanent pulmonary vein isolation (PVI) remains an essential goal of ablation therapy in patients with atrial fibrillation. Aim of this study was the intraindividual comparison of unexcitability to pacing along the ablation line versus dormant conduction (DC) as additional procedural endpoints.



A total of 58 patients with paroxysmal atrial fibrillation (PAF) underwent PVI by circumferential ablation of ipsilateral pulmonary veins (PVs), followed by testing for DC by adenosine administration. Irrespective of the presence of DC, pacing along the ablation line for left atrium capture was performed and additional radio frequency energy applied if necessary. PVs with initial DC were retested after achieving unexcitability.



PVI was achieved in 224 of 224 PVs. In 33 of 224 PVs (15%) DC was revealed. At 92 of 112 ablation lines (82%) sites of excitability were found. Three (9%) of the initial 33 PVs with DC showed further DC after achieving unexcitability at repeated testing. Thirty-two of 33 assumed areas of unmasked PV-LA reconduction as revealed by DC-testing showed a corresponding site of excitability on the ablation line. After a follow-up of 11.6 ± 3.4 months 79% of patients were free of arrhythmia.



Pacing for unexcitability can safely identify potential sites of DC and even sites that would have not been detected by testing for DC. Unexcitability, therefore, serves as a suitable and safe procedural endpoint not only for patients with contraindications to adenosine administration. Our data suggest that adenosine may be expendable when achieving unexcitability along the ablation line.
GATA3 Is a Sensitive and Specific Marker of Benign and Malignant Mesonephric Lesions in the Lower Female Genital Tract.

GATA3 is a transcription factor critical for embryogenesis, development, and cell differentiation. Recent studies have suggested that GATA3 is a sensitive and relatively specific biomarker for urothelial and breast carcinomas, with most Müllerian carcinomas being negative. We investigated GATA3 expression in mesonephric/Wolffian remnants and tumors in the female genital tract. A western blot was performed to assess specificity for the GATA3 antibody. GATA3 immunohistochemistry was performed on 59 formalin-fixed paraffin-embedded mesonephric samples, including 17 mesonephric remnants (MR; 11 cervical and 6 fallopian tube), 15 mesonephric hyperplasias, 21 mesonephric carcinomas, and 6 female adnexal tumors of probable Wolffian origin. Thirty conventional endocervical adenocarcinomas (ENDO-CA), 9 gastric-type cervical adenocarcinomas, and 165 endometrial adenocarcinomas (EM-CA) were also evaluated. GATA3 nuclear intensity and extent of staining was evaluated. The western blot revealed GATA3 expression in seminal vesicle and cell lines derived from breast and urothelial carcinomas, but not in other cell lines including ovarian, cervical, and endometrial cancers. All cervical MRs and mesonephric hyperplasias, 5/6 (83%) fallopian tube MRs, and 20/21 (95%) mesonephric carcinomas were GATA3 positive, although with great variability in both intensity (weak to strong) and extent (1+ to 3+) of staining. Only 1/6 (17%) female adnexal tumors of probable Wolffian origin showed weak multifocal staining. One of 30 (3%) usual-type ENDO-CAs and 3/165 EM-CAs exhibited weak-moderate GATA3 immunoreactivity; all gastric-type cervical adenocarcinomas were negative. GATA3 is a highly sensitive and specific marker for mesonephric lesions in the lower genital tract; however, its utility in the upper genital tract may be more limited. In addition, GATA3 can aid in distinguishing lower genital mesonephric lesions from usual-type and gastric-type ENDO-CAs and uterine EM-CAs.
Deep patch-wise colorization model for grayscale images

To handle the colorization problem, we propose a deep patch-wise colorization model for grayscale images. Distinguished with some constructive color mapping models with complicated mathematical priors, we alternately apply two loss metric functions in the deep model to suppress the training errors under the convolutional neural network. To address the potential boundary artifacts, a refinement scheme is presented inspired by guided filtering. In the experiment section, we summarize our network parameters setting in practice, including the patch size, amount of layers and the convolution kernels. Our experiments demonstrate this model can output more satisfactory visual colorizations compared with the state-of-the-art methods. Moreover, we prove our method has extensive application domains and can be applied to stylistic colorization.
Cortisol response to diazepam: its relationship to age, dose, duration of treatment, and presence of generalized anxiety disorder

Acute diazepam administration has been shown to decrease plasma cortisol levels consistent with decreased activity of the hypothalamic-pituitary-adrenal axis, especially in individuals experiencing stress. However, the effects of chronic diazepam treatment on cortisol have been less studied, and the relationship to age, anxiety, duration of treatment, and dose are not well understood. This double-blind placebo-controlled study examined acute and chronic effects of diazepam on plasma cortisol levels in young (19–35 years) and elderly (60–79 years) individuals with and without generalized anxiety disorder (GAD). Subjects received single oral challenges of placebo or diazepam (2.5 mg or 10 mg) in a placebo-controlled cross-over design, followed by 3 weeks of chronic daily treatment with 2.5 mg or 10 mg diazepam or placebo taken at 10 p.m., and then by a final acute challenge with a single oral dose of the same study medication received during chronic treatment. The elderly experienced significant reductions in plasma cortisol levels compared to placebo both in the initial challenge and during chronic treatment, but the young did not. However, cortisol response to drug was comparable in both groups. Final challenge did not produce any significant cortisol effects in either group and the cortisol response in the elderly was significantly reduced compared to the initial challenge. GAD status was not a factor in plasma cortisol responses to diazepam. Diazepam reduced cortisol both acutely and during chronic treatment, but not during final challenge, consistent with some tolerance development. This effect was most apparent in the elderly compared with the young adults and was not modulated by GAD status or dosage, and was not related to drug effects on performance and on self-ratings of sedation and tension.
Intraoperative monitoring of carotid endarterectomy by transcranial motor evoked potential: A multicenter study of 600 patients

This study was to investigate the utility of motor evoked potential monitoring elicited by transcranial electrical stimulation (tcMEP) during CEA in addition to the established median nerve somatosensory evoked potentials (mSSEPs).



We retrospectively reviewed data from 600 patients undergoing CEA under general anesthesia with monitoring of mSSEPs and tcMEPs in a multicenter study. MSSEP and tcMEP parameters were recorded during internal carotid artery (ICA) cross clamping and compared with the postoperative motor outcome, demographic and patient history data.



The intraoperative monitoring of tcMEPs was successful in 594 of the patients (99%) and selective shunt was performed in 29 of them (4.83%). Nine of the patients showed a transient contralateral loss of tcMEPs, without changes in mSSEPs and required intervention (1.5% "false-negative"). Three of them showed postoperative motor deficits. The time period from tcMEP loss to intervention was significantly longer (p = 0.01) in this group compared to the patients without postoperative motor deficit.



TcMEPs during CEA may be an adjunct to mSSEP monitoring to avoid "false-negative" mSSEP results, as mSSEPs seem to lack specificity for detecting isolated ischemia of corticospinal pathway.



TcMEPs seem to improve postoperative outcome, especially in case of a timely correction of cerebral ischemia.
Randomized controlled trial of a nurse-led rheumatology clinic for monitoring biological therapy

To compare and evaluate the treatment outcomes of a nurse-led rheumatology clinic and a rheumatologist-led clinic in patients with low disease activity or in remission who are undergoing biological therapy.



Patients with chronic inflammatory arthritis treated with biological therapy are usually monitored by rheumatologists. Nurse-led rheumatology clinics have been proposed in patients with low disease activity or in remission.



Randomized controlled trial.



A 12-month follow-up trial was conducted between October 2009 and August 2011, where 107 patients were randomized into two groups with a 6-month follow-up to a nurse-led rheumatology clinic based on person-centred care (intervention group; n = 53) or to a rheumatologist-led clinic (control group; n = 54). The hypothesis was that the nurse-led clinic outcomes would not be inferior to those obtained from a rheumatologist-led clinic at the 12-month follow-up. The primary outcome was disease activity measured by Disease Activity Score 28.



A total of 47 patients in the intervention group and 50 in the control group completed the 12-month trial. The trial revealed no statistically significant differences between groups in mean change of Disease Activity Score 28, Visual Analogue Scales for pain, the Health Assessment Questionnaire, satisfaction with or confidence in obtaining rheumatology care.



Patients with stable chronic inflammatory arthritis undergoing biological therapy could be monitored by a nurse-led rheumatology clinic without difference in outcome as measured by the Disease Activity Score 28.
Facilitating understanding of mental health problems in GP consultations: a qualitative study using taped-assisted recall.

Mental health problems are common in primary care and most are managed solely by the GP. Patients strive to understand their mental health problems, and facilitating patients' understanding may be important in their care, yet little is known about this process in GP consultations.



To explore how patients' understanding of common mental health problems is developed in GP consultations.



Qualitative study.



Ten general practices in North Central London.



Fourteen patients and their GPs were interviewed using the taped-assisted recall (TAR) method, and asked how understanding of the patients' mental health problems had been discussed in a recent consultation. The resulting 42 transcripts of the GP-patient consultations and separate GP and patient TAR interviews were analysed using qualitative thematic and process analytic methods.



Patients considered understanding their mental health problems to be important, and half reported their GP consultations as helpful in this respect. The process of coming to an understanding was predominantly patient-led. Patients suggested their own explanations, and these were facilitated and focused by the doctors' questioning, listening, validating, and elaborating aspects they considered important. Both doctors and patients experienced constraints on the extent to which developing understanding of problems was possible in GP consultations.



GPs can help patients understand their mental health problems by recognising patients' own attempts at explanation and helping to shape and develop these.
Three-dimensional seed reconstruction from an incomplete data set for prostate brachytherapy.

Intra-operative dosimetry in prostate brachytherapy requires 3D coordinates of the implanted, radioactive seeds. Since CT is not readily available during the implant operation, projection x-rays are commonly used for intra-operative seed localization. Three x-ray projections are usually used. The requirement of the current seed reconstruction algorithms is that the seeds must be identified on all three projections. However, in practice this is often difficult to accomplish due to the problem of heavily clustered and overlapping seeds. We have developed an algorithm that permits seed reconstruction from an incomplete data set. Instead of all three projections, the new algorithm requires only one of the three projections to be complete. Furthermore, even if all three projections are incomplete, it can reconstruct 100% of the implanted seeds depending on how the undetected seeds are distributed among the projections. The method utilizes the principles of epipolar imaging geometry and pseudo-matching of the undetected seeds. The algorithm was successfully applied to a large number of clinical cases where seeds imperceptibly overlap in some projections.
Evaluation of a brief aerobic exercise intervention for high anxiety sensitivity.

Anxiety sensitivity, or the belief that anxiety-related sensations can have negative consequences, has been shown to play an important role in the etiology and maintenance of panic disorder and other anxiety-related pathology. Aerobic exercise involves exposure to physiological cues similar to those experienced during anxiety reactions. The present study sought to investigate the efficacy of a brief aerobic exercise intervention for high anxiety sensitivity. Accordingly, 24 participants with high anxiety sensitivity scores (Anxiety Sensitivity Index-Revised scores >28) were randomly assigned to complete either six 20-minute sessions of aerobic exercise or a no-exercise control condition. The results indicated that individuals assigned to the aerobic exercise condition reported significantly less anxiety sensitivity subsequent to exercise, whereas anxiety sensitivity scores among non-exercisers did not significantly change. The clinical research and public health implications of these findings are discussed, and several potential directions for additional research are recommended.
Screening for Hypoglycemia in Exclusively Breastfed High-risk Neonates.

To determine incidence of hypoglycemia in exclusively breastfed, high-risk but healthy newborns, and risk factors for its development.



This observational study enrolled 407 exclusively breastfed high-risk (low birth weight newborns (1800-2499 g), late preterms, small-for-gestation, large-for-gestation and infant of diabetic mother), who did not require admission to neonatal intensive care unit and were kept in postnatal wards with mother. Hypoglycemia was defined as blood glucose £46 mg/dL (2.6 mmol/L). Blood glucose was monitored till 48 hours of life.



27% of the screened newborns developed hypoglycemia in first 48 hours. 31 (7.6%) developed recurrent (>2) episodes, 28 (6.8%) had moderate (<37mg/dL) while 8 (1.9%) developed symptomatic hypoglycemia. With increase in birthweight, risk of hypoglycemia reduced significantly (P=0.003). Hypoglycemia was observed more frequently in first 2 hours as compared to next 48 hours (P=0.0001). Low birth- weight, preterm gestation and male gender was significantly associated with increased risk of hypoglycemia.



Healthy, high-risk exclusively breastfed newborns in postnatal wards need close monitoring for hypoglycemia in first 24 hrs of life.