nils-herrmann/clean_scirepeval huggingface dataset:
Esophageal pH-Impedance Monitoring in Patients With Therapy-Resistant Reflux Symptoms: ‘On’ or ‘Off’ Proton Pump Inhibitor?

In patients with proton pump inhibitor (PPI)-resistant symptoms, ambulatory 24-h pH-impedance monitoring can be used to assess whether a relationship exists between symptoms and reflux episodes. Until now, it is unclear whether combined pH-impedance monitoring in these patients should be performed on or off PPI.METHODS:Thirty patients with symptoms of heartburn, chest pain, and/or regurgitation despite PPI twice daily underwent ambulatory 24-h pH-impedance monitoring twice, once on PPI and once after cessation of the PPI for 7 days. The order of the measurements was randomized. Reflux episodes were identified and classified as acid, weakly acidic, or weakly alkaline reflux. In addition, the symptom association probability (SAP) was calculated for each measurement.The total number of reflux episodes and proximal extent were not affected by PPI therapy. On PPI, there were fewer acid reflux episodes (49 ± 34 off PPI vs 20 ± 25 on PPI) while more weakly acidic reflux episodes were identified (24 ± 17 off PPI vs 48 ± 31 on PPI). Symptom association analysis identified 15 and 11 patients with a positive SAP in the measurement off and on PPI, respectively, the difference in yield of the SAP not being statistically significant. Eight of the 19 patients who had no symptoms or a negative SAP during measurement on PPI had a positive SAP off PPI therapy. In contrast, only 4 patients with a positive SAP on PPI were missed in the measurement off PPI therapy.In order to demonstrate or exclude GERD in patients with PPI-resistant symptoms, ambulatory 24-h pH-impedance monitoring should preferably be performed after cessation of PPI therapy because this approach seems to offer the best chance to assess a relationship between symptoms and reflux episodes.
[Effects of individualized nutritional education programs on the level of nutrient intake and nutritional status of colorectal cancer patients undergoing palliative chemotherapy].

The purpose of this study was to examine the effects of an individualized nutritional education programs on nutrient intake and nutritional status of patients with colorectal cancer who are undergoing palliative chemotherapy.



Forty patients with colorectal cancer (19 experimental and 21 control patients) were recruited from a chemotherapy ward at S University Hospital in Seoul, Korea. The experimental group received two individualized nutritional counseling sessions and two telephone counseling sessions over 6 weeks. The control group received nutritional counseling after completion of data collection. Nutritional education included general guidelines for food intake while receiving chemotherapy, dietary guidelines for patients with colorectal cancer, daily meal schedules to overcome cancer, and dietary guideline for each chemotherapy side effect. Data were analyzed using χ²-test and t-test with the SPSS program 17.0.



Two group comparison revealed that the experimental group had significantly improved calorie (p=.038) and total protein intake (p=.001), and serum albumin percentage change (p=.040). Body weight did not increase but remained the same as the baseline in both groups.



Study results indicate that this individualized nutritional education programs are effective in enhancing nutrient intake and nutritional status of patients with colorectal cancer who are undergoing palliative chemotherapy.
Onset Time of 2% Lidocaine and 0.5% Bupivacaine Mixture versus 0.5% Bupivacaine Alone using Ultrasound and Double Nerve Stimulation for Infraclavicular Brachial Plexus Anesthesia in ESRD Patients Undergoing Arteriovenous Fistula Creation.

To reduce the onset of 0.5% bupivacaine by adding 2% lidocaine with 0.5% bupivacaine for ultrasound-guided and double stimulation technique at musculocutaneous and radial nerve for infraclavicular brachial plexus block.



Prospective randomized double-blinded, controlled trial study.



90 patients undergoing creation of arteriovenous fistula under ultrasound-guided infraclavicular brachial plexus block were randomized into 2 groups. Gr B (46 patients) received 0.5% bupivacaine 30 mL and Gr BL (44 patients) received mixture of 0.5% bupivacaine 20 mL and 2% lidocaine 10 mL. The onset of sensory block were assessed by response to pinprick (grading: 0 = no sensation, 1 = hypoesthesia, and 2 = normal sensation). Rescue analgesia during the operation, duration of sensory and motor blockade were recorded. Surgeon and patient satisfactions are also evaluated using 6-point scale (0 = dissatisfied to 5 = very satisfied).



There were no significant difference in the onset time of either group. Duration of sensory and motor block was not different. Surgeons' and patients' satisfaction were also not significantly different between the groups.



Mixing 2% lidocaine with 0.5% bupivacaine to the final concentration of 0.67%for lidocaine and 0.33% for bupivacaine does not reduce the onset of ultrasound-guided infraclavicular brachial plexus block.
The effect of education in managing side effects in women receiving chemotherapy for treatment of breast cancer.

To determine the effectiveness of informational audiotapes on self-care behaviors, state anxiety, and use of self-care behaviors; to describe the occurrence and intensity of common side effects in patients with breast cancer.



Randomized clinical trial.



Outpatient chemotherapy clinics operated by a university center in a rural area.


SAMPLE
70 women receiving their first treatment of chemotherapy.



Subjects completed demographic data and the Spielberger State-Trait Anxiety instrument (stai). The experimental group received two audiotapes. At one and three months, subjects completed the modified nail self-care diary and stai via telephone.



State anxiety, side-effect severity, and use and efficacy of self-care behaviors.



The most frequent side effects were fatigue, nausea and vomiting, and taste change. The experimental group reported symptom improvements that were not found in the control group. The experimental group increased the use of recommended self-care behaviors, whereas the control group continued to use the same self-care behaviors without effectiveness. State anxiety for both groups diminished over time; however, anxiety in the control group was consistently higher.



Audiotapes are effective teaching tools. Self-care behaviors can be taught and can be effective in managing side effects. Anxiety was high in both groups, but the symptom decreased in the women who received audiotapes and telephone calls.



Constraints on nurses decrease the length of teaching time available, but audiotapes provide effective teaching and reinforcement of education. Anxiety in clinical environments interferes with patient learning. Teaching effective self-care behaviors enhances patients' independence, comfort, control, and quality of life.
Framework for open data mining in e-government

Data mining in e-government is the process of translating data from government web site in useful knowledge that can provide various types of support in decision making. Data mining can be applied to any type of data, but we have chosen to use this technique on open government data. Open data is a new concept in the development of e-government. It stands for a public sector information which is available for distribution and usage without any restrictions. In this paper we will give an overview of a framework for open data mining and present an example of usage of this framework for data mining on government open data portals.
Early response as predictor of final remission in elderly depressed patients.

Several studies have attempted to predict the final response or remission based on improvement during the early course of treatment of major depression. There is however a great variation in cut offs used to define early response and in the optimal week to predict final results.



To compare different cut offs at different time points early in the treatment of elderly depressed patients.



A 12 week randomised, controlled trial in 81 elderly inpatients with DSM-IV major depression comparing venlafaxine with nortriptyline. At least 20, 25, 30 or 50% improvement was analysed after 1, 3 and 5 weeks using the Hamilton Depression Rating Scale and the Montgomery Asberg Depression Rating Scale. We plotted sensitivity against 1-specificity and calculated areas under the curve (AUCs).



The highest percentage of correctly classified patients is found using at least 50% decrease as cut off in week 5, with acceptable sensitivity (81.8%) and specificity (87.4%). In week 5, the AUCs were 0.891 (95% CI 0.798-0.984) and 0.866 (95% CI 0.789-0.983) for the HAM-D and MADRS, respectively.



Combining the results from our study and the other studies addressing this issue, we suggest that the treatment should be changed in the elderly if after 3-4 weeks less than 30% improvement in depression score has been achieved.
Noninvasive ventilation for acute respiratory failure after lung resection: an observational study

A single prospective randomized study found that, in selected patients with acute respiratory failure (ARF) following lung resection, noninvasive ventilation (NIV) decreases the need for endotracheal mechanical ventilation and improves clinical outcome. We prospectively evaluated early NIV use for ARF after lung resection during a 4-year period in the setting of a medical and a surgical ICU of a university hospital. We documented demographics, initial clinical characteristics and clinical outcomes. NIV failure was defined as the need for tracheal intubation. Among 690 patients at risk of severe complications following lung resection, 113 (16.3%) experienced ARF, which was initially supported by NIV in 89 (78.7%), including 59 with hypoxemic ARF (66.3%) and 30 with hypercapnic ARF (33.7%). The overall success rate of NIV was 85.3% (76/89). In-ICU mortality was 6.7% (6/89). The mortality rate following NIV failure was 46.1%. Predictive factors of NIV failure in univariate analysis were age (P = 0.046), previous cardiac comorbidities (P = 0.0075), postoperative pneumonia (P = 0.0016), admission in the surgical ICU (P = 0.034), no initial response to NIV (P < 0.0001) and occurrence of noninfectious complications (P = 0.037). Only two independent factors were significantly associated with NIV failure in multivariate analysis: cardiac comorbidities (odds ratio, 11.5; 95% confidence interval, 1.9–68.3; P = 0.007) and no initial response to NIV (odds ratio, 117.6; 95% confidence interval, 10.6–1305.8; P = 0.0001). This prospective survey confirms the feasibility and efficacy of NIV in ARF following lung resection.
[The management of prostate cancer: a retrospective chart review in 808 French men undergoing biopsy].

We explored the characteristics of a sample of men who had undergone a biopsy in clinical practice in France and evaluated initial treatment choice in men with a positive biopsy.



This was a multi-centre, retrospective chart review including men who had undergone a biopsy in France. Clinical variables were collected using an electronic data capture system.



Eight hundred and eight men were included; 632 men (78%) had an initial biopsy and 176 men (22%) had one or more repeat biopsy. The mean age was 64 years and 9% of men were 75 years or more. The mean (median) PSA was 11.6 (7.0) ng/mL; 25% of men had a PSA greater than 10 ng/mL. Twenty-eight percent of men had a suspicious DRE. A total of 52% of men had a positive initial and 26% a positive repeat biopsy. One hundred and eleven patients (34%) had low-risk PCa (stage T1c-2a, PSA<10 ng/mL, Gleason sum<7) and 195 (59%) were at intermediate/high risk of disease progression. The most common treatment was radical therapy (54% of patients), even in men with low-risk PCa (40% of patients). A total of 38% of low-risk patients chose active surveillance.



The French biopsy sample appeared to be at a relatively high risk of having PCa at initial biopsy. Radical therapy was the most common treatment choice in men with a positive biopsy. In patients with low-risk PCa, radical therapy and active surveillance were used most often and to the same extent.
The geriatric cancer experience at the end of life: testing an adapted model.

To test an adapted end-of-life conceptual model of the geriatric cancer experience and provide evidence for the validity and reliability of the model for use in practice and research.



Nonexperimental and cross-sectional using baseline data collected within 24-72 hours of admission to hospice.



Two hospices in the southeastern United States.


SAMPLE
403 hospice homecare patients; 56% were men and 97% were Caucasian with a mean age of 77.7 years.



Confirmatory factor analyses using structural equation modeling with AMOS statistical software.



Clinical status; physiologic, psychological, and spiritual variables; and quality of life (QOL).



A three-factor model with QOL as an outcome variable showed that 67% of the variability in QOL is explained by the patient's symptom and spiritual experiences.



As symptoms and associated severity and distress increase, the patient's QOL decreases. As the spiritual experience increases (the expressed need for inspiration, spiritual activities, and religion), QOL also increases.



The model supports caring for the physical and metaphysical dimensions of the patient's life. It also highlights a need for holistic care inclusive of physical, emotional, and spiritual domains.
Oral hydration and alkalinization is noninferior to intravenous therapy for prevention of contrast-induced nephropathy in patients with chronic kidney disease.

Contrast-induced nephropathy (CIN) is the third leading cause of all cases of hospital-acquired renal failure and contributes to poorer outcomes; in particular, length of hospital stay, fiveand threefold increase in mortality at hospital discharge and at 1 year, and potential dialysis that adds to further reduced outcomes.1–4 Of concern, 14.5% of patients undergoing cardiac catheterization develop CIN and reports have illustrated 50% incidence in high-risk patients; therefore, accurate risk stratification and management are necessary.1,3 Until novel contrast agents become available, the mainstay of CIN management is prevention. Current prevention strategies have focused on renal vasodilators including fenoldapam, low-dose dopamine, calcium-channel antagonists, atrial natriuretic peptide, N-acetylcysteine (NAC), and adenosine antagonists; however, these have not proved superior to preand postprocedure intravenous saline hydration.5–8 A recent study illustrated 11.9% reduced incidence of CIN in patients treated with intravenous saline and intravenous sodium bicarbonate versus intravenous saline alone; however, the protocol involved 8 hours of perioperative intravenous therapy.9 Although prevention
Cost-effectiveness of cardiac rehabilitation program delivery models in patients at varying cardiac risk, reason for referral, and sex.

Little is known about the relative cost-effectiveness of different secondary prevention cardiac rehabilitation (CR) program designs or how cost-effectiveness is influenced by patient clinical and demographic characteristics. The purpose of the study was (i) to evaluate the incremental cost-effectiveness of a standard 3-month CR program (SCR) versus a program distributed over 12 months (distributed CR, DCR); and (ii) to determine the effect of patient demographic characteristics (cardiac risk, cardiac diagnosis, sex) on incremental cost-effectiveness.



A two group cost-effectiveness analysis was conducted alongside a randomized controlled trial. Patients with coronary artery disease (mean age=58 years, SD+/-10) were randomized to either SCR (n=196) or DCR (n=196) and followed for 24 months. Program delivery costs, cardiac healthcare use, morbidity, mortality, and quality-adjusted life years were assessed. Cost-effectiveness was evaluated with incremental cost-utility analysis.



In the pooled analysis, we found the probability of SCR being more cost-effective than DCR was 63-67%. The subanalysis found SCR to be the more cost-effective intervention for patients at high risk, patients with previous coronary artery bypass graft and for male patients. The DCR program was more cost-effective for patients with lower risk of disease progression and for female patients.



Differences were noted in the cost-effectiveness of CR models based on cardiac risk level, reason for referral, and demographic characteristics. Our results suggest improved cost-effectiveness may be gained by triaging patients to different CR intervention models, however, further investigation is required.
Performance of a previously validated CT colonography computer-aided detection system in a new patient population.

A computer-aided detection (CAD) system with high sensitivity in the detection of adenomatous polyps in varied CT colonography (CTC) data sets increases the utility of CAD in the clinical setting. The purpose of this study was to evaluate the standalone performance of an existing CAD system with a new set of CTC data from screening patients at an institution and geographic location different from those at which the CAD system was trained.



CTC data were collected from the records of 104 patients undergoing screening for colorectal neoplasia. Most of the patients were at average risk, had CTC findings suggestive of polyps, and underwent colonoscopy. Patients underwent cathartic bowel preparation, were given an oral contrast agent, and underwent imaging in the prone and supine positions. The patients had 86 adenomas confirmed at same-day optical colonoscopy; 47 of these tumors were 10 mm in diameter or larger, and 39 measured 6-9 mm. The CTC data were analyzed with an existing CAD system for colonography that was trained with previously acquired data. In a previous non-polyp-enriched screening cohort, the standalone performance of the CAD system was 93.3% (28/30) sensitivity for adenomatous polyps 10 mm or larger, 51.1% (47/92) sensitivity for adenomas 6-9 mm, and a mean false-positive rate of 8.6 per patient. Sensitivity comparisons were made with findings in the previous study.



The CAD system had per-polyp sensitivities of 91.5% (43/47; 95% CI, 78.7-97.2%; p = 1.0) for adenomas 10 mm or larger and 82.1% (32/39; 65.9-91.9%; p = 0.0009) for adenomas 6-9 mm. The per-patient sensitivities were 97.6% (40/41; 85.6-99.9%; p = 0.6) for patients with adenomas 10 mm or larger and 82.4% (28/34; 64.8-92.6%; p = 0.047) for patients with adenomas 6-9 mm. The mean and median false-positive rates were 9.6 +/- 9.6 and 7.0 per patient, respectively. Common reasons for CAD misses (false-negative findings) were the presence of adherent contrast medium, flat adenomas, and adenomas located on or adjacent to normal colonic folds. In a random sample, 72.5% (29/40) of false-positive findings were attributable to folds or residual feces.



The CAD system evaluated has a high level of performance in the detection of adenomatous polyps with CTC data from a polyp-enriched cohort different from that used to train the system.
A comparison of the clinical effectiveness and costs of mental health nurse supplementary prescribing and independent medical prescribing: a post-test control group study

Supplementary prescribing for mental health nurses was first introduced in the UK in 2003. Since then, a number of studies have reported stakeholders' perceptions of the success of the initiative. However, there has been little experimental research conducted into its effectiveness. This paper reports findings from the first known study to compare the cost and clinical impact of mental health nurse supplementary prescribing to independent medical prescribing.



A post-test control group experimental design was used to compare the treatment costs, clinical outcomes and satisfaction of patients in receipt of mental health nurse supplementary prescribing with a matched group of patients in receipt of independent prescribing from consultant psychiatrists. The sample comprised 45 patients in receipt of mental health nurse supplementary prescribing for a minimum of six months and a matched group (by age, gender, diagnosis, and chronicity) of patients prescribed for by psychiatrists.



There were no significant differences between patients in the nurse supplementary prescribers' group and the independent prescribers' group in terms of medication adherence, health status, side effects, and satisfaction with overall care. Total costs per patient for service use were 803 pounds higher for the nurse prescribers' group but this difference was not significant (95% confidence interval--1341 pounds to 3020 pounds).



No significant differences were found between the health and social outcomes of patients in the mental health nurse supplementary prescribers' group, and those prescribed for by the independent medical prescribers. The cost appraisal also showed that there was no significant difference in the costs of the two types of prescribing, although the pattern of resources used differed between patients in the two prescriber groups. The results suggest that mental health nurse supplementary prescribers can deliver similar health benefits to patients as consultant psychiatrists without any significant difference in patients' service utilisation costs.
Combined thalidomide and cyclophosphamide treatment for refractory or relapsed multiple myeloma patients: a prospective phase II study

Thalidomide is an effective agent for patients with refractory multiple myeloma (MM) with a response rate of 30–40% at doses of 200–800 mg but with considerable side effects. We questioned whether lower doses of thalidomide in combination with a daily dose of cyclophosphamide might be an effective regimen with fewer side effects. We included 38 patients with relapsed or refractory MM. The median doses of thalidomide and cyclophosphamide were 100 and 95 mg/day, respectively. Side effects were observed in all patients, with neurotoxicity as the most troublesome. With a median follow-up of 14 months 84% of the patients responded, including 64% partial responses. The median time of progression-free survival was 30 months and the median overall survival time was 20 months. In conclusion, the results demonstrate that the combination of low-dose thalidomide with a daily dose of cyclophosphamide is an effective regimen with a high overall response rate and manageable side effects.