nils-herrmann/clean_scirepeval huggingface dataset:
Clinical assessment of topiramate therapy in patients with migrainous vertigo.

To assess the efficacy of topiramate in reducing both the frequency and the severity of vertigo and headache attacks in patients with migrainous vertigo and to compare 50 and 100 mg/day doses of the drug.



Thirty patients diagnosed as definite migrainous vertigo were recruited in the study. Vertigo and headache frequency was determined as the monthly number of attacks whereas severity was determined by visual analog scales measured in millimeters from 0 to 100. Patients were randomized to either 50 or 100 mg/day topiramate for 6 months. Vertigo and headache frequency and severity were evaluated at the end of the study period.



Number of mothly vertigo attacks decreased significantly in the overall group after treatment (median from 5.5 to 1; P < .01). The same was true for monthly headache attacks (median from 4 to 1; P < .01). A statically significant improvement in vertigo severity was noted (median from 80 to 20 mm; P < .01). Headache severity showed significant improvement as well (median from 60 to 30 mm; P < .01). No statistically significant difference between high- and low-dose groups was present regarding efficacy (P > .05). Four patients in the high-dose group discontinued treatment at the end of the first month because of adverse effects.



In the overall group, topiramate was found to be effective in reducing the frequency and the severity of vertigo and headache attacks. Both doses of the drug were equally efficacious. The 50 mg/day dose seems to be appropriate as higher adverse effects were noted when 100 mg/day was used.
Effects of testosterone replacement therapy on skeletal muscle after spinal cord injury

Randomized control. To examine the effects of testosterone replacement therapy (TRT) on skeletal muscle 11 weeks after complete SCI.Setting: Athens, Georgia USA.Methods: Soleus (SOL), gastrocnemius (GA), tibialis anterior (TA), vastus lateralis (VL) and triceps brachii (TRI) muscles were taken from twelve young male Charles River rats 11 weeks after complete SCI (T-9 transection, n=8) or sham surgery (n=4). Rats received either TRT (two 5 cm capsules, n=4) or empty capsules (n=8) implanted at surgery. Muscle samples were sectioned and fibers analyzed qualitatively for myosin ATPase and quantitatively for succinate dehydrogenase (SDH), α-glycerol-phosphate dehydrogenase (GPDH) and actomyosin ATPase (qATPase) activities using standard techniques. SCI decreased average fiber size (49±4%) in affected muscles and the percentage of slow fibers in SOL (93±3% to 17±2%). In addition, there was a decrease in SDH and an increase in GPDH and qATPase activities across the four hind-limb muscles of the SCI animals. Fiber size in the TRI was increased (31±2%) by SCI while enzyme activities were not altered. Average fiber size across the four hind limb muscles was decreased by only 30% in TRT SCI animals and their SOL contained 39±2% slow fibers. TRT also attenuated changes in enzyme activities. There was no effect of TRT on the TRI relative to SCI.Conclusions: TRT was effective in attenuating alterations in myofibrillar proteins during 11 weeks of SCI in affected skelatal muscles. Supported by a grant from The National Institutes of Health (HD-33738) and HD-37645 to KV, and HD-39676 to GAD.
Efficacy and Safety of Infliximab Therapy and Predictors of Response in Korean Patients with Crohn's Disease: A Nationwide, Multicenter Study

Infliximab is currently used for the treatment of active Crohn's disease (CD). We aimed to assess the efficacy and safety of infliximab therapy and to determine the predictors of response in Korean patients with CD.



A total of 317 patients who received at least one infliximab infusion for active luminal CD (n=198) and fistulizing CD (n=86) or both (n=33) were reviewed retrospectively in 29 Korean referral centers. Clinical outcomes of induction and maintenance therapy with infliximab, predictors of response, and adverse events were evaluated.



In patients with luminal CD, the rates of clinical response and remission at week 14 were 89.2% and 60.0%, respectively. Male gender and isolated colonic disease were associated with higher remission rates at week 14. In week-14 responders, the probabilities of sustained response and remission were 96.2% and 93.3% at week 30 and 88.0% and 77.0% at week 54, respectively. In patients with fistulizing CD, clinical response and remission were observed in 85.0% and 56.2% of patients, respectively, at week 14. In week-14 responders, the probabilities of sustained response and remission were 94.0% and 97.1%, respectively, at both week 30 and week 54. Thirty-nine patients (12.3%) experienced adverse events related to infliximab. Serious adverse events developed in 19 (6.0%) patients including seven cases of active pulmonary tuberculosis.



Infliximab induction and maintenance therapy are effective and well tolerable in Korean patients with luminal and fistulizing CD. However, clinicians must be aware of the risk of rare yet critical adverse events.
Diagnostic value of the blind brush in mechanically ventilated patients with nosocomial pneumonia

To check on the accuracy of a new protected blind brush (BB) inserted through an endotracheal tube to collect respiratory secretions to be used in the diagnosis of nosocomial pneumonia (NP) in ventilated patients. Prospective study of patients who had undergone both BB and plugged telescoping catheter via fiberoptic bronchoscopy (PTC-FB) sample collection sessions. Intensive Care Unit of a referral-based University HospitalPatients: All patients (n=37) mechanically ventilated for more than 3 days with clinical and radiological criteria of NP between July 1990 and March 1991.Interventions: Randomized BB and PTC-FB sample collection sessions carried out less than 30 min apart.Measurements and main results: The two sampling procedures resulted in similar findings with both cultures either negative or positive and identified the same organism and colonies in 31 patients (83.7%). Agreement was 90% when the patients with right or bilateral pulmonary infiltrates were grouped together and 100% when only the right field was considered. Complications arising from BB sampling were much lower than those from the conventional PTC-FB technique. Our results, pending confirmation by other prospective studies, indicate that BB sampling is useful in the diagnosis of NP in ventilated patients with radiological evidence of either right or bilateral pulmonary infiltrates and that it could stand in for PTC-FB in ICU settings where this procedure is not available.
Catecholamine-resistant hypotension and myocardial performance following patent ductus arteriosus ligation

We performed a multicenter study of preterm infants, who were about to undergo patent ductus arteriosus ligation, to determine whether echocardiographic indices of impaired myocardial performance were associated with subsequent development of catecholamine-resistant hypotension following ligation.A standardized treatment approach for hypotension was followed at each center. Infants were considered to have catecholamine-resistant hypotension if their dopamine infusion was >15 μg kg–1min–1. Echocardiograms and cortisol measurements were obtained between 6 and 14 h after the ligation (prior to the presence of catecholamine-resistant hypotension).Result:Forty-five infants were enrolled, 10 received catecholamines (6 were catecholamine-responsive and 4 developed catecholamine-resistant hypotension). Catecholamine-resistant hypotension was not associated with decreased preload, shortening fraction or ventricular output. Infants with catecholamine-resistant hypotension had significantly lower levels of systemic vascular resistance and postoperative cortisol concentration.We speculate that low cortisol levels and impaired vascular tone may have a more important role than impaired cardiac performance in post-ligation catecholamine-resistant hypotension.
Two medical abortion regimens for late first-trimester termination of pregnancy: a prospective randomized trial.

Medical abortion regimens based on the use of either misoprostol alone or in association with mifepristone have shown high efficacy and excellent safety profile in early pregnancy abortion. However, no clear recommendation is available for late first-trimester termination of pregnancy.



A prospective randomized controlled trial included 122 women seeking medical abortion at 9 to 12 weeks of gestation. Seventy-three patients were given a fixed protocol of 200 mg of mifepristone followed 48 h later by 400 mcg oral misoprostol (Group 1). The second group of 49 patients was administered 800-mcg intravaginal single-dose misoprostol (Group 2). This study sought to compare safety, efficacy and acceptability of these two nonsurgical abortion regimens.



Fifty-nine (80.8%) women in Group 1 had complete abortion vs. 38 (77.4%) women in Group 2 (p=.66). Abdominal pain was observed significantly more often in Group 2 (35/49 (71.4%) vs. 32/73 (43.8%) in Group 1, p<.0001. Medical abortion was equally acceptable among the two groups [37/49 (75.5%) and 55/73 (75.7%), p=.89].



For late first-trimester termination, a single 800-mcg vaginal dose of misoprostol seems to be as effective as the mifepristone+misoprostol regimen, with acceptable side effects.
Linguistic validation of a disease-specific quality of life measure for children and teenagers with cardiac disease.

To anglicise an American--that is, English language--disease-specific health-related quality of life measure, using the Paediatric Cardiac Quality of Life Inventory, for children in the age group of 8-12 years and adolescents in the age group of 13-18 years with cardiac disease, and to assess conceptual equivalence of the American and British versions.



A process of forward and backward translation of the measure was undertaken before focus groups and individual interviews with 40 participants--that is, 20 children/adolescents with cardiac disease and 20 parents of children/adolescents with cardiac disease--to determine their understanding of the meaning of the questions.



Interviews established that participants understood the meaning of the questions, although some found it difficult to explain the meaning of questions in which the language was explicit and wanted instead to answer the individual questions as they applied to them/their child. There was agreement that all versions of the questionnaire were relevant and comprehensive, and that the length of the questionnaires was acceptable and practical.



The anglicised version of the Paediatric Cardiac Quality of Life Inventory appears to be a linguistically valid measure of health-related quality of life for children and adolescents with cardiac disease. The psychometric properties of the anglicised Paediatric Cardiac Quality of Life Inventory are now being tested in a multi-centre study in the United Kingdom.
Value of age, creatinine, and ejection fraction (ACEF score) in assessing risk in patients undergoing percutaneous coronary interventions in the 'All-Comers' LEADERS trial.

The age, creatinine, and ejection fraction (ACEF) score (age/left ventricular ejection fraction+1 if creatinine >2.0 mg/dL) has been established as an effective predictor of clinical outcomes in patients undergoing elective coronary artery bypass surgery; however, its utility in "all-comer" patients undergoing percutaneous coronary intervention is yet unexplored.



The ACEF score was calculated for 1208 of the 1707 patients enrolled in the LEADERS trial. Post hoc analysis was performed by stratifying clinical outcomes at the 1-year follow-up according to ACEF score tertiles: ACEF(low) ≤1.0225, 1.0225< ACEF(mid) ≤1.277, and ACEF(high) >1.277. At 1-year follow-up, there was a significantly lower number of patients with major adverse cardiac event-free survival in the highest tertile of the ACEF score (ACEF(low)=92.1%, ACEF(mid)=89.5%, and ACEF(high)=86.1%; P=0.0218). Cardiac death was less frequent in ACEF(low) than in ACEF(mid) and ACEF(high) (0.7% vs 2.2% vs 4.5%; hazard ratio=2.22, P=0.002) patients. Rates of myocardial infarction were significantly higher in patients with a high ACEF score (6.7% for ACEF(high) vs 5.2% for ACEF(mid) and 2.5% for ACEF(low); hazard ratio=1.6, P=0.006). Clinically driven target-vessel revascularization also tended to be higher in the ACEF(high) group, but the difference among the 3 groups did not reach statistical significance. The rate of composite definite, possible, and probable stent thrombosis was also higher in the ACEF(high) group (ACEF(low)=1.2%, ACEF(mid)=3.5%, and ACEF(high)=6.2%; hazard ratio=2.04, P<0.001).



ACEF score may be a simple way to stratify risk of events in patients treated with percutaneous coronary intervention with respect to mortality and risk of myocardial infarction.
Characterizing the usability of interactive applications through query log analysis

People routinely rely on Internet search engines to support their use of interactive systems: they issue queries to learn how to accomplish tasks, troubleshoot problems, and otherwise educate themselves on products. Given this common behavior, we argue that search query logs can usefully augment traditional usability methods by revealing the primary tasks and needs of a product's user population. We term this use of search query logs CUTS - characterizing usability through search. In this paper, we introduce CUTS and describe an automated process for harvesting, ordering, labeling, filtering, and grouping search queries related to a given product. Importantly, this data set can be assembled in minutes, is timely, has a high degree of ecological validity, and is arguably less prone to self-selection bias than data gathered via traditional usability methods. We demonstrate the utility of this approach by applying it to a number of popular software and hardware systems.
Vagus nerve stimulation in children with refractory seizures associated with Lennox-Gastaut syndrome.

Vagus nerve stimulation (VNS) is approved for use for refractory partial seizures. Nevertheless, information regarding VNS therapy for special populations, including Lennox-Gastaut syndrome (LGS) is limited. We discuss the effectiveness, tolerability, and safety of VNS therapy in patients with LGS.



A six-center, retrospective study evaluated the effectiveness of VNS therapy in patients with LGS at 3 and 6 months and compared preimplant and postimplant seizure frequency. Adverse effects and quality of life (QOL) were included as secondary measures.



Fifty patients, median age 13 years, with medically refractory epilepsy, were implanted. Median age at onset of seizures was 1.4 years, and a median of nine anticonvulsants (AEDs) had been tried before implantation. Data-collection forms were designed for retrospectively gathering data on each patient's preimplant history, seizures, implants, device settings, QOL, and adverse events. Median reductions in total seizures were 42% at 1 month, 58.2% at 3 months, and 57.9% at 6 months. The most common adverse events reported were voice alteration and coughing during stimulation. Other uncommon adverse events included increased drooling and behavioral changes. Investigators noted that QOL had improved for some patients in the study.



VNS is an effective treatment for medically refractory epilepsy in LGS. This treatment is well tolerated, safe, and may improve QOL.
Intracellular sodium and the response to nitrendipine or atenolol in African blacks.

The relationship between the hypotensive effect of nitrendipine (N), 20 mg/day (n = 17), or atenolol (A), 100 mg/day (n = 17), and the erythrocyte sodium [( Na]i) and potassium [( K]i) concentrations was investigated in hypertensive African blacks during a randomized double-blind study. After 6 weeks, both treatments significantly reduced supine and standing blood pressures; however, the magnitude of the decrease in supine systolic (-22.0 +/- 2.0 vs -12.1 +/- 3.4 mm Hg) and diastolic (-14.1 +/- 1.3 vs -7.6 +/- 2.1 mm Hg) pressures and in standing diastolic pressure (-16.0 +/- 1.7 vs -9.2 +/- 2.0 mm Hg) was more pronounced (p less than 0.05) in the N-treated than in the A-treated group. Pulse rate, plasma aldosterone, and plasma renin activity were lower (p less than 0.05) in the A-treated patients. Neither treatment had significant influence on [Na]i, [K]i, or ouabain-sensitive sodium efflux. The N-induced changes in supine systolic and diastolic pressure correlated (p less than 0.05) with age (r = -0.65 and r = -0.58, respectively) and pretreatment plasma renin activity (r = 0.71). Multiple regression analysis demonstrated a negative association between pretrial [Na]i and the change in systolic pressure during N treatment that was independent of age, pretreatment blood pressure, and change in pulse rate. Age and the change in supine pulse rate were also independently correlated with the change in diastolic pressure during N treatment. The results show a greater antihypertensive efficacy of N than A in the patients entered in this study and suggest that a higher intracellular sodium concentration could predict a better hypotensive response to N.
Selektive dorsale Dekompression der degenerativen Zervikalstenose

Auslöser einer therapiebedürftigen zentralen Zervikalstenose kann eine Hypertrophie des dorsalen Bandapparats sein. Für derartige Stenosen stellen selektive Dekompressionsoperationen ohne Stabilisation und Fusion u. U. eine ausreichende Alternative dar. Vorgelegt wird eine Beobachtungsstudie an 17 Patienten, die mit einer selektiven Flavektomie und einem „undercutting“ der Laminae und medialen Gelenkportionen behandelt wurden. Verglichen wurden die Parameter Japanese-Orthopedic-Association(JOA)-Score, Neck Pain Disability Index (NPDI) und Arm- sowie Nackenschmerz auf der visuellen Analogskala (VAS) prä- und postoperativ bis zum medianen Nachuntersuchungsintervall von 14 Monaten (Minimum 12 Monate). Das Ausmaß der Dekompression und der Nachbarsegmentdegeneration wurde mittels MRT bestimmt. Die segmentale und regionale Lordose sowie der Range of Motion (ROM) HWK2–7 prä- und postoperativ wurden mit der Cobb-Methode anhand seitlicher HWS-Röntgenaufnahmen bestimmt. Die Behandlung verlief in allen 17 Fällen komplikationslos, es mussten keine Revisionen vorgenommen werden. Alle klinischen Parameter besserten sich von präoperativ bis zum letzten Kontrollzeitpunkt signifikant. Bildmorphologisch ergaben sich in allen Fällen eine signifikante Reduktion der Stenose und keine Zunahme der Myelopathie (im T2-MRT). Die sagittalen Parameter blieben ebenso wie der Schweregrad der Nachbarsegmentdegeneration unverändert. Die klinischen und radiologischen Ergebnisse dieser Nonfusionstechnik sind für diese spezielle Indikation mindestens konkurrenzfähig zu den publizierten Ergebnissen der Laminektomie und Fusion sowie zur Laminoplastie. Hypertrophy of the dorsal ligaments is one reason for central stenosis of the cervical spinal canal. Selective decompression techniques without stabilization and fusion could be a sufficient alternative surgical treatment option. This article presents the results of an observational study on 17 patients after treatment with selective decompression and undercutting of the cervical laminae and medial joint portion. The Japanese Orthopedic Association (JOA) score, the neck pain disability index (NPDI) and arm and neck pain on a visual analogue scale (VAS) were compared preoperatively and postoperatively (mean follow-up period was 14 months, minimum 12 months). The reduction of the stenosis and degree of adjacent level disease were measured using presurgical and postsurgical magnetic resonance imaging (MRI). The segmental and regional lordosis and range of motion were determined using the Cobb method on plain standing lateral radiographs. There were no complications and no revision surgery was necessary. All clinical parameters improved significantly. The stenosis was significantly decompressed and no progression of myelopathy was observed on MRI. The sagittal parameters and degree of adjacent level degeneration remained unchanged. The clinical and radiological results of this non-fusion technique are convincing. Selective decompression is therefore an alternative to laminectomy and fusion as well as laminoplasty.
Cross-correlation of instantaneous phase increments in pressure-flow fluctuations: applications to cerebral autoregulation.

We investigate the relationship between the blood flow velocities (BFV) in the middle cerebral arteries and beat-to-beat blood pressure (BP) recorded from a finger in healthy and post-stroke subjects during the quasisteady state after perturbation for four different physiologic conditions: supine rest, head-up tilt, hyperventilation, and CO2 rebreathing in upright position. To evaluate whether instantaneous BP changes in the steady state are coupled with instantaneous changes in the BFV, we compare dynamical patterns in the instantaneous phases of these signals, obtained from the Hilbert transform, as a function of time. We find that in post-stroke subjects the instantaneous phase increments of BP and BFV exhibit well-pronounced patterns that remain stable in time for all four physiologic conditions, while in healthy subjects these patterns are different, less pronounced, and more variable. We propose an approach based on the cross-correlation of the instantaneous phase increments to quantify the coupling between BP and BFV signals. We find that the maximum correlation strength is different for the two groups and for the different conditions. For healthy subjects the amplitude of the cross-correlation between the instantaneous phase increments of BP and BFV is small and attenuates within 3-5 heartbeats. In contrast, for post-stroke subjects, this amplitude is significantly larger and cross-correlations persist up to 20 heartbeats. Further, we show that the instantaneous phase increments of BP and BFV are cross-correlated even within a single heartbeat cycle. We compare the results of our approach with three complementary methods: direct BP-BFV cross-correlation, transfer function analysis, and phase synchronization analysis. Our findings provide insight into the mechanism of cerebral vascular control in healthy subjects, suggesting that this control mechanism may involve rapid adjustments (within a heartbeat) of the cerebral vessels, so that BFV remains steady in response to changes in peripheral BP.
Clinical observation on trigonella foenum-graecum L. total saponins in combination with sulfonylureas in the treatment of type 2 diabetes mellitus.

To evaluate the efficacy and safety of trigonella foenum-graecum L. total saponins (TFGs) in combination with sulfonylureas (SU) in the treatment of patients with type 2 diabetes mellitus (T2DM) not well controlled by SU alone.



Sixty-nine T2DM patients whose blood glucose levels were not well controlled by oral sulfonylureas hypoglycemic drug were randomly assigned to the treated group (46 cases) and the control group (23 cases), and were given TFGs or placebo three times per day, 6 pills each time for 12 weeks, respectively. Meanwhile, the patients continued taking their original hypoglycemic drugs. The following indexes, including effects on traditional Chinese medicine (TCM) symptoms, fast blood glucose (FBG), 2-h post-prandial blood glucose (2h PBG), glycosylated hemoglobin (HbA1c), clinical symptomatic quantitative scores (CSQS), body mass index (BMI), as well as hepatic and renal functions, were observed and compared before and after treatment.



The efficacy on TCM symptoms was obviously better in the treated group than that in the control group (P<0.01), and there were statistically remarkable decreases in aspect of FBG, 2h PBG, HbA1c and CSQS in the treated group as compared to those in the control group (P<0.05 or P<0.01), while no significant difference was found in BMI, hepatic and renal functions between the two groups (P>0.05).



The combined therapy of TFGs with sulfonylureas hypoglycemic drug could lower the blood glucose level and ameliorate clinical symptoms in the treatment of T2DM, and the therapy was relatively safe.