nils-herrmann/clean_scirepeval huggingface dataset:
Importance of Aspergillus spp. isolation in Acute exacerbations of severe COPD: prevalence, factors and follow-up: the FUNGI-COPD study

Acute exacerbations of COPD (AECOPD) are often associated with infectious agents, some of which may be non-usual, including Aspergillus spp. However, the importance of Aspergillus spp. in the clinical management of AECOPD still remains unclear.



The aims of the study were to analyze the prevalence and risk factors associated with Aspergillus spp. isolation in AECOPD, and to investigate the associated clinical outcomes during a 1-year follow-up period.



Patients presenting with an AECOPD requiring hospitalization were prospectively included from four hospitals across Spain. Clinical, radiological and microbiological data were collected at admission and during the follow-up period (1, 6 and 12 months after discharge), and re-admissions and mortality data collected during the follow-up.



A total of 240 patients with severe AECOPD were included. Valid sputum samples were obtained in 144 (58%) patients, and in this group, the prevalence of Aspergillus spp. isolation was 16.6% on admission and 14.1% at one-year follow-up. Multivariate logistic-regression showed that AECOPD in the previous year (OR 12.35; 95% CI, 1.9-29.1; p < 0.001), concurrent isolation of pathogenic bacteria (OR 3.64; 95% CI 1.65-9.45, p = 0.001) and concomitant isolation of Pseudomonas aeruginosa (OR 2.80; 95% IC, 1.81-11.42; p = 0.001) were the main risk factors for Aspergillus spp. isolation.



The main risk factors for Aspergillus spp. isolation were AECOPD in the previous year and concomitant isolation of Pseudomonas aeruginosa. However, although Aspergillus spp. is often isolated in sputum samples from patients with AECOPD, the pathogenic and clinical significance remains unclear.
Measuring Primary Care Organizational Capacity for Diabetes Care Coordination: The Diabetes Care Coordination Readiness Assessment

Not all primary care clinics are prepared to implement care coordination services for chronic conditions, such as diabetes. Understanding true capacity to coordinate care is an important first-step toward establishing effective and efficient care coordination. Yet, we could identify no diabetes-specific instruments to systematically assess readiness and/or status of primary care clinics to engage in diabetes care coordination. This report describes the development and initial validation of the Diabetes Care Coordination Readiness Assessment (DCCRA), which is intended to measure primary care clinic readiness to coordinate care for adult patients with diabetes. The instrument was developed through iterative item generation within a framework of five domains of care coordination: Organizational Capacity, Care Coordination, Clinical Management, Quality Improvement, and Technical Infrastructure. Validation data was collected on 39 primary care clinics. Content validity, inter-rater reliability, internal consistency, and construct validity of the 49-item instrument were assessed. Inter-rater agreement indices per item ranged from 0.50 to 1.0. Cronbach’s alpha of the entire instrument was 0.964, and for the five domain scales ranged from 0.688 to 0.961. Clinics with existing care coordinators were rated as more ready to support care coordination than clinics without care coordinators for the entire DCCRA and for each domain, supporting construct validity. As providers increasingly attempt to adopt patient-centered approaches, introduction of the DCCRA is timely and appropriate for assisting clinics with identifying gaps in provision of care coordination services. The DCCRA’s strengths include promising psychometric properties. A valid measure of diabetes care coordination readiness should be useful in diabetes program evaluation, assistance with quality improvement initiatives, and measurement of patient-centered care in research.
A prospective, randomized trial comparing lymphoblastoid to recombinant interferon alfa 2a as therapy for chronic hepatitis C.

To compare the long-term effectiveness and tolerability of lymphoblastoid interferon (IFN-alphaN1) and recombinant interferon alfa 2a (IFN-alpha2a) in patients with chronic hepatitis caused by hepatitis C virus (HCV), 234 consecutive patients with HCV-related chronic hepatitis were randomized prospectively to receive titrated doses (starting dose = 6 million units [MU]) of IFN-alpha2a (n = 118) or IFN-alphaN1 (n = 116) for 12 months. HCV RNA was detected by reverse-transcription polymerase chain reaction (RT-PCR), quantified by branched-DNA (bDNA) assay, and genotyped by reverse hybridization assay. Thirty-one patients in the IFN-alpha2a group and 28 in the IFN-alphaN1 group (total, 59 [25%] had normal transaminases and undetectable HCV RNA by RT-PCR after 12 months of therapy, but only 19 in the first group and 20 in the second group (total, 39 [17%]) had biochemical and virological responses 12 months after treatment was discontinued. The two treatment groups differed in terms of prevalence of major drug-related adverse reactions (23% vs. 37%, P = .025). The mean total dose per patient was similar for the two groups, i.e., 502 MU IFN-alpha2a vs. 496 MU IFN-alphaN1, and the cost of each sustained response was $31,800 and $32,440, respectively. By multivariate analysis, pretreatment viremia higher than 0.2 MEq/mL and infection with genotype 1 were independently associated to treatment failure. The outcome of treatment in chronic hepatitis C patients was not improved by the administration of high cumulative doses of lymphoblastoid IFN.
Clinical efficacy of web-based versus standard asthma self-management.

Guided self-management is an important component of asthma care. Most trials have evaluated paper-based strategies. The effectiveness of new communication technologies remains uncertain.



To compare the feasibility and clinical outcomes of a standard paper-based asthma self-management strategy with web-based strategies.



In a crossover trial, 21 patients using inhaled corticosteroids and long-acting B2-agonists (mean [SD] age 29  years) were randomly assigned to use a sequence of web-based and paper-based diary and action plan. Quality of life, asthma control, lung function, and airway inflammation were assessed using the Asthma Life Quality Questionnaire (ALQ), Asthma Control Questionnaire (ACQ-5), Mini Asthma Quality of Life Questionnaire (Mini AQLQ), and office spirometry. The ratio of forced expiratory volume in the first second of expiration (FEV1) to peak expiratory flow (PEF) rate (PiKo-1) and fraction of exhaled nitric oxide (FE(NO)) were monitored. The main clinical outcomes were asthma control and FE(NO). Quality of data and adherence to monitoring tools were the main process outcomes.



Significant improvements were observed in the AQL and ACQ scores, although lung function did not change. FE(NO) was significantly reduced only after a web-based strategy but a significant period effect occurred (P = .006). There were no differences in clinical outcomes between web-based and paper-based management. No intervention-related adverse effects were observed. Adherence seemed higher with the paper-based strategy (P < .001). However, paper data were unreliable when compared to automatic daily electronic FEV1/PEF records. Twelve patients were very interested in continuing self-management with the web-based approach compared with 2 in using paper tools (P = .002).



Web-based management was feasible, safe, and preferred by patients. Short-term outcomes were at least as good, and data quality was improved.
Fever phobia in Korean caregivers and its clinical implications.

Fever is the most common complaint among children brought into the emergency department (ED). 'Fever phobia' is a descriptive term for an unrealistic concern about the consequences of fever. 'Fever phobia' is prevalent among parents and even healthcare providers, worldwide. The aim of this study was to determine the implications of fever-phobic ideas in Korean caregivers. A prospective, multi-center survey was conducted on Korean caregivers who visited the EDs with febrile children. In total, 746 caregivers were enrolled. The mean age of the subjects was 34.7 yr (SD±5.0). Three hundred sixty respondents (48.3%) believed that the body temperature of febrile children can reach higher than 42.0℃. Unrealistic concerns about the improbable complications of fever, such as brain damage, unconsciousness, and loss of hearing/vision were believed by 295 (39.5%), 66 (8.8%), and 58 (7.8%) caregivers, respectively. Four hundred ninety-four (66.2%) guardians woke children to give antipyretics. These findings suggest that fever phobia is a substantial burden for Korean caregivers.
Phase II study of capecitabine and cisplatin combination as first-line chemotherapy in Chinese patients with metastatic nasopharyngeal carcinoma

Cisplatin combined with 5-fluorouracil (5-Fu) is widely used in the management of advanced nasopharyngeal carcinoma (NPC). However, catheters and pumps are necessary for the continuous infusion of 5-Fu, which add to the cost, immobility and inconvenience of treatment. Capecitabine, an oral fluoropyrimidine, is a potentially more active and more convenient substitute to 5-Fu. A phase II study was conducted to evaluate the efficacy and safety of a capecitabine and cisplatin combination in metastatic NPC. In the multicenter, open-label, single-arm phase II study, patients with metastatic NPC who previously received no palliative chemotherapy were enrolled. Patients received oral capecitabine (1,000 mg/m2 twice daily from day 1 to 14) and intravenous cisplatin (80 mg/m2, day1) every 3 weeks. A total of 48 patients were enrolled and included in the intention-to-treat analysis of efficacy and adverse events. There were 3 patients (6.3%) with complete response and 27 patients (56.3%) with partial response, giving an overall response rate of 62.5% (95% CI, 49.1–76.4%). The median duration of response in the 30 responding patients was 7.5 months (range 1.4–22.4 months). With a median follow-up period of 13.3 months (range 2.3–50 months), the median time to progression and median overall survival for all patients were 7.7 months (95% CI, 6.3–9.2 months) and 13.3 months (95% CI, 9.4–17.2 months), respectively. Toxicities were moderate and manageable. Grade 3/4 toxicities included neutropenia (14.6%), anemia (4.2%) and thromocytopenia (2.1%), nausea (8.3%), vomiting (10.4%), diarrhea (8.3%), stomatitis (6.3%) and hand–foot syndrome (HFS) (4.2%). The combination of capecitabine and cisplatin is active and well tolerated as a first-line therapy for patients with metastatic NPC.
A comparison of human and model observers in multislice LROC studies

Model and human observers have been compared in a series of localization receiver operating characteristic (LROC) studies involving single-slice and multislice image displays. The task was detection of Ga-avid lymphomas within single photon emission computed tomography (SPECT)-reconstructed transverse slices of a mathematical phantom, and the studies involved four reconstruction strategies: the filtered-backprojection (FBP) and ordered-subset expectation-maximization (OSEM) algorithms with two- and three-dimensional postreconstruction filtering. The human-observer data was drawn from studies performed by Wells et al. (2000), while multiclass versions of the nonprewhitening (NPW), channelized nonprewhitening (CNPW), and channelized Hotelling (CH) model observers, each capable of performing the tumor search task, were applied. The channelized observers were evaluated with multiple square-channel models and both with and without internal noise. For the multislice studies, two different capacities for integrating the slice information were also tested. The CH observer gave good quantitative agreement with the human data from both image-display studies when the internal-noise model was used. The CNPW observer performed similarly with the iterative strategies. Wells et al. had shown that human observers are imperfect integrators of multislice information, and this is characterized as increased internal noise with the model observers.
A phase I/II trial combining high-dose melphalan and autologous transplant with bortezomib for multiple myeloma: a dose- and schedule-finding study.

We did a randomized phase I/II trial designed to evaluate the safety and efficacy of combining the proteasome inhibitor bortezomib with high-dose melphalan as the conditioning for high-dose therapy and autologous transplant for myeloma.



Enrolled patients were limited to those who did not achieve a very good partial remission (VGPR) following one or more induction regimens, and were randomized to receive a single escalating dose of bortezomib (1.0, 1.3, or 1.6 mg/m(2)) either 24 hours before or 24 hours after high-dose melphalan. Dose escalation was based on the escalation with overdose control (EWOC), a Bayesian statistical model. Bone marrow aspirates were collected before initiation of therapy and at the time of transplant to evaluate which sequence resulted in maximal plasma cell apoptosis, and response to transplant was assessed by the International Myeloma Working Group criteria.



Among 39 randomized patients, 20 received bortezomib after melphalan and 19 received bortezomib before melphalan. Toxicities and posttransplant hematopoietic recovery rates were similar between arms. The overall response rate for all patients was 87%, with 51% achieving a VGPR or better. Pharmacodynamic studies showed greater plasma cell apoptosis among patients who received bortezomib following melphalan.



The use of bortezomib in conjunction with high-dose melphalan is safe, with data suggesting improved efficacy. A single dose of bortezomib administered after high-dose melphalan is the recommended dose and schedule for future clinical investigation.
Clinical conditions and central dopamine metabolism in alcoholics during acute withdrawal under treatment with different pharmacological agents

A group of 45 male alcoholics were studied during acute withdrawal. Patients were kept in hospital and treated with amobarbital (15 patients), oxazepam (15 patients), and melperone (15 patients) respectively in a double-blind design. Clinical symptoms were rated with a modified version of the Comprehensive Psychopathological Rating Scale after 1, 4 and 7 days. Blood pressure, body temperature and pulse rate were also recorded. Lumbar cerebrospinal fluid was collected after 1 and 7 days. A group of healthy males served as controls. The three treatment groups showed only small differences with regard to the investigated clinical items, except for a higher incidence of epileptic fits being evidenced in the melperone group. Levels of HVA in the cerebrospinal fluid did not differ between the treatment groups and the controls and did not change during treatment. Statistically significant correlations were noted between levels of HVA and auditory and visual hallucinations as well as concentration difficulties. Assuming that HVA levels reflect the activity of the central nervous dopamine system, the findings indicate a connection between central dopamine metabolism, psychotic symptoms and possibly other symptoms during acute alcohol withdrawal in man.
Partial enumeration of solutions traces for the problem of sorting by signed reversals

Traditional algorithms to solve the problem of sorting by signed reversals output just one optional solution while the space of optimal solutions can be huge. Algorithms for enumerating the complete set of solutions traces were developed aiming to support biologists studies of alternative evolutionary scenarios. Due to the exponential complexity of the algorithms, their practical use is limited to small permutations. In this work, we propose and evaluate three different approaches to producing a partial enumeration of the complete set of traces to transform a given permutation to another one.
Acute and chronic stress exposure predicts 1-year recurrence in adult outpatients with residual depression symptoms following response to treatment.

One of the strongest predictors of depression recurrence in those who respond to treatment is the presence of residual depressive symptoms. Our goal was to examine stressful life event exposure as a mechanism of recurrence in previously depressed patients with residual depression symptoms. That is, we predicted that higher levels of residual symptoms will significantly predict exposure to acute life events that will then heighten prospective recurrence risk.



Participants included 68 adult outpatients with major depression (42 women; age 18-60) who completed a 12-month naturalistic follow-up after achieving remission in a 20-week randomized, open label trial of interpersonal psychotherapy, cognitive-behavioral therapy, or antidepressant medication. Depression recurrence was defined as the reemergence of an episode of major depression as determined by structured interview. Acute life events and chronic stressors were assessed at the end of follow-up using a contextual interview.



Posttreatment depression scores significantly prospectively predicted an increased risk for recurrence, and acute life events in the follow-up period. Cox regression survival analyses modeling life events as time-dependent covariates showed that life event exposure mediated the relation of residual symptoms to recurrence even controlling for chronic stress.



Our findings implicate residual symptoms in heightening depression recurrence risk through exposure to stressful life events. Depression recurrence adds significantly to the burden of the disorder. Therefore, rigorous follow-up of patients targeting the stressful context has the potential to prevent a lifelong pattern of illness.
FLU-ID (fludarabine and idarubicin) regimen as salvage therapy in pretreated low-grade non-Hodgkin's lymphoma.

Fludarabine (FLU) is a new antimetabolite chemotherapeutic agent with promising activity in lymphoproliferative disorders and, in particular, in low-grade non-Hodgkin's lymphoma (LG-NHL). Recently, a few reports have described interesting results using FLU in polychemotherapy regimens. In order to evaluate FLU in combination with other antineoplastic agents, we used a combination of FLU and idarubicin, called the FLU-ID regimen, to treat 10 patients with recurrent LG-NHL. The FLU-ID regimen was as follows: FLU 25 mg/sqm i.v. on days 1 to 3 and idarubicin 12 mg/sqm i.v. on day 1. Of the 10 patients, 2 (20%) achieved complete response (CR), 5 (50%) partial response, and the remaining 3 showed no benefit from the treatment. The 2 CR patients are still in remission after 6 and 8 months, respectively. The median duration of overall survival of all patients was 8 months. The major toxic effects observed were neutropenia (40%) and infections and/or febrile episodes (15%); no fatalities due to drug side effects occurred. These results indicate the efficacy of the FLU-ID regimen in inducing a good remission rate with moderate side effects in recurrent LG-NHL.
A comparison of dual vs. triple antiplatelet therapy in patients with non-ST-segment elevation acute coronary syndrome: results of the ELISA-2 trial.

To compare dual vs. triple antiplatelet pre-treatment in patients with non-ST-elevation acute coronary syndrome (NSTE ACS) who were planned for early catheterization.



A total of 328 consecutive patients with NSTE ACS were included and were randomized to pre-treatment with dual (n = 166, aspirin, clopidogrel 600 mg) or triple antiplatelet therapy (n = 162, aspirin, clopidogrel 300 mg, and Tirofiban). The primary endpoint was enzymatic infarct size, defined as cumulative LDH release (LDHQ(48)). Initial TIMI flow of the culprit vessel was a pre-specified secondary endpoint. Angiography was performed in 98% of patients at a median of 23 h after admission. Enzymatic infarct size (median, 25-75%) was 166 (60-349) IU/L in the triple group compared with 193 (75-466) IU/L in the dual group (P = 0.2). Initial TIMI 3 flow of the culprit vessel was significantly more often observed after triple antiplatelet therapy (67 vs. 47%, P = 0.002). At 30 days follow-up, myocardial infarction (MI) occurred in 46% of patients in the triple antiplatelet group, compared with 57% in the dual antiplatelet group, P = 0.052. No significant difference in bleeding was present.



This study showed that in patients with NSTE ACS, triple antiplatelet pre-treatment was associated with a non-significant reduction in enzymatic infarct size, a significantly better initial perfusion of the culprit vessel, and a trend towards a better survival without death or MI. Further, large-scale studies should be performed to find whether the beneficial trend in favour of triple antiplatelet pre-treatment can be reproduced.
Equity in the use of antiretroviral treatment in the public health care system in urban South Africa.

The scaling up of antiretroviral treatment (ART) for HIV-infected adults requires a sizeable investment of resources in the South African public health care system. It is important that these resources are used productively and in ways that reach those in need, irrespective of social status or personal characteristics. In this study we evaluate whether the distribution of ART services in the public system reflects the distribution of need among adults in the urban population.



Data from a 2008 national survey were used to estimate the distribution of socioeconomic status (SES) and sex in HIV-positive adults in urban areas. These findings were compared to SES and sex distributions in 635 ART users within 6 urban public ART facilities.



Close to 40% of those with HIV are in the lowest SES quintile, while 67% are women. The distributions in users of ART are similar to these distributions in HIV-positive people.



Patterns of ART use in study settings correspond to patterns of HIV in the urban population at the national level. This suggests that the South African ART programme is on track to ensure equitable delivery of treatment services in urban settings.