nils-herrmann/clean_scirepeval huggingface dataset:
Altered postural responses persist following physical therapy of general versus specific trunk exercises in people with low back pain.

Interventions that target trunk muscle impairments in people with LBP have been promoted; however, the treatment effects on muscle activation impairments during postural tasks remain unclear. Thus, our objective was to evaluate the effects trunk stabilization vs. general strength and conditioning exercises on the automatic postural response in persons with chronic low back pain (LBP). Fifty-eight subjects with chronic, recurrent LBP (n = 58) (i.e., longer than six months) were recruited and randomly assigned to one of two, 10-week physical therapy programs: stabilization (n = 29) or strength and conditioning (n = 29). Pain and function were measured at 11 weeks and 6 months post-treatment initiation. To quantify postural following support surface perturbations, surface electrodes recorded electromyography (EMG) of trunk and leg muscles and force plates recorded forces under the feet, to calculate the center of pressure. Both groups demonstrated significant improvements in pain and function out to 6 months. There were also changes in muscle activation patterns immediately post-treatment, but not at 6 months. However, changes in center of pressure (COP) responses were treatment specific. Following treatment, the stabilization group demonstrated later onset of COP displacement, while the onset of COP displacement in the strengthening group was significantly earlier following treatment. Despite two different treatments, clinical improvements and muscle activation patterns were similar for both groups, indicating that the stabilization treatment protocol does not preferentially improve treatment outcomes or inter-muscle postural coordination patterns for persons with LBP.
Motivation to change substance use among offenders of domestic violence.

Substance use alone leads to increased rates of violence, reduction in adherence to treatment regimes, and other negative psychiatric sequelae. Given the high rates of co-occurring substance use and family violence-related problems, substance use was assessed among offenders of domestic violence who were mandated by court to attend anger management classes. Rates of substance dependence diagnoses ranged from 33 to 50%, while rates of substance abuse diagnoses ranged from 60 to 75%. This study evaluated the effectiveness of a motivational enhancement intervention on readiness to change substance use. Two anger management groups were targeted to assess substance use, violence, and motivation to change substance use behaviors. One group was randomly chosen to partake in a motivational enhancement intervention session. The comparison group was offered standard anger management classes. Forty-one clients were evaluated for substance abuse and dependence diagnosis using criteria from the Diagnostic and Statistical Manual of Mental Disorders, 4th ed. A brief motivation to change survey, adapted from the Readiness to Change subscale of the Stages of Change Readiness and Treatment Eagerness Scale was administered pre- and postsession. Results indicate that a motivational enhancement intervention is feasible and effective in increasing readiness to change substance use among domestic violence offenders. The results illustrate the importance of assessing and treating substance use among offenders of domestic violence, as this may be an important indicator for higher dropout rates and reoffenses among this population.
Kilovoltage rotational external beam radiotherapy on a breast computed tomography platform: a feasibility study.

To demonstrate the feasibility of a dedicated breast computed tomography (bCT) platform to deliver rotational kilovoltage (kV) external beam radiotherapy (RT) for partial breast irradiation, whole breast irradiation, and dose painting.



Rotational kV-external beam RT using the geometry of a prototype bCT platform was evaluated using a Monte Carlo simulator. A point source emitting 178 keV photons (approximating a 320-kVp spectrum with 4-mm copper filtration) was rotated around a 14-cm voxelized polyethylene disk (0.1 cm tall) or cylinder (9 cm tall) to simulate primary and primary plus scattered photon interactions, respectively. Simulations were also performed using voxelized bCT patient images. Beam collimation was varied in the x-y plane (1-14 cm) and in the z-direction (0.1-10 cm). Dose painting for multiple foci, line, and ring distributions was demonstrated using multiple rotations with varying beam collimation. Simulations using the scanner's native hardware (120 kVp filtered by 0.2-mm copper) were validated experimentally.



As the x-y collimator was narrowed, the two-dimensional dose profiles shifted from a cupped profile with a high edge dose to an increasingly peaked central dose distribution with a sharp dose falloff. Using a 1-cm beam, the cylinder edge dose was <7% of the dose deposition at the cylinder center. Simulations using 120-kVp X-rays showed distributions similar to the experimental measurements. A homogeneous dose distribution (<2.5% dose fluctuation) with a 20% decrease in dose deposition at the cylinder edge (i.e., skin sparing) was demonstrated by weighted summation of four dose profiles using different collimation widths. Simulations using patient bCT images demonstrated the potential for treatment planning and image-guided RT.



Rotational kV-external beam RT for partial breast irradiation, dose painting, and whole breast irradiation with skin sparing is feasible on a bCT platform with the potential for high-resolution image-guided RT.
Induction of a chronic disease state in patients with smoldering or indolent multiple myeloma by targeting interleukin 1{beta}-induced interleukin 6 production and the myeloma proliferative component.

To conduct in vitro studies as well as a phase 2 clinical trial in patients with smoldering or indolent multiple myeloma to determine if interleukin 1 (IL-1) inhibitors can delay or prevent active myeloma.



Stromal cells were cocultured with IL-1beta-expressing myeloma cells in the presence of dexamethasone, IL-1 receptor antagonist (IL-1Ra), or both. Levels of interleukin 6 (IL-6) and of apoptosis were also quantified. Between November 19, 2002, and May 24, 2007, 47 patients were enrolled in the study and subsequently treated with IL-1Ra. In 25 (53%) of the 47 study patients, low-dose dexamethasone (20 mg/wk) was added. The primary end point was progression-free survival (PFS).



In vitro, IL-1Ra was superior to dexamethasone at inhibiting IL-6 production; maximal IL-6 inhibition and apoptosis induction were achieved by addition of both IL-1Ra and dexamethasone. In the clinical trial, 3 patients achieved a minor response to IL-1Ra alone; 5 patients achieved a partial response and 4 patients a minor response after addition of dexamethasone. Seven patients showed a decrease in the plasma cell labeling index that paralleled a decrease in high-sensitivity C-reactive protein (hs-CRP) levels. The median overall PFS was 37.5 months. The median PFS for patients without (n=12) or with (n=35) a greater than 15% decrease in 6-month vs baseline hs-CRP levels was 6 months and more than 3 years, respectively (P=.002). Disease stability was maintained in 8 patients who received therapy for more than 4 years.



In patients with smoldering or indolent multiple myeloma who were at risk of progression to active myeloma, treatment with IL-1 inhibitors decreased the myeloma proliferative rate and hs-CRP levels in those who responded, leading to a chronic disease state and an improved PFS.
Treatment of Female Veterans with Posttraumatic Stress Disorder: The Role of Comfort in a Predominantly Male Environment

This study examines the role of women's comfort in coming for treatment of posttraumatic stress disorder in a predominantly male environment. Consecutive admissions (N = 224) to the Department of Veterans Affairs (VA)'s Women's Stress Disorder Treatment Teams were enrolled in an outcome study from July 1998 through June 2000. Women reported that they were somewhat comfortable in coming to the VA for their mental health care. For women who had no prior experience with the VA, comfort increased with their exposure to the treatment program. Further, for this group of women, comfort level was related significantly to their commitment to working in therapy and the regularity of their attendance in treatment over time. There were no significant changes in comfort level for women who had prior contact with the VA. Comfort level was unrelated to satisfaction and only minimally related to clinical outcomes. The primary role of women's comfort level, therefore, appeared to be as a facilitator of their participation in the therapeutic process.
Comparative effectiveness of macrolides and quinolones for patients hospitalized with acute exacerbations of chronic obstructive pulmonary disease (AECOPD).

Meta-analyses of randomized trials have found that antibiotics are effective in acute exacerbations of chronic obstructive pulmonary disease (AECOPD), but there is insufficient evidence to guide antibiotic selection. Current guidelines offer conflicting recommendations.



To compare the effectiveness of macrolides and quinolones for  Retrospective cohort study using logistic regression, propensity score-matching, and grouped treatment models.



A total of 375 acute care hospitals throughout the United States.



Age > or =40 years and hospitalized for AECOPD.



Macrolide or quinolone antibiotic begun in the first 2 hospital days.



Treatment failure (defined as the initiation of mechanical ventilation after hospital day 2, inpatient mortality, or readmission for AECOPD within 30 days), length of stay, and hospital costs.



Of the 19,608 patients who met the inclusion criteria, 6139 (31%) were treated initially with a macrolide and 13,469 (69%) with a quinolone. Compared to patients treated initially with a quinolone, those who received macrolides had a lower risk of treatment failure (6.8% vs. 8.1%; P < 0.01), a finding that was attenuated after multivariable adjustment (odds ratio [OR], 0.89; 95% confidence interval [CI], 0.78-1.01), and disappeared in a grouped-treatment analysis (OR, 1.01; 95% CI, 0.75-1.35). There were no differences in adjusted length of stay (ratio, 0.98; 95% CI, 0.97-1.00) or adjusted cost (ratio, 1.00; 95% CI, 0.99-1.02). After propensity score-matching, antibiotic-associated diarrhea was more common with quinolones (1.2% vs. 0.6%; P < 0.001).



Macrolide and quinolone antibiotics are associated with similar rates of treatment failure in AECOPD; however, macrolides are less frequently associated with diarrhea.
Phenobarbitone prophylaxis of intraventricular haemorrhage.

Thirty preterm infants (birthweight under 1500 g) were treated with phenobarbitone to examine its effectiveness in reducing the incidence of intraventricular haemorrhage (IVH), the control group comprising 28 infants. The treated group had 57% incidence of IVH and mortality of 13% compared with 68% and 14%, respectively, in controls.
Direct comparison of rest and adenosine stress myocardial perfusion CT with rest and stress SPECT.

We have recently described a technique for assessing myocardial perfusion using adenosine-mediated stress imaging (CTP) with dual source computed tomography. SPECT myocardial perfusion imaging (SPECT-MPI) is a widely utilized and extensively validated method for assessing myocardial perfusion. The aim of this study was to determine the level of agreement between CTP and SPECT-MPI at rest and under stress on a per-segment, per-vessel, and per-patient basis.



Forty-seven consecutive patients underwent CTP and SPECT-MPI. Perfusion images were interpreted using the 17 segment AHA model and were scored on a 0 (normal) to 3 (abnormal) scale. Summed rest and stress scores were calculated for each vascular territory and patient by adding corresponding segmental scores.



On a per-segment basis (n = 799), CTP and SPECT-MPI demonstrated excellent correlation: Goodman-Kruskall gamma = .59 (P < .0001) for stress and .75 (P < .0001) for rest. On a per-vessel basis (n = 141), CTP and SPECT-MPI summed scores demonstrated good correlation: Pearson r = .56 (P < .0001) for stress and .66 (P < .0001) for rest. On a per-patient basis (n = 47), CTP and SPECT-MPI demonstrated good correlation: Pearson r = .60 (P < .0001) for stress and .76 (P < .0001) for rest.



CTP compares favorably with SPECT-MPI for detection, extent, and severity of myocardial perfusion defects at rest and stress.
An Internet-based technique for the identification of persons with symptoms of inflammatory polyarthritis of less than 12 weeks

Identifying persons with early rheumatoid arthritis (RA) is a major challenge. The role of the Internet in making decisions about seeking care has not been studied. We developed a method for early diagnosis and referral using the Arthritis Foundation’s website. A person with less than 3 months of joint pain symptom who has not yet sought medical attention was screened. Prescreened persons are linked to a self-scoring questionnaire and get a “likelihood” of RA statement. If “likely,” the person is offered a free evaluation and biomarker testing performed by Quest Diagnostics. The system available only to Massachusetts’s residents yielded a small steady flow of screen-positive individuals. Over 21 months, 43,244 persons took the Arthritis Foundation website prescreening questionnaire; 196 were from Massachusetts and 60 took the self-scoring algorithm. Of the 48 who screened positive, 29 set up an appointment for a free evaluation, but six never came in. Twenty-four subjects were evaluated and diagnosed independently by three rheumatologists. One met the 1987 American College of Rheumatology (ACR) criteria for RA and two met the 2010 ACR/EULAR RA criteria. The 24 examined individuals were contacted at a minimum of 1 year and asked to redo the case-finding questionnaire and asked about their health resource utilization during the interval. Seventeen of the 24 subjects responded, and 10 had seen a health professional. Three of the 17 had a diagnosis of RA; all were on at least methotrexate. Internet case finding was useful in identifying new potential RA cases. The system’s performance characteristics are theoretically limited only by the number of study sites available. However, the major barrier may be that seeing a health professional is not a priority for many individuals with early symptoms.
A randomized controlled trial on the benefits and respiratory adverse effects of morphine for refractory dyspnea in patients with COPD: Protocol of the MORDYC study.

Dyspnea is one of the most reported symptoms of patients with advanced Chronic Obstructive Pulmonary Disease (COPD) and is often undertreated. Morphine has proven to be an effective treatment for dyspnea and is recommended in clinical practice guidelines, but questions concerning benefits and respiratory adverse effects remain. This study primarily evaluates the impact of oral sustained release morphine (morphine SR) on health-related quality of life and respiratory adverse effects in patients with COPD. Secondary objectives include the impact on exercise capacity, the relationship between description and severity of dyspnea and the presence of a clinically relevant response to morphine, and cost-effectiveness. A single-center, randomized, double blind, placebo controlled intervention study will be performed in 124 patients with COPD who recently completed a comprehensive pulmonary rehabilitation program. Participants will receive 20-30 mg/24h morphine SR or placebo for four weeks. After the intervention, participants will be followed for twelve weeks. Outcomes include: the COPD Assessment Test, six minute walking test, Multidimensional Dyspnea Scale and a cost diary. Furthermore, lung function and arterial blood gasses will be measured. These measures will be assessed during a baseline and outcome assessment, two home visits, two phone calls, and three follow-up assessments. The intervention and control group will be compared using uni- and multivariate regression analysis and logistic regression analysis. Finally, an economic evaluation will be performed from a societal and healthcare perspective. The current manuscript describes the rationale and methods of this study and provides an outline of the possible strengths, weaknesses and clinical consequences.
Surface EMG analysis and changes in gait following electrical stimulation of quadriceps femoris and tibialis anterior in children with spastic cerebral palsy

To evaluate the clinical feasibility and effect of neuromuscular electrical stimulation (NMES) therapy of quadriceps femoris (QF) and tibialis anterior (TA) muscles on improving gait and functional outcomes in children with spastic cerebral palsy (CP).  Ten children with spastic diplegic/hemiplegic CP who were in the age group of 7 to 14 years recruited from a rehabilitation institute were randomly assigned either to a control group or a NMES group. Both groups obtained conventional physiotherapy and muscle strengthening exercises. The NMES group in addition received surface electrical stimulation to QF and TA muscles for four weeks duration.  The NMES group showed significant improvements as compared to the control group in walking speed (mean difference: 7.83 meters per min, 95% confidence interval: 3.13 to 12.53, p<;60;0.01) and cadence (mean difference: 23.33 steps per min, 95% confidence interval: 5.90 to 40.77, p<;60;0.01). The NMES group also showed significant reduction in physiological cost index of walking or PCI (mean difference: -1.32 beats per meter, 95% confidence interval: -1.83 to -0.80, p<;60;0.001) indicating greater energy-efficiency of walking. No significant changes were seen in EMG parameters.  The findings of this study suggests that NMES therapy together with conventional physiotherapy more efficiently improves walking ability and functional outcomes as compared to conventional physiotherapy alone in children with spastic CP.
Designing storytelling technologies to encouraging collaboration between young children

We describe the iterative design of two collaborative storytelling technologies for young children, KidPad and the Klump. We focus on the idea of designing interfaces to subtly encourage collaboration so that children are invited to discover the added benefits of working together. This idea has been motivated by our experiences of using early versions of our technologies in schools in Sweden and the UK. We compare the approach of encouraging collaboration with other approaches to synchronizing shared interfaces. We describe how we have revised the technologies to encourage collaboration and to reflect design suggestions made by the children themselves.
Effects of antiepileptic drugs on bone mineral density and bone metabolism in children: A meta-analysis

The aim of our meta-analysis was to assess the effects of antiepileptic drugs on bone mineral density and bone metabolism in epileptic children. Searches of PubMed and Web of Science were undertaken to identify studies evaluating the association between antiepileptic drugs and bone mineral density and bone metabolism. A total of 22 studies with 1492 subjects were included in our research. We identified: (1) a reduction in bone mineral density at lumbar spine (standardized mean difference (SMD)=−0.30, 95% confidence interval (CI) [−0.61, −0.05]), trochanter (mean difference (MD)=−0.07, 95% CI [−0.10, −0.05]), femoral neck (MD=−0.05, 95% CI [−0.09, −0.02]), and total body bone mineral density (MD=−0.33, 95% CI [−0.51, −0.15]); (2) a reduction in 25-hydroxyvitamin D (MD=−3.37, 95% CI [−5.94, −0.80]) and an increase in serum alkaline phosphatase (SMD=0.71, 95% CI [0.38, 1.05]); (3) no significant changes in serum parathyroid hormone, calcium, or phosphorus. Our meta-analysis suggests that treatment with antiepileptic drugs may be associated with decreased bone mineral density in epileptic children. 癫痫是神经系统常见病,半数以上患者儿童时期便发病,癫痫病患者常需终身服用抗癫痫药。研究表明,长期服用抗癫痫药物会影响骨代谢,加速骨矿物质的丢失,导致骨质疏松。但是,每种抗癫痫药物的具体作用还不清楚。作为典型的肝酶诱导剂的抗癫痫药物,卡马西平已经公认有降低骨密度的作用,但是作为非肝酶诱导剂的丙戊酸钠,还没有定论。在新型抗癫痫药物中,奥卡西平、托吡酯和拉莫三嗪等对骨密度似乎没有影响,但目前相关的研究很少,各研究所得结果也不一致。本研究拟通过荟萃分析评估抗癫痫药对癫痫病儿童骨密度和骨代谢的影响。 目前已有荟萃分析评估抗癫痫药对成人骨密度的影响,但尚无研究分析抗癫痫药对儿童的影响。 检索PubMed 和Web of Science 数据库中评估抗癫痫药与儿童骨密度及骨代谢关系的临床试验。入选标准为:(1)至少包括一项骨代谢的标志物;(2)骨密度用双能×线吸收计量法计算;(3)研究结果包括平均的骨密度和骨密度的标准差;(4)年龄小于18 岁;(5)患者采用单药或多药治疗;(6)具有健康对照组;(7)必须是观察性研究或随机对照研究。采用固定效应模型和随机效应模型对22 篇文献的1492 例患者中的骨密度及骨代谢资料进行荟萃分析,结果用加权均数差(WMD)或标准均数差(SMD)进行评估。 共22 篇文献符合纳入标准,共计1492 例患者。荟萃分析的结果显示,抗癫痫药物的使用可以引起儿童:(1)腰椎、转子、股骨颈的骨密度和全身骨密度的下降;(2)维生素D 下降和血清碱性磷酸酶的上升;(3)甲状旁腺激素、钙和磷没有显著改变。荟萃分析的结果表明,抗癫痫药的使用可能和癫痫病患儿骨密度降低相关。
Natural killer cells and lymphocytes increase in women with breast cancer following massage therapy.

Women diagnosed with breast cancer received massage therapy or practiced progressive muscle relaxation (PMR) for 30-min sessions 3 times a week for 5 weeks or received standard treatment. The massage therapy and relaxation groups reported less depressed mood, anxiety, and pain immediately after their first and last sessions. By the end of the study, however, only the massage therapy group reported being less depressed and less angry and having more vigor. Dopamine levels, Natural Killer cells, and lymphocytes also increased from the first to the last day of the study for the massage therapy group. These findings highlight the benefit of these complementary therapies, most particularly massage therapy, for women with breast cancer.
Relationship between disease severity and quality of life and assessment of health care utilization and cost for ulcerative colitis in Australia: a cross-sectional, observational study.

The burden of ulcerative colitis (UC) in relation to disease severity is not well documented. This study quantitatively evaluated the relationship between disease activity and quality of life (QoL), as well as health care utilization, cost, and work-related impairment associated with UC in an Australian population.



A cross-sectional, noninterventional, observational study was performed in patients with a wide range of disease severity recruited during routine specialist consultations. Evaluations included the Assessment of Quality of Life-8-dimension (AQoL-8D), EuroQol 5-dimension, 5-level (EQ-5D-5L), the disease-specific Inflammatory Bowel Disease Questionnaire (IBDQ), and the Work Productivity and Activity Impairment (WPAI) instrument. The 3-item Partial Mayo Score was used to assess disease severity. Health care resource utilization was assessed by chart review and patient questionnaires.



In 175 patients, mean (SD) AQoL-8D and EQ-5D-5L scores were greater for patients in remission (0.80 [0.19] and 0.81 [0.18], respectively) than for patients with active disease (0.70 [0.20] and 0.72 [0.19], respectively, both Ps<0.001). IBDQ correlated with both AQoL-8D (r=0.73; P<0.0001) and EQ-5D-5L (0.69; P<0.0001). Mean 3-month UC-related health care cost per patient was AUD $2914 (SD=$3447 [mean for patients in remission=$1970; mild disease=$3736; moderate/severe disease=$4162]). Patients in remission had the least work and activity impairment.



More severe UC disease was associated with poorer QoL. Substantial health care utilization, costs, and work productivity impairments were found in this sample of patients with UC. Moreover, greater disease activity was associated with greater health care costs and impairment in work productivity and daily activities.