nils-herrmann/clean_scirepeval huggingface dataset:
Discharge home after acute stroke: Differences between older and younger patients.

To identify determinants for discharge destination of older (≥ 70 years) and younger (< 70 years) acute stroke patients.



Multicentre prospective cohort.



A total of 395 patients, within 7 days of clinically evaluated stroke, were included from 6 hospital stroke units.



The main outcome measure was discharge destination (home vs clinical rehabilitation). Independent variables were: demographic factors, stroke characteristics, functional impairments and disabilities, cognition, comorbidity, and premorbid social participation. Multivariate logistic regression analysis established the independent strength of the contribution of possible determinants to discharge destination.



Seventy-six percent of younger patients were discharged home, compared with 63% of older patients. Most of the younger patients discharged to clinical rehabilitation (71%) had a spouse, whereas only 40% of the older age group discharged to clinical rehabilitation had a spouse. Multivariate analysis showed that, besides National Institutes of Health Stroke Scale and Barthel Index scores, having a spouse was an important determinant for discharge home in the older age group (adjusted odds ratio 4.77, 95% confidence interval 2.01-11.31), but not in the younger age group.



The presence of a spouse is an additional important factor determining discharge home in older stroke patients. It is important to monitor and support informal caregivers in order to provide appropriate care for older community-dwelling stroke patients.
Olsalazine in maintenance of clinical remission in patients with ulcerative colitis

Frequent minor side effects are associated with sulfasalazine. The realization that it is the 5-aminosalicylic acid moiety that is the active component of sulfasalazine and that the side effects are probably due to the sulfapyridine has prompted the search for a similar but safer compound. Olsalazine, consisting of two molecules of 5-ASA without sulfasalazine may avoid the problems due to sulfasalazine. One hundred one patients were entered into a double-blind placebo-controlled study of the use of olsalazine 92 g daily) in preventing relapse in patients who had recently recovered from an acute attack of ulcerative colitis. Patients were treated for 12 months. Forty-nine were randomized to olsalazine (39 with limited and 10 with extensive disease) and 52 to placebo (42 with limited and 10 with extensive disease). Life-table analysis showed that the median time to relapse in patients on olsalazine was 342 days, which was significantly longer than the 100 days in the placebo group (P=0.024). The most important side effect experienced with olsalazine that necessitated withdrawal from the study was “drug-induced diarrhea” in 16% (8/49). There was a similar incidence of minor side effects reported in the two groups, and in no patients were major or dangerous side effects reported. In patients who did not develop diarrhea, olsalazine was well tolerated and successfully prevented rapid relapse in the recently ill patients entered into this study.
Long-term therapeutic outcome of ophthalmic complications following endoscopic sinus surgery

Ophthalmic complications associated with endoscopic sinus surgery (ESS) are quite rare. There is a paucity of reliable data and limited experience on the clinical findings and treatments of these injuries. Our study here is to characterize the types of orbital injury following ESS, in particular extraocular muscle injury, and to evaluate the long-term therapeutic outcomes as compiled from a relatively large sample of Chinese patients.A series of 27 patients (21 males and 6 females; mean age = 42.6 years, ranges: 10-60 years) were retrospectively reviewed. The mean duration of orbital complication was 6.6 months (ranges: 1 day to 24 months). The right eye was affected in 19 patients and the left in 8 patients. All patients had various extraocular muscle dysfunction, including contusion, oculomotor nerve damage, muscle entrapment, muscle transection, and muscle destruction. All patients subjected to strabismus surgery showed an obvious reduction in deviation. Three patients achieved orthophoria without any surgery during the period of observation. All patients displayed mild to complicated orbital hemorrhage that often disappeared within 2 weeks. Optic nerve injury occurred in 29.6% of patients and vision damage in these patients was often irreversible.All patients with ophthalmic complications after ESS had strabismus and extraocular muscle dysfunction. Timing and type of strabismus surgery performed depended on the severity and number of muscles involved as well as the type of injury. This surgery is less effective in cases of restriction factor adhesion and/or entrapment as compared to that of patients with other types of strabismus. Orbital hemorrhages were usually resolved spontaneously, but optic nerve injury was mostly irreversible.
Prospective , Randomized Trial of 5-Fluorouracil , Leucovorin , Doxorubicin , and Cyclophosphamide Chemotherapy in Combination With the Interleukin-3 / Granulocyte-Macrophage Colony-Stimulating Factor ( GM-CSF ) Fusion Protein ( PIXY 321 ) Versus GM-CSF in Patients With Advanced Breast Cancer

We conducted a prospective randomized trial t o evaluate the ability of the interleukin-3/granulocyte-macrophage colonystimulating factor (GM-CSF) fusion protein, PIXY321, t o ameliorate cumulative thrombocytopenia after multiple cycles of 5-fluorouracil, leucovorin, doxorubicin, cyclophosphamide (FLAC) chemotherapy compared with GM-CSF in patients with advanced breast cancer. Fifty-three patients were randomized t o receive either PIXY321, 375 pg/m2 twice a day subcutaneously, or GM-CSF, 250 pg/m2daily subcutaneously after FLAC chemotherapy. PIXY321 was less well tolerated than GM-CSF, with more patients developing chills and local skin reactions and more patients stopping PIXY321 due to intolerance. While no difference in the neutrophil nadirs was seen with the two cytokines, the duration of the abso-
Sample Size Requirements for Studies of Treatment Effects on Beta-Cell Function in Newly Diagnosed Type 1 Diabetes

Preservation of β-cell function as measured by stimulated C-peptide has recently been accepted as a therapeutic target for subjects with newly diagnosed type 1 diabetes. In recently completed studies conducted by the Type 1 Diabetes Trial Network (TrialNet), repeated 2-hour Mixed Meal Tolerance Tests (MMTT) were obtained for up to 24 months from 156 subjects with up to 3 months duration of type 1 diabetes at the time of study enrollment. These data provide the information needed to more accurately determine the sample size needed for future studies of the effects of new agents on the 2-hour area under the curve (AUC) of the C-peptide values. The natural log(x), log(x+1) and square-root (√x) transformations of the AUC were assessed. In general, a transformation of the data is needed to better satisfy the normality assumptions for commonly used statistical tests. Statistical analysis of the raw and transformed data are provided to estimate the mean levels over time and the residual variation in untreated subjects that allow sample size calculations for future studies at either 12 or 24 months of follow-up and among children 8-12 years of age, adolescents (13-17 years) and adults (18+ years). The sample size needed to detect a given relative (percentage) difference with treatment versus control is greater at 24 months than at 12 months of follow-up, and differs among age categories. Owing to greater residual variation among those 13-17 years of age, a larger sample size is required for this age group. Methods are also described for assessment of sample size for mixtures of subjects among the age categories. Statistical expressions are presented for the presentation of analyses of log(x+1) and √x transformed values in terms of the original units of measurement (pmol/ml). Analyses using different transformations are described for the TrialNet study of masked anti-CD20 (rituximab) versus masked placebo. These results provide the information needed to accurately evaluate the sample size for studies of new agents to preserve C-peptide levels in newly diagnosed type 1 diabetes.
The effect of atropine on rhythm and conduction disturbances during 322 critical care intubations.

Our objectives were to describe the prevalence of arrhythmia and conduction abnormalities before critical care intubation and to test the hypothesis that atropine had no effect on their prevalence during intubation.



Prospective, observational study.



PICU and pediatric/neonatal intensive care transport.



All children of age less than 8 years intubated September 2007-2009. Subgroups of intubations with and without atropine were analyzed.



None.



A total of 414 intubations were performed in the study period of which 327 were available for analysis (79%). Five children (1.5%) had arrhythmias prior to intubation and were excluded from the atropine analysis. Atropine was used in 47% (152/322) of intubations and resulted in significant acceleration of heart rate without provoking ventricular arrhythmias. New arrhythmias during intubation were related to bradycardia and were less common with atropine use (odds ratio, 0.14 [95% CI, 0.06-0.35], p < 0.001). The most common new arrhythmia was junctional rhythm. Acute bundle branch block was observed during three intubations; one Mobitz type 2 rhythm and five ventricular escape rhythms occurred in the no-atropine group (n = 170). Only one ventricular escape rhythm occurred in the atropine group (n = 152) in a child with an abnormal heart. One child died during intubation who had not received atropine.



Atropine significantly reduced the prevalence of new arrhythmias during intubation particularly for children over 1 month of age, did not convert sinus tachycardia to ventricular tachycardia or fibrillation, and may contribute to the safety of intubation.
Concurrent validity of questions on arm, shoulder and neck symptoms of the RSI QuickScan.

The objective was to determine the concurrent validity of questions on arm, shoulder and neck symptoms of an Internet-based questionnaire. In addition, the inter-observer reliability of physical examinations by occupational physicians was investigated.



A total of 160 employees of a Dutch occupational health service were approached, of which 106 participated. Right after the assessment of arm, shoulder and neck symptoms using a self-administered questionnaire, each participant was examined by two occupational physicians. The presence of symptoms in the past 7 days was compared to the physical examinations. The participation of two occupational physicians allowed us to study also the inter-observer reliability.



Overall, the concurrent validity of the symptom questions of the questionnaire can be defined as poor to moderate with κ values between 0.16 and 0.53. Detecting the presence of symptoms (p(pos)) could be considered as moderately valid with values below 0.60, but the p(neg) shows that the concurrent validity for detecting the absence of arm, shoulder or neck symptoms can be considered sufficient with values above 0.69. The agreement between occupational physicians can, with a few exceptions, be considered as moderate with κ values below 0.60. The agreement was sufficient for detecting the absence of symptoms (p(neg) > 0.7).



The agreement between the symptom questions of the questionnaire and physical examinations of occupational physicians can be considered as poor to moderate. The results are comparable to what is generally reported in the literature. Future studies should be aimed at gaining more fundamental knowledge about the possible conceptual differences between self-reported symptoms and symptoms assessed using physical examinations. Moreover, it is advisable to improve the inter-observer reliability of physical examinations as applied in the present study.
Langzeitergebnisse zweier verschiedener Behandlungskonzepte mit HDR-Brachytherapie-Boost bei Prostatakarzinomen mit intermediärem Risiko

mit transrektalem Ultraschall (TRUS) gesteuert. Die perinealen Templates wurden während der Zeit der HDRBestrahlung auf dem Perineum mit Nähten befestigt. Die Computertomographie (CT) ermöglichte die Lagekontrolle der Nadeln. Etwaige Nadeldislokationen wurden korrigiert, bevor die endgültige CT in das Planungssystem transferiert wurde. Das klinische Zielvolumen (CTV) war die Prostata ohne zusätzliche Sicherheitssäume (CTV= Planungszielvolumen,PTV); Rektum, Blase und Urethra wurden konfiguriert. Die Verweildauer der Strahler wurde mit der Inverse-Planning-Simulation-Annealing-(IPSA-) Software optimiert. Die Verschreibungsdosis bezog sich auf die Peripherie des CTV. Es wurde angestrebt, jeweils V100> 95%, V150< 40% und V200< 14% zu halten sowie an der Urethra eine Dmax < 118% und an Blase und Rektum eine Dmax < 80% zu erreichen. Es wurde keine Androgenablation in den untersuchten Patientenkohorten durchgeführt. Bei allen Patienten wurde der initiale PSA-Wert gemessen und im ersten Jahr alle 3 Monate, in den darauffolgenden 4 Jahren alle 6 Monate und danach einmal jährlich kontrolliert. Prostatabiopsien erfolgten 2 Jahre nach der Strahlentherapie. Die Lebensqualität wurde erhoben und mittels EPIC-Score dokumentiert; therapiebedingte Nebenwirkungen gemäß den CTC Adverse Events v3.0 wurden vermerkt. Die Statistical Analysis Software 9.3 ermöglichte bewährte statistische Methoden wie ROCund AUCAnalysen, Kaplan-Meier-Auswertung und Log-Rank-Test für das Überleben, das Cox proportional Hazard Model, Hazard Ratio und 95%-Konfidenzintervall.
Validation of the Athens Insomnia Scale for screening insomnia in South Korean firefighters and rescue workers

Sleep problems are a major cause of occupational stress in firefighters and rescue workers. We evaluated the psychometric properties of the Athens Insomnia Scale (AIS) among South Korean firefighters and rescue workers. Structured clinical interviews and self-report questionnaires were administered to 221 firefighters and rescue workers. The Pittsburgh Sleep Quality Index (PSQI), Insomnia Severity Index (ISI), Epworth Sleepiness Scale (ESS), Short-Form 36-item Health Survey (SF36), and Alcohol Use Disorder Identification Test—Consumption (AUDIT-C) were used to examine convergent and divergent validity. Test–retest reliability was calculated from a subsample (n = 24). Analysis of internal consistency, factor analysis, and receiver operator characteristic curve analysis were conducted. Cronbach’s alpha was 0.88. The mean item-total correlation coefficient was 0.73. The test–retest reliability was excellent (ICC = 0.94). Significant correlations of the AIS with the PSQI, ISI, ESS, and SF36 confirmed convergent validity. Nonsignificant associations of the AIS with the AUDIT-C and socioeconomic status showed divergent validity. Factor analysis revealed a one-factor structure. For groups with different symptom severity, group-specific cutoff scores which may improve positive predictive values were suggested. The AIS may be a useful tool with good reliability and validity for screening insomnia symptoms in firefighters and rescue workers.
Mission and method: the early-nineteenth-century French public health movement

There are then, some knotty problems of overall interpretation in this work. They do not, however, detract from the immenseness of Dora Weiner's achievement, nor the debt in which she leaves us all. Following a trail blazed by Erwin Ackerknecht and later illuminated by William Coleman,  La Berge provides a full-scale analysis of the public health movement in post-Revolutionary France, and especially in the 1 830s and 1 840s. Her coverage of public health interest is exceptionally broad and researched with commendable intensity. The public and private hygiene of early nineteenth-century Paris, that laboratory of public health experimentation, as well as the city's water-supply, sewerage and waste disposal, hospitals and poor relief, food quality, patent medicines, epidemic controls, vaccination schemes, housing regulations, prostitution and wet-nursing all and more come under her microscope. The main focus of her interest is the ideology of what she calls "hygienism", and her way into this is largely prosopographical: the main actors in her story are the motley crew of physicians, administrators, enlightened philanthropists, scientists and engineers who dominated the Paris health council and who, from 1829, wrote in the pages of the Annales d 'hygiene publique et de medecine legale. This was a high-profile and self-conscious group-self-regarding too, with a strong sense of social mission. Largely shunning efforts at mobilizing public opinion, they operated in a way which evoked the enlightened "medical police" and social medicine traditions which had evolved before 1789. Compared with similar groups in western Europe at the time, Professor La Berge shows, the Paris hygienists were highly statist in their approach and tended to concentrate their efforts on influencing the administrative and legislative efforts of government. Their sense of mission was crucial, for throughout the period, they had an uphill fight against the dominant non-interventionist policies associated with laisser-faire liberalism. Professor La Berge is exceptionally thorough and helpful in showing how this group went about its task, and how they developed and elaborated the "scientific" discipline of hygienism. She is perhaps less successful in providing a broader explanatory framework to highlight their successes and their failures. For such a high-profile group with a strongly statist orientation, it is chastening to learn that by mid-century, their only real legislative success was a (largely unenforced) child labour law. Though it is true that Napoleon III implemented many of the policies with which their names had been associated, La Berge is not …
First-line sequential high-dose VIP chemotherapy with autologous transplantation for patients with primary mediastinal nonseminomatous germ cell tumours: a prospective trial

To determine the efficacy of first-line sequential high-dose VIP chemotherapy (HD-VIP) in patients with primary mediastinal nonseminomatous germ cell tumours (GCT), 28 patients were enrolled on a German multicentre trial. High-Dose VIP chemotherapy consisted of 3–4 cycles of dose-intensive etoposide and ifosfamide plus cisplatin, q22days, each cycle followed by autologous peripheral blood stem cell transplantation plus granulocyte-colony stimulating factor (G-CSF) support. One cycle of standard-dose VIP was applied to harvest peripheral blood stem cells. Ten patients had mediastinal involvement as the only manifestation (36 %), 18 of 28 patients had additional metastatic sites, such as lung (n=17; 61%), liver (n=7; 25%), bone (n=5; 18%), lymph nodes (n=3; 11%) and CNS (n=3; 11%). Median follow-up was 43 months (range, 7–113) for all patients and 52 months (range, 22–113) for surviving patients. Nineteen of 28 patients obtained a disease-free status; 11 with HD-VIP alone and eight with adjunctive surgery. In addition, one of the four patients with marker negative partial remission after HD-VIP without resection of residual masses is currently alive. Two patients developed recurrence of GCT or teratoma. Two patients have died due to an associated haematologic disorder. The 2-year progression-free survival and overall survival rates are 64 and 68%, respectively. This report represents a subgroup analysis of 28 patients with mediastinal nonsemina within the German first-line study for ‘poor prognosis’ GCT. Compared to data of an international database analysis including 253 patients with mediastinal nonseminoma treated with conventional chemotherapy, the results may indicate that HD-VIP results in an approximately 15% survival improvement.
Case control study of the geographic variability of exposure to disinfectant byproducts and risk for rectal cancer

Levels of byproducts that result from the disinfection of drinking water vary within a water distribution system. This prompted us to question whether the risk for rectal cancer also varies, depending upon one's long term geographic location within the system. Such a geographic distribution in rectal cancer risk would follow naturally from an association between level of byproduct and rectal cancer risk. We assess the effects of estimated geographic variability in exposure to some of the components of the trihalomethane group of disinfectant byproducts (DBPs) on the odds ratios and probabilities for rectal cancer in white males in a case control study of 128 cases and 253 controls, conducted in Monroe County, Western New York State, U.S.A. The study was designed around health data initially collected at the University at Buffalo (Department of Social and Preventative Medicine) as part of the Upstate New York Diet Study, and trihalomethane (THM) data collected from a separate independent study of THMs conducted by Monroe County Department of Health. Case participants were chosen from hospital pathology records. The controls are disease-free white males between 35-90 years old, living in Monroe County, and chosen from control groups for studies from cancer of five other (unrelated) sites. Using a combination of case control methodology and spatial analysis, the spatial patterns of THMs and individual measures of tap water consumption provide estimates of the effects of ingestion of specific amounts of some DBPs on rectal cancer risk. Trihalomethane (THM) data were used to spatially interpolate levels at the taps of cases and controls, and odds ratios were estimated using logistic regression to assess the effects of estimated THM exposure dose on cancer risk, adjusting for alcohol, dietary beta carotene intake, tap water intake, and total caloric intake.



Trihalomethane levels varied spatially within the county; although risk for rectal cancer did not increase with total level of trihalomethanes, increasing levels of the component bromoform (measured in ug/day) did correspond with an increase in odds ratios (OR = 1.85; 95% CI = 1.25 - 2.74) for rectal cancer. The highest quartiles of estimated consumption of bromoform (1.69-15.43 ug/day) led to increased risk for rectal cancer (OR = 2.32; 95% CI = 1.22-4.39). Two other THMs were marginally associated with an increase in risk - chlorodibromomethane (OR = 1.78, 95% CI = 1.00-3.19) and bromodichloromethane (OR = 1.15; 95% CI = 1.00-1.32).



Levels of THMs in the water distribution system exhibited spatial variation that was partially due to variation in water age. We also observed a geographic pattern of increased risk of rectal cancer in areas with the highest levels of bromoform in the county.
Effects of a three-month therapeutic lifestyle modification program to improve bone health in postmenopausal Korean women in a rural community: a randomized controlled trial.

In this randomized controlled trial, we examined the effects of a 3-month therapeutic lifestyle modification (TLM) intervention on knowledge, self-efficacy, and health behaviors related to bone health in postmenopausal women in rural Korea. Forty-one women ages 45 or older were randomly assigned to either the intervention (n = 21) or control (n = 20) group. The intervention group completed a 12-week, 24-session TLM program of individualized health monitoring, group health education, exercise, and calcium-vitamin D supplementation. Compared with the control group, the intervention group showed significant increases in knowledge and self-efficacy and improvement in diet and exercise after 12 weeks, providing evidence that a comprehensive TLM program can be effective in improving health behaviors to maintain bone health in women at high risk of osteoporosis.