nils-herrmann/clean_scirepeval huggingface dataset:
Effects of abdominal massage in management of constipation--a randomized controlled trial.

Associated with decreases in quality of life, constipation is a relatively common problem. Abdominal massage appears to increase bowel function, but unlike laxatives with no negative side effects. Because earlier studies have methodological flaws and cannot provide recommendations, more research is needed.



This study investigates the effects of abdominal massage on gastrointestinal functions and laxative intake in people who have constipation.



Randomized controlled trial.



A sample of 60 people with constipation was included and randomized in two groups. The intervention group received abdominal massage in addition to an earlier prescribed laxative and the control group received only laxatives according to earlier prescriptions. Gastrointestinal function was assessed with Gastrointestinal Symptoms Rating Scale (GSRS) on three occasions; at baseline, week 4 and week 8. The statistical methods included linear regression, Wilcoxon sign rank test, and Mann-Whitney U-test.



Abdominal massage significantly decreased severity of gastrointestinal symptoms assessed with GSRS according to total score (p=.003), constipation syndrome (p=.013), and abdominal pain syndrome (p=.019). The intervention group also had significant increase of bowel movements compared to the control group (p=.016). There was no significant difference in the change of the amount of laxative intake after 8 weeks.



Abdominal massage decreased severity of gastrointestinal symptoms, especially constipation and abdominal pain syndrome, and increased bowel movements. The massage did not lead to decrease in laxative intake, a result that indicates that abdominal massage could be a complement to laxatives rather than a substitute.
Physician implicit review to identify preventable errors during in-hospital cardiac arrest.

T he overall prevalence of preventable errors during cardiacarrestsandtheirimpactonsurvivalarelargely unknown,limitingeffortstoimprovequalityofcare during theseevents.Toexplore these issues further,wehad physiciansacross4medical subspecialties—hospitalmedicine, emergency medicine, critical care medicine, and cardiovascularmedicine—performastructuredimplicit review toassessqualityofcare in47consecutivecardiacarrestsdue toventricular arrhythmiasamongadults atourhospitalbetween 2005 and 2007.
Vaccination of colorectal cancer patients with modified vaccinia Ankara delivering the tumor antigen 5T4 (TroVax) induces immune responses which correlate with disease control: a phase I/II trial.

The highly attenuated strain of vaccinia virus, modified vaccinia Ankara (MVA), encoding the tumor antigen 5T4 (termed TroVax), has been evaluated in an open-label phase I/II study in colorectal cancer patients. The primary objectives were to assess the safety and immunogenicity of ascending doses of TroVax and to determine the biodistribution of the vector.



TroVax was given to 22 patients with metastatic colorectal cancer. Seventeen patients received doses of TroVax ranging from 5 x 10(7) up to 5 x 10(8) plaque-forming units at 0, 4, and 8 weeks and were considered to be evaluable for assessment of immunologic responses. Both antibody and cellular responses specific for the tumor antigen 5T4 and the viral vector were monitored throughout the study.



TroVax was well tolerated in all patients with no serious adverse events attributed to vaccination. Of 17 evaluable patients, 16 showed 5T4-specific cellular responses whereas 14 had detectable antibody levels following vaccination. TroVax was able to boost 5T4-specific immune responses in the presence of MVA neutralizing antibodies. Periods of disease stabilization ranging from 3 to 18 months were observed in five patients, all of whom mounted 5T4-specific immune responses. Furthermore, statistical analysis showed a positive association between the development of a 5T4 (but not MVA) antibody response and patient survival or time to disease progression.



These data indicate that vaccination with TroVax is safe and well tolerated and that immune responses to 5T4 can be induced without any evidence of autoimmune toxicity. Furthermore, 5T4-specific antibody responses correlate with evidence of disease control.
A robust HIV-1 viral load detection assay optimized for Indian sub type C specific strains and resource limiting setting

Human Immunodeficiency Virus Type 1 (HIV-1) viral load testing at regular intervals is an integral component of disease management in Acquired Immunodeficiency Syndrome (AIDS) patients. The need in countries like India is therefore an assay that is not only economical but efficient and highly specific for HIV-1 sub type C virus. This study reports a SYBR Green-based HIV-1 real time PCR assay for viral load testing and is designed for enhanced specificity towards HIV-1 sub type C viruses prevalent in India. Linear regression of the observed and reference concentration of standards used in this study generated a correlation coefficient of 0.998 (p < 0.001). Lower limit of detection of the test protocol was 50 copies/ml of plasma. The assay demonstrated 100% specificity when tested with negative control sera. The Spearman coefficient of the reported assay with an US-FDA approved, Taqman probe-based commercial kit was found to be 0.997. No significant difference in viral load was detected when the SYBR Green based assay was used to test infected plasma stored at -20°C and room temperature for 7 days respectively (Wilcoxon signed rank test, p = 0.105). In a comparative study on 90 pretested HIV-1 positive samples with viral loads ranging from 5,000–25,000 HIV-1 RNA copies/ml and between two commercial assays it was found that the later failed to amplify in 13.33% and 10% samples respectively while in 7.77% and 4.44% samples the copy number values were reduced by >0.5 log value, a figure that is considered clinically significant by physicians. The HIV-1 viral load assay reported in this study was found to be robust, reliable, economical and effective in resource limited settings such as those existing in India. PCR probes specially designed from HIV-1 Subtype C-specific nucleotide sequences originating from India imparted specificity towards such isolates and demonstrated superior results when compared to two similar commercial assays widely used in India.
Cost-Effectiveness of Triple Therapy Versus Etanercept Plus Methotrexate in Early Aggressive Rheumatoid Arthritis.

To evaluate the cost-effectiveness of all 4 interventions in the Treatment of Early Aggressive Rheumatoid Arthritis (TEAR) clinical trial: immediate triple (IT), immediate etanercept (IE), step-up triple (ST), and step-up etanercept (SE). Step-up interventions started with methotrexate and added either etanercept or sulfasalazine plus hydroxychloroquine to patients with persistent disease activity.



We built a Markov cohort model that uses individual-level data from the TEAR trial, published literature, and supplemental clinical data. Costs were in US dollars, benefits in quality-adjusted life years (QALYs), perspective was societal, and the time horizon was 5 years.



The immediate strategies were more efficacious than step-up strategies. SE and IE were more costly than ST and IT, primarily due to treatment cost differences. In addition, IT was the least expensive and most effective strategy when the time horizon was 1 and 2 years. When the time horizon was 5 years, IE was marginally more effective than IT (3.483 versus 3.476 QALYs), but IE was substantially more expensive than IT ($148,800 versus $52,600), producing an incremental cost-effectiveness ratio of $12.5 million per QALY. These results were robust to both one-way deterministic and joint probabilistic sensitivity analyses.



IT was highly cost-effective in the majority of scenarios. Although IE was more effective in 5 years, a substantial reduction in the cost of biologic agents was required in order for IE to become cost-effective in early aggressive RA under willingness-to-pay thresholds that most health care settings may find acceptable.
Effect of dietary fat selection on plasma cholesterol synthesis in older, moderately hypercholesterolemic humans.

To study factors controlling plasma cholesterol levels, the effect of dietary fat type on cholesterol synthesis was examined in 15 hypercholesterolemic subjects (low-density lipoprotein [LDL] cholesterol > 130 mg.dL-1) consuming over a period of 32 days (1) a baseline diet (36% kcal as fat: 15% saturated, 15% monounsaturated, and 6% polyunsaturated fat; 180 mg cholesterol.1000 kcal-1) and diets meeting National Cholesterol Education Program step 2 criteria (30% kcal as fat, < or = 7% saturated fat, 80 to 85 mg cholesterol/Mcal), where two thirds of the fat was either (2) olive, (3) corn, or (4) canola oil. Plasma total, LDL, and high-density lipoprotein (HDL) cholesterol and triglyceride levels were determined at the end of each period. Cholesterol fractional synthesis rate (FSR) was also measured as the deuterium (D) incorporation into plasma total cholesterol relative to body D2O level (1.2 g D2O.kg-1 estimated body water) over 24 hours. Absolute synthesis rates (ASRs) were determined as the product of FSR and rapid turnover cholesterol pool size. Plasma total and LDL cholesterol levels declined significantly (P < .005) on all plant-oil diets compared with the baseline diet; however, triglyceride levels were not different. FSRs were higher (P < .05) for the corn oil (0.0665 +/- 0.0097 pool.d-1) compared with baseline (0.0412 +/- 0.0060 pool.d-1) and olive oil (0.0409 +/- 0.0052 pool.d-1) but not canola oil (0.0492 +/- 0.0072 pool.d-1) diets.(ABSTRACT TRUNCATED AT 250 WORDS)
The effectiveness of brief alcohol interventions delivered by community pharmacists: randomized controlled trial.

To undertake the first randomized controlled trial to evaluate the effectiveness of a brief intervention delivered by community pharmacists to reduce hazardous or harmful drinking.



This parallel group randomized trial allocated participants individually to brief alcohol intervention (n = 205) or a leaflet-only control condition (n = 202), with follow-up study after 3 months.



Sixteen community pharmacies in one London Borough, UK.



A total of 407 pharmacy customers (aged 18 years or over) with Alcohol Use Disorder Identification Test (AUDIT) scores 8-19, inclusive.



A brief motivational discussion of approximately 10 minutes' duration, for which 17 pharmacists received a half-day of training.



Hazardous or harmful drinking was assessed using the AUDIT administered by telephone by a researcher blind to allocation status. The two primary outcomes were: (1) change in AUDIT total scores and (2) the proportions no longer hazardous or harmful drinkers (scoring < 8) at 3 months. The four secondary outcomes were: the three subscale scores of the AUDIT (for consumption, problems and dependence) and health status according to the EQ-5D (a standardized instrument for use as a measure of health outcome).



At 3 months 326 (80% overall; 82% intervention, 78% control) participants were followed-up. The difference in reduction in total AUDIT score (intervention minus control) was -0.57, 95% confidence interval (CI) = -1.59 to 0.45, P = 0.28. The odds ratio for AUDIT ˂ 8 (control as reference) was 0.87, 95% CI = 0.50 to 1.51, P = 0.61). For two of the four secondary outcomes (dependence score: -0.46, 95% CI = -0.82 to -0.09, P = 0.014; health status score: -0.09, 95% CI = -0.16 to -0.02, P = 0.013) the control group did better, and in the other two there were no differences (consumption score: -0.05, 95% CI = -0.54 to 0.44, P = 0.85; non-dependence problems score: -0.13, 95% CI = -0.66 to 0.41). Sensitivity analyses did not change these findings.



A brief intervention delivered by community pharmacists appears to have had no effect in reducing hazardous or harmful alcohol consumption.
A Jerte valley cherry product provides beneficial effects on sleep quality. Influence on aging.

In the present work, we evaluated the effect of the intake of a Jerte Valley cherry-based product (JVCP), compared to a placebo product, on sleep quality, urinary 6-sulfatoxymelatonin (aMT6-s) levels and the serum concentration of interleukin-1β (IL-1β), tumor necrosis factor α (TNF-α) and interleukin-8 (IL-8).



This was a blind, placebo-controlled, randomized, crossover study.



University of Extremadura (Spain).



Ten young (20-30 years old), ten middle-aged (35-55 years old), and ten elderly (65-85 years old) participants.



A placebo (Kool-Aid®) or JVCP (patent no. ES 2342141 B1) were consumed twice a day, as lunch and dinner desserts.



Actigraphic monitoring was used to record and display the temporal patterns of the individuals' activity and rest. Urinary aMT6-s and serum cytokines (IL-1β, TNF-α and IL-8) were also determined.



The consumption of the JVCP improved the nocturnal rest, measured by sleep efficiency, number of awakenings, total nocturnal activity, sleep latency, assumed sleep, actual sleep time and immobility. Moreover, it was detected an increase in both the levels of aMT6-s found in first-void morning urine and the concentrations of serum pro-somnogenic cytokines obtained from samples collected at the acrophase of the melatonin rhythm (1.00 am) in all experimental age groups after the JVCP consumption. Generally, better results were obtained with advancing age.



The ingestion of the JVCP may contribute to establish a high-quality sleep and be used as a potential nutraceutical tool to prevent sleep disorders with the advance of age.
Novel and simple prognostic index for nasal natural killer/T-cell lymphoma.

Few studies have investigated the prognostic factors for nasal natural killer (NK)/T-cell lymphoma.



This was a retrospective multicenter clinical study. The clinical records of 36 patients with nasal NK/T-cell lymphoma who had been first treated between 1996 and 2011 were collected from 12 hospitals.



High serum levels of C-reactive protein (≥1.0 mg/dL), lactate dehydrogenase (≥350 IU/L), and soluble interleukin-2 receptor (sIL-2R; ≥600 U/mL) were associated with worse prognosis. A prognostic score was devised by totaling the number of these 3 predictors: 0 or 1 = score 0; and 2 or 3 = score 1. As for tumor invasion, local invasion beyond the nasal cavity was associated with poor prognosis, and a prognostic score was devised as: tumor restricted to nasal cavity, yes = score 0; no = score 1. A novel prognostic index (NPI) was established based on these scores from 0 to 2. Disease-specific survival rates at 5 years were: 90.0% for NPI = 0; 29.3% for NPI = 1; and 0.0% for NPI = 2.



Our NPI is valid for anticipating prognosis of nasal NK/T-cell lymphoma.
Smoking reductions and increased self-efficacy in a randomized controlled trial of smoking abstinence-contingent incentives in residential substance abuse treatment patients.

Individuals with substance use disorders (SUDs) experience increased smoking-related morbidity and mortality but severely compromised smoking treatment benefits. Residential SUD treatment settings may be particularly positioned to target smoking, with ever-increasing smoking bans and culture shifts, but most smokers continue smoking. This study examined the effects of contingency management (CM) for increasing smoking abstinence in residential patients.



Smokers interested in quitting were recruited from a residential SUD program for men and were randomized to frequent smoking monitoring with behavioral support (monitoring; n = 21) or that plus smoking abstinence-contingent (expired carbon monoxide [CO] ≤ 6 ppm; urinary cotinine ≤ 30ng/ml) incentives (CM, n = 24) for 4 weeks. After setting a quit date, procedures included daily behavioral support and smoking self-reports, 2 CO samples (a.m./p.m.) Monday through Friday, and cotinine tests on Mondays. CM participants received escalating draws for prizes ($1, $20, and $100 values) for negative tests; positive and missed samples reset draws. Follow-ups involved samples, self-reported smoking, and self-efficacy (weeks 4, 8, 12, and 24).



Percent days CO-negative was higher with CM (median [interquartile range] 51.7% [62.8%]) compared to monitoring (0% [32.1%]) (p = .002). Cigarettes per day declined and point-prevalence abstinence increased through follow-up (p < .01), without significant group by time effects (p > .05). Abstinence self-efficacy increased overall during the intervention and more with CM compared to monitoring and was associated with abstinence across conditions through follow-up.



CM improved some measures of response to smoking treatment in residential SUD patients.
Diuretics shift circadian rhythm of blood pressure from nondipper to dipper in essential hypertension.

Recently, we found that sodium restriction shifted the circadian rhythm of blood pressure from nondipper to dipper in patients with the sodium-sensitive essential hypertension. This study examined whether diuretics can transform the circadian rhythm of blood pressure from nondipper to dipper.



We studied 21 patients with essential hypertension during both a baseline period and a period of treatment with hydrochlorothiazide (25 mg daily). The periods lasted 4 weeks each. Twenty-four hour ambulatory blood pressures were measured on the same day of the week at the end of the each period. In nondippers (n=11), but not in dippers (n=10), a significant interaction existed between diuretic therapy and nocturnal fall in systolic and diastolic blood pressure, which indicated that the degree of nocturnal blood pressure fall was affected by diuretic therapy. Nocturnal fall, which was diminished in nondippers, was restored by diuretic therapy with hydrochlorothiazide, indicating that the circadian rhythm of blood pressure shifted from nondipper to dipper patterns.



The present study demonstrated that diuretics can restore nocturnal blood pressure decline in a manner similar to sodium restriction, which suggests that the kidneys and sodium metabolism may play important roles in the genesis of the circadian rhythm of blood pressure. Diuretic-based treatment may have an additional therapeutic advantage of reducing the risk for cardiovascular complications by transforming the circadian rhythm of blood pressure.
Bronchodilator therapy with metered-dose inhaler and spacer versus nebulizer in mechanically ventilated patients: comparison of magnitude and duration of response.

Four-hour comparison of the bronchodilator response of albuterol administered via metered-dose inhaler (MDI) with spacer versus small-volume nebulizer (SVN) to mechanically ventilated patients with chronic obstructive pulmonary disease (COPD).



Prospective randomized clinical trial.



Medical intensive care unit in a university hospital.



Thirteen mechanically ventilated COPD patients.



Albuterol administration of 4 puffs (0.4 mg) or 10 puffs (1.0 mg) via MDI with spacer or 2.5 mg via SVN to mechanically ventilated patients in order to assess the bronchodilator response over 4 hours.



Mechanically ventilated patients were enrolled in a randomized crossover study wherein one group received 4 puffs (0.4 mg) or 2.5 mg of albuterol and another group received 10 puffs (1.0 mg) or 2.5 mg of albuterol on separate days. Respiratory mechanics measurements were obtained over 4 hours. Total airway resistance declined by 14.4 +/- 3.8% after 4 MDI puffs, 18.3 +/- 1.8% after 10 MDI puffs, or 13.7 +/- 2.6% after 2.5 mg via SVN, compared to baseline (p < 0.01). After albuterol delivery, airway resistance remained improved for 90-120 minutes (p < 0.05) and returned to baseline by 4 hours with all treatments.



The airway response to albuterol administration via MDI and SVN to mechanically ventilated patients was similar in magnitude and duration, returning to baseline by 240 minutes. In stable, mechanically ventilated COPD patients, albuterol may be administered via MDI with spacer or via SVN every 4 hours.
Computer-driven management of prolonged mechanical ventilation and weaning: a pilot study

To evaluate the ability of a computer-driven system (CDS) to manage pressure-support ventilation over prolonged periods and to predict weaning readiness compared to intensivists. The system continuously adapts pressure support, gradually decreases ventilatory assistance when possible, and indicates weaning readiness. A two-center, prospective, open, clinical, pilot study in medical ICUs of two university hospitals. 42 consecutive mechanically ventilated patients (60±14 years, SAPS II 39±15), 9 of whom were excluded. As soon as patients could tolerate pressure support, they were ventilated with the CDS. The times of weaning readiness determined by the intensivists and CDS were compared. Weaning was successful in 25 patients and failed in 7; unplanned extubation occurred in 1 patient. Time on CDS ventilation was 3±3 days (maximum, 12 days). The CDS detected weaning readiness earlier than the intensivists in 17 patients, and intensivists earlier than the CDS in 4; in 11 patients detection times coincided. A CDS was successful in fully managing pressure-support ventilation over prolonged periods and often proposed weaning readiness earlier than the intensivists did. Use of this CDS may reduce the duration of mechanical ventilation.
Selective antimicrobial modulation of human microbial flora: infection prevention in patients with decreased host defense mechanisms by selective elimination of potentially pathogenic bacteria.

To reduce the frequency and severity of bacterial infection, selective antimicrobial modulation (SAM) was applied in 39 patients with severely decreased host defense mechanisms. The objective was to eliminate potentially pathogenic aerobic microorganisms with minimal disturbance of the normal anaerobic bacterial flora. Elimination of potentially pathogenic aerobic microorganisms was easily accomplished in patients not infected at hospitalization. The anaerobic flora seemed to be undisturbed, and selection of or overgrowth with resistant microorganisms did not occur. The microbiologic results of the SAM regimen correlated with the incidence of infection. Only three major infections occurred in 23 patients who were free of potentially pathogenic microorganisms; 10 major infections occurred in 16 patients who were not free of potential pathogens. Seven of these 10 infections were present at hospitalization. The incidence of major infections was 47% in the patients on the SAM regimen and 82% in a group of control patients with a similar risk of infection.