nils-herrmann/clean_scirepeval huggingface dataset:
Relation of iron and red meat intake to blood pressure: cross sectional epidemiological study

To investigate associations of dietary iron (total, haem, and non-haem), supplemental iron, and red meat with blood pressure.



Cross sectional epidemiological study.



17 population samples from Japan, China, the United Kingdom, and the United States participating in the international collaborative study on macro-/micronutrients and blood pressure (INTERMAP).



4680 adults aged 40-59.



Average of eight blood pressure readings.



In multiple linear regression analyses dietary total iron and non-haem iron were consistently inversely associated with blood pressure. With adjustment for potential non-dietary and dietary confounders, dietary total iron intake higher by 4.20 mg/4.2 MJ (2 SD) was associated with -1.39 mm Hg (P<0.01) lower systolic blood pressure. Dietary non-haem iron intake higher by 4.13 mg/4.2 MJ (2 SD) was associated with -1.45 mm Hg (P<0.001) lower systolic blood pressure. Differences were smaller for diastolic blood pressure. In most models haem iron intake from food was positively, non-significantly associated with blood pressure. Iron intake from combined diet and supplements yielded smaller associations than dietary iron alone. Red meat intake was directly associated with blood pressure; 102.6 g/24 h (2 SD) higher intake was associated with 1.25 mm Hg higher systolic blood pressure. Associations between red meat and blood pressure persisted after adjustment for multiple confounders.



Non-haem iron has a possible role in the prevention and control of adverse blood pressure levels. An unfavourable effect of red meat on blood pressure was observed. These results need confirmation including in prospective studies, clinical trials, and from experimental evidence on possible mechanisms.
A randomized trial of a single bolus dosage regimen of recombinant tissue plasminogen activator in patients with acute pulmonary embolism.

Experiments in animals have demonstrated that recombinant tissue plasminogen activator (rt-PA) produces continuing thrombolysis after it is cleared from the circulation and that thrombolysis is both increased and accelerated, and bleeding is reduced when rt-PA is administered over a short period. In previous studies in patients with thrombotic disease, rt-PA has been shown to be an effective thrombolytic agent when administered by continuous infusion over a period between 90 minutes and 8 hours. To determine whether a short course regimen of rt-PA can achieve thrombolysis, a double-blind randomized trial has been conducted in which patients with objectively established acute symptomatic pulmonary embolism who were receiving heparin were allocated to either a 2-minute infusion of rt-PA at a dose of 0.6 mg/kg (33 patients) or saline placebo (25 patients). Perfusion lung scanning was used to assess the change in pulmonary perfusion at 24 hours and seven days post-study drug administration. Thirty-four percent of the rt-PA patients had a greater than 50 percent resolution in the perfusion defect at 24 hours compared to 12 percent of placebo patients (p = 0.026). At 24 hours, the mean relative improvement in the perfusion defect was 37.0 percent in rt-PA treated patients compared to 18.8 percent in the placebo group (p = 0.017). By day 7, no difference in lung scan resolution was detected between the groups. There were no major bleeds in either group nor were there any differences in transfusion requirements between groups. Minor bleeding occurred in 15 of the rt-PA patients mainly at angiogram-catheter insertion and venipuncture sites. These results suggest that a bolus regimen of rt-PA produces accelerated thrombolysis and provides an alternative and convenient approach to thrombolytic therapy in patients with pulmonary embolism.
Acceptance rates in state-federal vocational rehabilitation of clients with brain injury: Is racial disparity an issue?

To utilize Aday and Andersen's Framework for the Study of Access to examine racial disparity within the State-Federal vocational rehabilitation system, among clients with brain injury.  Do pre-disposing characteristics such as age, race, ethnicity, gender, marital status and education influence vocational rehabilitation acceptance rates in the US? Do enabling characteristics such as referral source, insurance coverage and primary source of support at application influence vocational rehabilitation acceptance rates in the US? Is there a difference, based on race, in the reason for case closure for vocational rehabilitation services?



Exhaustive CHAID analysis was conducted with acceptance for rehabilitation as the criterion variable and pre-disposing characteristics as predictor variables. Chi-square analysis was calculated with regard to reason for closure.



Descriptive findings are presented. Of the pre-disposing factors, the most significant predictor of acceptance rate was education level. Pearson Chi-square analyses revealed significant differences between White and non-White clients with brain injury with regard to reason for closure.



The data indicate that racial differences were only a small part of the overall equation and again that distinct disparity by race is not evidenced in the RSA-911 data for persons with a primary or secondary diagnosis of brain injury.
Height and risk of incident intraparenchymal hemorrhage: Atherosclerosis Risk in Communities and Cardiovascular Health study cohorts.

Height is inversely associated with incident coronary disease and total stroke, but few studies have examined the association between height and intraparenchymal hemorrhage (IPH). We hypothesized that height would be inversely associated with incident IPH in the combined cohorts of the Atherosclerosis Risk in Communities Study and the Cardiovascular Health Study.



Data on Caucasian and African American participants were used to estimate the association of height at baseline with incident IPH verified by clinician review of medical records and imaging reports. Sex-specific Cox proportional hazards regression models were used to calculate hazard ratios.



A total of 20,983 participants initially free of stroke (11,788 women and 9195 men) were followed for an average of 15.9 years (standard deviation [SD] 5.1 years). Incident IPH occurred in 115 women and 73 men. Sex, but not age, race, study, or blood pressure, modified the association (P = .03). After adjustment for risk factors (age, systolic blood pressure, triglycerides, low-density lipoprotein cholesterol, fibrinogen, and race), among women, height was significantly inversely associated with incident IPH (hazard ratio [HR] per SD [6.3 cm] was 0.81; 95% confidence interval [CI] 0.66-0.99; P = .04). The HR for tertile 3 vs 1 in women was 0.63 (95% CI 0.37-1.08). Among men, height was not linearly associated with incident IPH (HR per SD [6.7 cm] was 1.09; 95% CI 0.84-1.40; P = .52).



This large prospective study provides evidence that shorter height may be a risk factor for incident IPH in women.
Frequency of side effects in outpatient cancer care and their influence on patient satisfaction—a prospective survey using the PASQOC® questionnaire

The aims of the study were to examine the frequency of side effects and fatigue in ambulatory cancer patients and to analyse how these symptoms are reflected in patient satisfaction. Private practices (N = 41) and day hospitals (N = 8) in Germany took part in the study. The respondents were 4,538 patients with cancer (response rate: 82%). The diagnoses were: 25% breast cancer, 21% colorectal cancer, 11% lymphomas and 12% haematological malignancies; mean age 63.5 years; 57% female. The 2004 PASQOC® questionnaire contained 63 problem-oriented items which covered patient satisfaction for 15 dimensions of care. One item specifically assessed the prevalence of 17 different side effects. A score reflecting the severity of fatigue (fatigue index) was computed from three additional questions. For statistical analysis of patient satisfaction, the problem frequency was computed for each item. The most frequent single side effects were fatigue (60%), hair loss (54%), nausea (51%), sleep disturbance (42%), weight loss (36%), diarrhoea (32%) and mouth ulcerations (31%). The mean number of side effects was 5 per patient (range 0 to 17). The fatigue index revealed that 42% of subjects complained of moderate and 28% of severe fatigue. Both the total number of side effects and the fatigue score were negatively associated with patient satisfaction. Side effects and especially fatigue are frequent problems in cancer patients and are related to the patients’ assessment of cancer care. Routine symptom assessment may identify patients who require more comprehensive supportive care.
A shortened postpartum magnesium sulfate prophylaxis regime in pre-eclamptic women at low risk of eclampsia.

To determine whether magnesium sulfate (MgSO(4)) prophylaxis is needed for up to 24 hours postpartum in all patients with pre-eclampsia.



In a randomized open clinical trial conducted in a tertiary health center in India between September 2008 and April 2010, 150 women with severe pre-eclampsia who received intrapartum MgSO(4) and delivered at more than 2 weeks gestation were enrolled. After 6hours postpartum, the participants were randomized to continue receiving (control group) or to discontinue (intervention group) MgSO(4), and outcomes were compared.



Administration of MgSO(4) had to be reinstituted for 1 woman in the intervention group. Under the current protocol in the institution, all 75 women in the intervention group would have received MgSO(4) for 24 hours postpartum. A significant reduction in time spent by the doctors (P<0.001) and nurses (P<0.001) was seen in the intervention group. The pain score in the intervention group was significantly less (P<0.001), and women in the intervention group were able to look after themselves better (P<0.001).



For women at low risk for postpartum eclampsia, a shortened (6-hour) MgSO(4) regime was as effective for seizure prophylaxis as the conventional 24-hour regime, with significant benefits in terms of cost and morbidity.
Acceptability of Diagnostic Tests for Breast Cancer

To assess the acceptability of new non-invasive breast cancer diagnostic tests intended to triage women in need of biopsy.  Women who had abnormal screening tests and had been recommended to have a biopsy were invited to receive digital mammography, magnetic resonance imaging (MRI), and nuclear medicine evaluation (Tc-99m-sestamibi scanning) before biopsy. Participants completed a questionnaire about satisfaction and acceptability of the procedures. Satisfaction measured women's overall and test-specific satisfaction. Acceptability was measured by self-reported discomfort, embarrassment and women's preference in terms of willingness to pay to avoid a biopsy.  Women were satisfied with all of the potential diagnostic triage procedures. Most found the tests more comfortable than a routine mammogram (47, 50, and 66% undergoing MRI, digital mammography, and sestamibi scanning, respectively). Women who provided a response to willingness to pay questions (N=43) were willing to pay an average of $611 to have a test instead of a biopsy, if the test was as accurate as biopsy. The willingness to pay significantly decreased to $308 if the test only had 95% accuracy. Those who had prior benign breast disease were less willing to pay for a test with 95% accuracy than those without this history.  Instead of immediate biopsy after an abnormal screening, these results suggest that women would find non-invasive triage tests acceptable, or preferable to biopsy if they were equally accurate or nearly equally accurate as a biopsy. New technologies to diagnose breast cancer should focus on decreasing discomfort as well as increasing test accuracy.
Harmful effects of viral replication in seropositive hepatitis C virus renal transplant recipients.

Seropositivity for hepatitis C virus (HCV) predicts lower patient and graft survival after renal transplantation (RT). However, the influence of viral replication at transplantation on long-term outcome remains to be determined.



This was a retrospective study conducted in four Spanish hospitals, from 1997 to 2006. Data of all patients with RT, who displayed HCV+ (enzyme-linked immunosorbent assay), and with negative viremia at RT (NEG group) were collected (n=41). For each NEG patient enrolled, data of two patients with RT nearest in time, HCV+, and positive viremia (POS group) were also collected (n=78).



The POS group showed a higher incidence of long-term liver disease (56.4% vs. 24.4%, P=0.0009) and episodes of transaminase elevation (38.5% vs. 7.3%, P=0.0003) and worse renal function (serum creatinine [sCr], 3.0 [2.7] vs. 1.9 [1.6] mg/dl, P=0.032; glomerular filtration rate, 43.7 [22.4] vs. 56.9 [27.9] ml/min, P=0.075). Noteworthy, 24.4% of NEG patients reactivated after RT, showing a worse patient survival (P=0.039). Active viral replication at RT and dialysis requirement in the first week remained as independent predictors of lower graft survival (death censored): hazards ratio, 3.11 (95% confidence interval, 1.34-7.19; P=0.009) and hazards ratio 3.13 (95% confidence interval, 1.53-6.37; P=0.002).



This study shows that active viral replication at transplantation is an independent risk factor for graft failure in patients with positive serology for HCV.
Robotic Assisted Radio-Frequency Ablation of Liver Tumors - Randomized Patient Study

The minimally invasive treatment of liver tumors represents an alternative to the open surgery approach. Radio-frequency ablation destroys a tumor by delivering radio-frequency energy through a needle probe. Traditionally, the probe is placed manually using imaging feedback. New approaches use robotic devices to accurately place the instrument at the target. The authors developed an image-guided robotic system for percutaneous interventions using computed tomography. The paper presents a randomized patient study comparing the manual versus robotic needle placement for radio-frequency ablation procedures of liver tumors. The results of this study show that in our case robotic interventions were a very viable solution. Several treatment parameters such as radiation exposures and procedure-times were found to be significantly improved in the robotic case.
The effect of a 12 week walking intervention on markers of insulin resistance and systemic inflammation.

The purpose of the present study was to determine whether a community-based walking intervention, using pedometers, is effective in reducing systemic inflammatory markers.



Participants (age=49(8.9)) were recruited in Glasgow, United Kingdom, from August to December 2006 and were randomly assigned to a control (n=24; 6 males, no change in walking) and intervention group (n=24; 5 males gradually increasing walking by 3000 steps/day on 5 days of the week). Blood samples were collected at baseline, and after 12 weeks, and analysed for glucose, insulin, high sensitivity C-reactive protein (hsCRP), interleukin-6 (IL-6), soluble IL-6 receptor (sIL-6R), tumour necrosis factor-alpha (TNF-alpha) and soluble TNF receptors I and II (sTNFR1 and sTNFRII).



In the control group baseline step counts were 6356 (2953) steps/day and did not change (P>0.05) after 12 weeks, 6709 (2918) steps/day. The intervention group increased (P<0.001) step count from 6682 (3761) steps/day at baseline to 10182 (4081) steps/day at 12 weeks. Over the 12 week period there was no change in any other variables measured, in either control or intervention group.



We conclude that the current community-based intervention did not affect systemic markers of inflammation or insulin sensitivity.
Hyperuricemia and uncontrolled hypertension in treated hypertensive patients

Previous epidemiological studies have suggested that uric acid is an independent risk factor for incident hypertension, whereas few studies have evaluated the effect of hyperuricemia on blood pressure control in hypertensive patients. We investigated whether hyperuricemia predicts uncontrolled hypertension through a large-scale prospective cohort study with hypertensive patients treated with fimasartan in the Republic of Korea (the Kanarb-Metabolic Syndrome study).Of the 10,601 hypertensive patients who were recruited from 582 private clinics and 11 university hospitals at baseline, 7725 completed the follow-up after 3 months of fimasartan medication, and 6506 were included in the analysis after excluding those with missing values. We estimated the risk of uncontrolled hypertension after 3 months (≥130/80 mm Hg in those with diabetes or chronic renal failure and ≥140/90 mm Hg in the remaining patients) related with baseline hyperuricemia (serum uric acid ≥7 mg/dL in males ≥6 mg/dL in females) using multiple logistic regression models.Hyperuricemia increased the risk of uncontrolled hypertension after 3 months of fimasartan medication (odds ratio, 1.247; 95% confidence interval, 1.063-1.462). Males in the highest quartile of uric acid level were at a 1.322 (95% confidence interval, 1.053-1.660) times higher risk of uncontrolled hypertension in reference to the lowest quartile; the same analyses in females were not significant. Patients without metabolic syndrome had significantly higher odds of uncontrolled hypertension with hyperuricemia (odds ratio, 1.328; 95% confidence interval, 1.007-1.751).Hyperuricemia predicted uncontrolled hypertension even after 3 months of fimasartan treatment in hypertensive patients.
Chlamydia trachomatis infection and risk of cervical intraepithelial neoplasia

High-risk human papillomavirus (hrHPV) is the primary cause of cervical cancer. As Chlamydia trachomatis is also linked to cervical cancer, its role as a potential co-factor in the development of cervical intraepithelial neoplasia (CIN) grade 2 or higher was examined.



The placebo arms of two large, multinational, clinical trials of an HPV6/11/16/18 vaccine were combined. A total of 8441 healthy women aged 15-26 years underwent cervicovaginal cytology (Papanicolaou (Pap) testing) sampling and C trachomatis testing at day 1 and every 12 months thereafter for up to 4 years. Protocol-specified guidelines were used to triage participants with Pap abnormalities to colposcopy and definitive therapy. The main outcome measured was CIN.



At baseline, 2629 (31.1%) tested positive for hrHPV DNA and 354 (4.2%) tested positive for C trachomatis. Among those with HPV16/18 infection (n = 965; 11.4%) or without HPV16/18 infection (n = 7382, 87.5%), the hazard ratios (HRs) associated with development of any CIN grade 2 according to baseline C trachomatis status were 1.82 (95% CI: 1.06 to 3.14) and 1.74 (95% CI 1.05 to 2.90), respectively. The results were comparable when only the 12 most common hrHPV infections were considered, but the excess risk disappeared when the outcome was expanded to include CIN grade 3 or worse.



Further studies based on larger cohorts with longitudinal follow-up in relation to the C trachomatis acquisition and a thorough evaluation of temporal relationships of infections with hrHPV types, C trachomatis and cervical neoplasia are needed to demonstrate whether and how in some situations C trachomatis sets the stage for cervical carcinogenesis.
Cardiorenal rescue study in acute decompensated heart failure: rationale and design of CARRESS-HF, for the Heart Failure Clinical Research Network.

Worsening renal function is common among patients hospitalized for acute decompensated heart failure (ADHF). When this occurs, subsequent management decisions often pit the desire for effective decongestion against concerns about further worsening renal function. There are no evidence-based treatments or guidelines to assist in these difficult management decisions. Ultrafiltration is a potentially attractive alternative to loop diuretics for the management of fluid overload in patients with ADHF and worsening renal function.



The National Heart, Lung, and Blood Institute Heart Failure Clinical Research Network designed a clinical trial to determine if ultrafiltration results in improved renal function and relief of congestion compared with stepped pharmacologic care when assessed 96 hours after randomization in patients with ADHF and cardiorenal syndrome. Enrollment began in June 2008. This paper describes the rationale and design of the Cardiorenal Rescue Study in Acute Decompensated Heart Failure (CARRESS-HF).



Treating the signs and symptoms of congestion in ADHF is often complicated by worsening renal function. CARRESS-HF compares treatment strategies (ultrafiltration vs stepped pharmacologic care) for the management of worsening renal function in patients with ADHF. The results of the CARRESS-HF trial are expected to provide information and evidence as to the most appropriate approaches for treating this challenging patient population.
Advances in the treatment of chronic heart failure.

I United States Agency for International Development. Breastfeeding: a report on AID programs. Washington, DC: US Agency for International Development, 1990. 2 De Zoysa I, Rea M, Martines J. Why promote breastfeeding in diarrhoeal disease control programmes? Health Policy and Planning 1991;6:371-9. 3 Brown KH, Stallings RY, Creed de Kanashiro H, Lopez de Romana G, Black RE. Effects of common illnesses on infants' energy intakes from breast milk and other foods during longitudinal community-based studies in Huascar (Lima),  Nunr 1990;52:1005-13. 4 Popkin BM, Adair L, Akin JS, Black R, Briscoe J, Flieger W. Breast-feeding and diarrheal morbidity. Pediatrics 1990;86:874-82. 5 Victora CG, Smith PG, Vaughan JP, Nobre LC, Lombardi C, Teixeira AMB, et al. Infant feeding and deaths due to diarrhea: a case-control study. AmJ7 Epidemiol 1989;129:1032-41. 6 Sachdev HPS, Krishna J, Purn RK, Satyanarayana L, Kumar S. Water supplementation in exclusively breastfed infants during summer in the tropics. Lancet 1991;337:929-33. 7 Martines JC, Ashworth A, Kirkwood, B. Breast-feeding among the urban poor in southern Brazil: reasons for termination in the first 6 months of life. Bull World Health Organ 1989;67:151-61. 8 Akre J, ed. Infant feeding: the physiological basis.  Water requirements of breastfed infants in a hot climate. Am J Clin Nutr 1978;31: 1154-7. 10 Armelini PA, Gonzalez CF. Breastfeeding and fluid intake in a hot climate. Clin Pediatr 1979;18:424-5. 11 Goldberg NM, Adams E. Supplementary water for breast-fed babies in a hot and dry climate-not really a necessity. Arch Dis Child 1983;58:73-4. 12 Almroth S, Bidinger PD. No need for water supplementation for exclusively breast-fed infants under hot and arid conditions.  Brown KH, Creed de Kanashiro H, del Aguila R, Lopez de Romana, G, Black RE. Milk consumption and hydration status of exclusively breast-fed infants in a warm climate. J7 Pediatr 1986;108:677-8. 14 Canahuati J. One country's story: the PROALMA program in Honduras. In J Gynecol Obstet 1990;31(suppl 1):17-24. 15 World Health Organisation, United Nations Children's Fund. Protecting, promoting and supporting breast-feeding: the special role ofmaternity services.  1989.