nils-herrmann/clean_scirepeval huggingface dataset:
Evaluation of postextraction bleeding incidence to compare patients receiving and not receiving warfarin therapy: a cross-sectional, multicentre, observational study

We investigated incidence and risk factors for postextraction bleeding in patients receiving warfarin and those not receiving anticoagulation therapy.



Cross-sectional, multicentre, observational study.



26 hospitals where an oral surgeon is available.



Data on 2817 teeth (from 496 patients receiving warfarin, 2321 patients not receiving warfarin; mean age (SD): 62.2 (17.6)) extracted between 1 November 2008 and 31 March 2010, were collected. Warfarin-receiving patients were eligible when prothrombin time-international normalised ratio (PT-INR) measured within 7 days prior to the extraction was less than 3.0.



Simple dental extraction was performed, and incidence of postextraction bleeding and comorbidities were recorded.



Postextraction bleeding not controlled by basic haemostasis procedure was clinically significant.



Bleeding events were reported for 35 (7.1%) and 49 (2.1%) teeth, of which 18 (3.6%) and 9 (0.4%) teeth were considered clinically significant, in warfarin and non-warfarin groups, respectively, the difference between which was 3.24% (CI 1.58% to 4.90%). The incidence rates by patients were 2.77% and 0.39%, in warfarin and non-warfarin groups, respectively (incidence difference 2.38%, CI 0.65% to 4/10%). Univariate analyses showed that age (OR 0.197, p=0.001), PT-INR (OR 3.635, p=0.003), mandibular foramen conduction anaesthesia (OR 4.854, p=0.050) and formation of abnormal granulation tissue in extraction socket (OR 2.900, p=0.031) significantly correlate with bleeding incidence. Multivariate analysis revealed that age (OR 0.126, p=0.001), antiplatelet drugs (OR 0.100, p=0.049), PT-INR (OR 7.797, p=0.001) and history of acute inflammation at extraction site (OR 3.722, p=0.037) were significant risk factors for postextraction bleeding.



Our results suggest that there is slight but significant increase in the incidences of postextraction bleeding in patients receiving warfarin. Although absolute incidence was low in both groups, the bleeding risk is not negligible.
Reliability and validity of the Thai version of the WHO-Five Well-Being Index in primary care patients.

Because of the high patient load in Thailand, we need a practical measurement to help primary physicians detect depression. This study aimed to examine the reliability and validity of the Thai version of the World Health Organization-Five Well-Being Index (WHO-5-T), which is short and easy to use as a screening tool for major depression in primary care patients.



The English version of the WHO-Five Well-Being Index was translated into Thai. Back-translations, cross-cultural adaptation and field testing of the pre-final version with final adjustments were performed accordingly. The WHO-5-T was administered randomly to 300 patients in our primary care clinic. Then the patients were further assessed using the Mini International Neuropsychiatric Interview and the Hamilton Rating Scale for Depression as the gold standard of diagnosis and symptom severity, respectively.



Completed data were obtained from 274 respondents. Their mean age was 44.6 years [standard deviation (SD) = 14.7] and 73.7% of them were female. The mean WHO-5-T score was 14.32 (SD = 5.26). The WHO-5-T had a satisfactory internal consistency (Cronbach's alpha = 0.87) and showed moderate convergent validity with the Hamilton Rating Scale for Depression (r = -0.54; P < 0.001). The optimal cut-off score of the WHO-5-T <12 revealed a sensitivity of 0.89 and a specificity of 0.71 in detecting depression. The area under the curve in this study was 0.86 (SD = 0.03, 95% confidence interval 0.81 to 0.89).



The Thai version of the WHO-Five Well-Being Index was found to be a reliable and valid self-assessment to screen for major depression in primary care setting at a cut-off point of <12.
Older adults' pain descriptions.

The purpose of this study was to describe the types of pain information described by older adults with chronic osteoarthritis pain. Pain descriptions were obtained from older adults' who participated in a post-test-only double-blind study testing how the phrasing of health care practitioners' pain questions affected the amount of communicated pain information. The 207 community-dwelling older adults were randomized to respond to either the open-ended or the closed-ended pain question. They viewed and orally responded to a computer-displayed videotape of a practitioner asking them the respective pain question. All of them then viewed and responded to the general follow-up questions, "What else can you tell me?" and lastly, "What else can you tell me about your pain, aches, soreness or discomfort?" Audiotaped responses were transcribed and their content analyzed by trained independent raters using 16 a priori criteria from the American Pain Society's Guidelines for the Management of Pain in Osteoarthritis, Rheumatoid Arthritis, and Juvenile Chronic Arthritis. Older adults described important but limited types of information primarily about pain location, timing, and intensity. Pain treatment information was elicited after repeated questioning. Therefore, practitioners need to follow up older adults' initial pain descriptions with pain questions that promote a more complete pain management discussion. Routine use of a multidimensional pain assessment instrument that measures information such as functional interference, current pain treatments, treatment effects, and side effects would be one way of ensuring a more complete pain management discussion with older adults.
The shock index predicts acute mortality outcomes in stroke.

Shock index (SI) (ratio between heart rate and systolic blood pressure) has been shown to be associated with poor mortality outcomes in trauma and pneumonia; however it has yet to be examined in stroke. We aimed to examine the relationship between SI and acute outcomes of inpatient, 3-day and 7-day mortality in stroke. Secondly, we aimed to compare SI and systolic blood pressure (SBP) alone in predicting above outcomes.



Data from a multicentre prospective cohort study conducted between October 2009 and September 2012 in eight NHS trusts in East of England were analysed. The relationships between SI, SBP and study outcomes were assessed using multivariable logistic regression models using mid-quintile groups as the reference category. Receiver operating characteristic (ROC) curves assessed the discriminating ability between the SI and SBP models.



A total of 2121 stroke patients were included (47.4% men; mean age 77.10 (sd) 12.40) years. The lowest quintile of the SI, had an increased odds of 3-day and 7-day mortality, adjusted odds ratio (AOR) 2.45 (95% CI:1.16-5.17) and 1.88 (1.01-3.49), respectively. Patients with the highest quintile of SI also had increased odds of in-patient, 3-day and 7-day mortality, AORs 1.85 (1.17-2.92), 2.18 (1.03-4.63) and 2.45 (1.34-4.49), respectively. Similarly, SBP had a U-shape relationship with mortality. All measures had an ROC area under the curve >0.8 but there was no difference in the discriminating ability between SI and SBP.



SI at extremely high and low values appeared to predict stroke mortality and appears to be particularly useful in predicting very early (3-day) mortality.
A Randomised Controlled Study of Propranolol for Prevention of Recurrent Gastrointestinal Bleeding in Patients with Cirrhosis

74 cirrhotic patients with a history of variceal or gastric bleeding were randomly assigned to treatment with propranolol (40 to 360 mg/day) or placebo. The patients were all in good condition and doses of propranolol were titrated until a 25% reduction in heart rate was achieved. After 2 years, the cumulative percentage of patients free from rebleeding was significantly greater among the patients receiving propranolol (79%) than in the placebo group (32%; p<0.0001). Similarly, the percentage of surviving patients was significantly greater with propranolol (90%) than with placebo (57%; p<0.02) after 2 years. It was concluded that in cirrhotic patients in good condition, propranolol reduced both the risk of recurrent gastrointestinal haemorrhage and the mortality rate during a 2-year period of continuous administration of the drug.
Comparison of cost affecting parameters and costs of the "closed" and "open" in situ bypass technique.

The "closed" in situ bypass results in a reduction of wound complications compared to the "open" technique. This advantage is partly diminished by extra costs for the "closed" procedure and a larger percentage of residual arteriovenous (AV)-fistulae. This aim of this study was to analyse costs related to "closed" and "open" procedures.



The cost affecting parameters: (1) duration of operation; (2) length of hospital stay; and (3) number of treated residual AV-fistulae, were analysed in a randomised group of 73 patients (35 "closed" and 38 "open") in two centres. In addition, costs of the operation, nursing care and treatment of AV-fistulae were analysed.



The "closed" and "open" group showed a median duration of operation of 210 min (range 105-570) and 154 min (range 90-355) (p < 0.05), length of hospital stay of 16 days (range 5-51) and 25 days (range 12-65) (p < 0.01), and a percentage of patients treated for residual AV-fistulae of 40% and 5%, respectively (p < 0.01). The median "closed" operation was US$798 more expensive than the "open". Median postoperative care was US$2664 less for the "closed" group. Mean estimated costs for treatment of AV-fistulae was US$9 in the "open" and US$167 in the "closed" group.



The "closed" in situ vein bypass technique is cost-effective in comparison with the "open" technique.
The power of the transmission disequilibrium test (TDT) with both case-parent and control-parent trios.

The transmission disequilibrium test (TDT) customarily uses affected children and their parents (often case-parent trios, TDTD). Control-parent trios are necessary to guard against spurious significant results due to segregation distortion but are not generally utilized in the identification of disease susceptibility loci (DSL). Controls are often easy to recruit and the TDT can easily be extended to include control-parent trios into the analyses with unrelated case-parent trios. We present an extension of the TDT (TDTDC) that incorporates unrelated cases and controls and their parents into a single analysis. We develop a simple and accurate analytical method for computing the statistical power of various TDT (e.g. the TDTD, TDTDC, TDTDC and TDTC that employ control-parent trios only) under any genetic model. We investigated the power of these TDT, and particularly compared the relative power of the TDTD and TDTDC. We found that the TDTDC is almost always more powerful than the TDTC and TDTD. The relative power of the TDTDC and TDTD depends largely upon a number of parameters identified in the study. This study provides a basis for efficient use of control-parent trios in DSL identification.
A Phase I vaccine trial using dendritic cells pulsed with autologous oxidized lysate for recurrent ovarian cancer

Ovarian cancer, like most solid tumors, is in dire need of effective therapies. The significance of this trial lies in its promise to spearhead the development of combination immunotherapy and to introduce novel approaches to therapeutic immunomodulation, which could enable otherwise ineffective vaccines to achieve clinical efficacy. Tumor-infiltrating T cells have been associated with improved outcome in ovarian cancer, suggesting that activation of antitumor immunity will improve survival. However, molecularly defined vaccines have been generally disappointing. Cancer vaccines elicit a modest frequency of low-to-moderate avidity tumor-specific T-cells, but powerful tumor barriers dampen the engraftment, expansion and function of these effector T-cells in the tumor, thus preventing them from reaching their full therapeutic potential. Our work has identified two important barriers in the tumor microenvironment: the blood-tumor barrier, which prevents homing of effector T cells, and T regulatory cells, which inactivate effector T cells. We hypothesize that cancer vaccine therapy will benefit from combinations that attenuate these two barrier mechanisms. We propose a three-cohort sequential study to investigate a combinatorial approach of a new dendritic cell (DC) vaccine pulsed with autologous whole tumor oxidized lysate, in combination with antiangiogenesis therapy (bevacizumab) and metronomic cyclophosphamide, which impacts Treg cells. This study uses a novel autologous tumor vaccine developed with 4-day DCs pulsed with oxidized lysate to elicit antitumor response. Furthermore, the combination of bevacizumab with a whole tumor antigen vaccine has not been tested in the clinic. Finally the combination of bevacizumab and metronomic cyclophosphamide in immunotherapy is novel.
Treatment of venous thromboembolism with the oral thrombin inhibitor, ximelagatran.

Venous thromboembolic diseases are treated initially with low molecular weight heparin followed by oral coumarins.



To investigate an orally available direct thrombin inhibitor for the acute treatment of venous thromboembolism as well as for prophylaxis of recurrent events.



The direct thrombin inhibitor ximelagatran was compared with subcutaneous LMW heparins followed by oral warfarin in a double-blind randomized prospective multicenter trial in patients with acute VTE. A pharmacokinetic study was performed in the VTE patients. For assessing the prevention of recurrent VTE, double-blind prospective randomized studies were conducted as follows: a) ximelagatran compared to warfarin for 6 months, and b) prolonged anticoagulation of ximelagatran vs. placebo for 18 months after termination of 6 months coumarin therapy.



Two dose-finding studies and the pharmacokinetic analysis of ximelagatran in acute VTE were completed. About 2,500 patients were randomized to investigate 2 x 36 mg ximelagatran versus 2 x 1 mg/kg body weight enoxaparin followed by warfarin. The study hypothesized that the efficacy was equal in both treatment regimens for recurrent VTE documented by objective methods. The second study, with 1,234 patients, aimed to demonstrate a reduced incidence of recurrent thromboembolic events documented by objective methods after 18 months of treatment with 2 x 24 mg ximelagatran daily compared to placebo.



These large-scale clinical trials will soon yield the results of the comparison between oral ximelagatran and subcutaneous LMW heparin for treatment of acute VTE, and of warfarin for prophylaxis of recurrent events for 6 months and for a prolonged prophylaxis for another 18 months.
Pulmonary function and fuel use: A population survey

In the backdrop of conflicting reports (some studies reported adverse outcomes of biomass fuel use whereas few studies reported absence of any association between adverse health effect and fuel use, may be due to presence of large number of confounding variables) on the respiratory health effects of biomass fuel use, this cross sectional survey was undertaken to understand the role of fuel use on pulmonary function.



This study was conducted in a village of western India involving 369 randomly selected adult subjects (165 male and 204 female). All the subjects were interviewed and were subjected to pulmonary function test. Analysis of covariance was performed to compare the levels of different pulmonary function test parameters in relation to different fuel use taking care of the role of possible confounding factors.



This study showed that biomass fuel use (especially wood) is an important factor for deterioration of pulmonary function (particularly in female). FEV1 (p < .05), FEV1% (p < .01), PEFR (p < .05) and FEF(25-75) (p < .01) values were significantly lower in biomass fuel using females than nonusers. Comparison of only biomass fuel use vs. only LPG (Liquefied Petroleum Gas) use and only wood vs. only LPG use has showed that LPG is a safer fuel so far as deterioration of pulmonary function is concerned. This study observes some deterioration of pulmonary function in the male subjects also, who came from biomass fuel using families.



This study concluded that traditional biomass fuels like wood have adverse effects on pulmonary function.
Aortic Hemodynamics and Arterial Stiffness Responses to Muscle Metaboreflex Activation With Concurrent Cold Pressor Test.

Overweight/obese young men have increased sympatho-excitation to cold and pain stress-induced by the cold pressor test (CPT) that may lead to abnormal hemodynamic responses. Concurrent CPT and exercise may augment the sympathetic-induced increases in aortic blood pressure (BP), pressure wave reflection (augmentation index, AIx), and arterial stiffness (pulse wave velocity, PWV). Since obesity is related with hypertension and sympathetic activity, we evaluated the aortic hemodynamic and PWV responses to muscle metaboreflex activation imposed by postexercise muscle ischemia (PEMI) concurrent with CPT in overweight/obese men.



In 16 healthy (body mass index >25 and <40kg/m(2)) men (24±2 years), heart rate (HR), brachial BP, aortic BP, augmented pressure (AP), AIx, AIx adjusted to 75 beats/min (AIx@75), reflection time (Tr), first (P1) and second systolic peak (P2, wave reflection magnitude), and PWV (brachial-ankle PWV, baPWV) were evaluated at baseline, during isometric-handgrip exercise (IHG), and PEMI with (PEMI + CPT) and without CPT.



During IHG, brachial BP, aortic BP, AP, AIx, AIx@75, P1, and P2 increased ( P < 0.01) while Tr decreased ( P < 0.05) compared with baseline. During PEMI, all hemodynamic parameters remained elevated ( P < 0.05) and baPWV increased (P < 0.05) while Tr and HR returned to baseline. Compared with PEMI, the increases in HR, brachial BP, aortic BP, AIx@75, P1, P2, and baPWV were greater ( P < 0.05) during PEMI + CPT. During PEMI + CPT, Tr remained lower ( P < 0.05) than baseline.



Cold exposure with concurrent metaboreflex activation induces a significant increase in aortic hemodynamics and arterial stiffness, which may explain the high risk of adverse cardiovascular events during physiological stress.
Tolerance and Antiviral Effects of High-Dose Interferon-α B/D in Patients with Chronic Hepatitis B

A novel recombinant interferon-α B/Dhybrid was applied to assess tolerability, antiviraleffect, and biological activity in chronic hepatitis B.The study was designed as an open nonrandomized trial. Treatment comprised a two-week run-in phasewith 16 MU three times a week followed by 14 weeks with64 MU three times a week (or 48 MU if toxicity occurredwith 64 MU). Total follow-up was 36 weeks. Nineteen patients were included; three discontinuedtreatment during the run-in with 16 MU. Fourteen of 16patients had 14 weeks of treatment with ≥32 MU threetimes a week. Fourteen dose reductions were necessary in nine patients. The adverse experienceprofile was similar to other interferon-αs.HBV-DNA decreased using all doses studied. HBV-DNAbecame undetectable in five patients, two of whom hadHBeAg seroconversion. No HBsAg seroconversion was observed. It isconcluded that interferon-α B/D is well toleratedin high doses. The anti-viral effect starts at at least16 MU three times a week.
Treatment of Helicobacter pylori in patients with duodenal ulcer hemorrhage— a long-term randomized, controlled study

Eradication of Helicobacter pylori (H. pylori) in patients with uncomplicated duodenal ulcers prevents long-term recurrence of ulcers. We aimed to study whether treatment of H. pylori prevents the long-term recurrence of duodenal ulcer hemorrhage.Patients with duodenal ulcer bleeding and confirmed H. pylori infection were recruited. A total of 120 patients were randomly assigned to triple therapy (DeNoltab 120 mg, amoxycillin 500 mg, and metronidazole 300 mg four times daily) or DeNoltab 120 mg four times daily alone. No maintenance therapy was given during the follow-up period. The endpoints were the cumulative rates of symptomatic and bleeding duodenal ulcer recurrences.Of the patients receiving the triple regimen, 85.1% had H. pylori eradicated as compared to 2.0% of patients receiving DeNoltab (p < 0.05). More patients in the DeNoltab group than those in the Triple group had recurrence of ulcer bleeding, but this did not reach statistical significance (12/60 vs 6/60, p = 0.20). Logistic regression analysis on clinical, personal, and endoscopic characteristics identified persistent H. pylori infection as the only independent predictor of recurrence of duodenal ulcer bleeding.Treatment of H. pylori alone with the present bismuth-based triple therapy in patients with duodenal ulcer hemorrhage did not result in significant reduction in further bleeding episodes, although a trend was seen for the group that was given triple therapy. On the other hand, posttreatment H. pylori status was found to be an independent predictor of bleeding recurrence.
Real-time Finite-elements Simulation of General Visco-elastic Materials for Haptic Presentation

This paper introduces a methodology to simulate the dynamics of visco-elastic 3-dimensional bodies in realtime using a nite element approach. The method is currently being applied to a haptic simulation of a deformable body incorporating mass, damping, and sti ness. The central idea in this scheme is to reduce the computation required in regions which are to the periphery of area of interaction between the virtual haptic device and the virtual body. This is accomplished by implementing a multi-layer mesh; the top layer, or parent mesh, consisting of a coarse mesh, while child meshes represent sub-regions of the coarse mesh but have a much ner resolution. The e ective decoupling of regions enables the system not only to have di erent resolutions in di erent regions, but also allows the regions of the mesh to be updated at di erent frequencies. The key to achieving this is by utilizing equivalent impedances.
Outcomes of crises before and after introduction of a crisis resolution team.

Crisis resolution teams (CRTs) are being introduced throughout England, but their evidence base is limited.



To compare outcomes of crises before and after introduction of a CRT.



A new methodology was developed for identification and operational definition of crises. A quasi-experimental design was used to compare cohorts presenting just before and just after a CRT was established.



Following introduction of the CRT, the admission rate in the 6 weeks after a crisis fell from 71% to 49% (OR 0.38, 95% CI 0.21-0.70). A difference of 5.6 points (95% CI 2.0-8.3) on mean Client Satisfaction Questionnaire (CSQ-8) score favoured the CRT. These findings remained significant after adjustment for baseline differences. No clear difference emerged in involuntary hospitalisations, symptoms, social functioning or quality of life.



CRTs may prevent some admissions and patients prefer them, although other outcomes appear unchanged in the short term.