nils-herrmann/clean_scirepeval huggingface dataset:
Short-term amiodarone therapy after reversion of persistent atrial fibrillation reduces recurrences at 18 months.

The aim of this study was to compare the outcome of 3 months vs. 18 months of amiodarone treatment after atrial fibrillation (AF) conversion in patients who experienced the first episode of persistent AF.



We included 51 patients who experienced the first episode of persistent AF receiving amiodarone (600 mg) daily for 4-6 weeks. If AF persisted, electrical cardioversion (ECV) was performed. All patients received amiodarone (200 mg daily) for 3 months and then were randomized to amiodarone (Group I) or placebo (Group II) and followed for 15 months. The control group comprised 9 untreated patients undergoing ECV. Treatment effectiveness was evaluated using a Bayesian model.



Eighteen months after AF reversion, 22 (81.5%) patients in Group I, 13 (54.2%) patients in Group II, and 1 (11.1%) patient in the control group remained in sinus rhythm. No differences were found between Group I patients who required ECV and Group II patients. Sinus rhythm was preserved in all Group I patients when it was achieved during amiodarone administration. Limiting adverse effects occurred in 3 (11.1%) patients in Group I.



In patients regaining sinus rhythm after the first episode of persistent AF, a 3-month amiodarone treatment after reversion is a reasonable option for rhythm control.
A clinical prediction rule for early discharge of patients with chest pain.

Current risk stratification tools do not identify very-low-risk patients who can be safely discharged without prolonged emergency department (ED) observation, expensive rule-out protocols, or provocative testing. We seek to develop a clinical prediction rule applicable within 2 hours of ED arrival that would miss fewer than 2% of acute coronary syndrome patients and allow discharge within 2 to 3 hours for at least 30% of patients without acute coronary syndrome.



This prospective, cohort study enrolled consenting eligible subjects at least 25 years old at a single site. At 30 days, investigators assigned a diagnosis of acute coronary syndrome or no acute coronary syndrome according to predefined explicit definitions. A recursive partitioning model included risk factors, pain characteristics, physical and ECG findings, and cardiac marker results.



Of 769 patients studied, 77 (10.0%) had acute myocardial infarction and 88 (11.4%) definite unstable angina. We derived a clinical prediction rule that was 98.8% sensitive and 32.5% specific. Patients have very low risk of acute coronary syndrome if they have a normal initial ECG, no previous ischemic chest pain, and age younger than 40 years. In addition, patients at least 40 years old and with a normal ECG result, no previous ischemic chest pain, and low-risk pain characteristics have very low risk if they have an initial creatine kinase-MB (CK-MB) less than 3.0 microg/L or an initial CK-MB greater than or equal to 3.0 microg/L but no ECG or serum-marker increase at 2 hours.



The Vancouver Chest Pain Rule for early discharge defines a group of patients who can be safely discharged after a brief evaluation in the ED. Prospective validation is needed.
Corticosteroid treatment of eosinophilic meningitis.

The role of corticosteroids in the treatment of eosinophilic meningitis has not been definitely established. Patients given a 2-week course of prednisolone (treatment group), 60 mg/day, were compared with those given placebo (control group) in a randomized, double-blind trial. Fifty-five patients were enrolled in each group. There were significant differences between the treatment and control groups, with regard to the number of patients who still had headache after 14 days (5 vs. 25, respectively; P=.00004), the median length of time until complete disappearance of headache (5 vs. 13 days, respectively; P=.00000), and the number of patients who had repeat lumbar puncture (7 vs. 22, respectively; P=.002). Serious side effects were not detected. These results indicate that a 2-week course of prednisolone was beneficial in relieving headache in patients with eosinophilic meningitis.
Randomized clinical trial comparing lumbar percutaneous hydrodiscectomy with lumbar open microdiscectomy for the treatment of lumbar disc protrusions and herniations

Hydrodiscectomy is a new technique used for percutaneous spinal discectomy that employs a high-intensity stream of water for herniated disc ablation and tissue aspiration. No previous clinical study has examined the effects of percutaneous hydrodiscectomy. The aim of this study is to evaluate the outcomes of hydrodiscectomy compared to open microdiscectomy regarding pain, function, satisfaction, complications and recurrence rates.



In this randomized clinical trial, patients referred to our tertiary hospital for lumbar back pain were recruited and included in the study if they had disc protrusion or small herniation in only one level, without neurological deficits and with no resolution after six weeks of conservative treatment. One group underwent open microdiscectomy, and the other group underwent percutaneous microdiscectomy via hydrosurgery. Function was evaluated using the Oswestry Disability Index and pain was assessed using a visual analog scale. Evaluations were performed preoperatively, and then during the first week and at one, three, six and twelve months postoperatively. Personal satisfaction was verified. 
During the study period, 20 patients were included in each arm and 39 completed one-year of follow-up (one patient died of unrelated causes). Both groups exhibited equal improvement on the visual analog scale and Oswestry evaluations after treatment, without any significant differences. The improvement in the lumbar visual analog scale score was not significant in the hydrodiscectomy group (p=0.138). The rates of infection, pain, recurrence and satisfaction were similar between the two groups.



Percutaneous hydrodiscectomy was demonstrated to be as effective as open microdiscectomy for reducing pain. The rates of complications and recurrence of herniation were similar between groups. Patient satisfaction with the treatment was also similar between groups.
Segmentation of Image Data from Complex Organotypic 3D Models of Cancer Tissues with Markov Random Fields

Organotypic, three dimensional (3D) cell culture models of epithelial tumour types such as prostate cancer recapitulate key aspects of the architecture and histology of solid cancers. Morphometric analysis of multicellular 3D organoids is particularly important when additional components such as the extracellular matrix and tumour microenvironment are included in the model. The complexity of such models has so far limited their successful implementation. There is a great need for automatic, accurate and robust image segmentation tools to facilitate the analysis of such biologically relevant 3D cell culture models. We present a segmentation method based on Markov random fields (MRFs) and illustrate our method using 3D stack image data from an organotypic 3D model of prostate cancer cells co-cultured with cancer-associated fibroblasts (CAFs). The 3D segmentation output suggests that these cell types are in physical contact with each other within the model, which has important implications for tumour biology. Segmentation performance is quantified using ground truth labels and we show how each step of our method increases segmentation accuracy. We provide the ground truth labels along with the image data and code. Using independent image data we show that our segmentation method is also more generally applicable to other types of cellular microscopy and not only limited to fluorescence microscopy.
Reproducibility of heart rate and blood pressure variability in patients with chronic obstructive pulmonary disease

Wide variations in respiratory rate and hypoxic stimulation of chemoreceptors may produce unreliable autonomic results in patients with COPD. We studied the reproducibility of two consecutive measurements of heart rate variability (HRV) and blood pressure variability (BPV) by time frequency analysis in patients with COPD while controlling respiratory rate and oxygen hemoglobin saturation (SaO2). Reproducibility was assessed by paired t-tests and correlation analyses between repeated measures. Correlation analyses of the log transformed low (LF) and high frequency (HF) HRV were x̄ 11.5 ± 1.1 in measurement A and x̄ 11.5 ± 1.0 in measurement B (r = 0.89, p < 0.0001), and x̄ 10.5 ± 1.1 in measurement A and x̄ 10.6 ± 1.1 in measurement B (r = 0.89, p < 0.0001) respectively. The log transformed LF and HF BPV were x̄ 4.9 ± 1.3 in measurement A and x̄ 5.3 ± 0.9 in measurement B (r = 0.70, p < 0.0002), and x̄ 6.4 ± 1.3 in measurement A and 6.6 ± 1.2 in measurement B (R = 0.71 p < 0.0001) respectively. In conclusion, time frequency analysis of HRV and BPV is reproducible and reliable in patients with COPD while controlling their respiratory rate and oxygen hemoglobin saturation. Reproducibility of these measurements may allow for a non-invasive evaluation of autonomic tone in response to treatments in COPD patients.
Relationship between baseline haemoglobin and major bleeding complications in acute coronary syndromes.

In patients with acute coronary syndromes (ACS), the negative impact of baseline haemoglobin levels on ischaemic events, particularly death, is well established, but the association with bleeding risk is less well studied. The aim of this study was to assess the impact of baseline haemoglobin levels on major bleeding complications.



Pooled analysis of OASIS 5 and 6 data involving 32 170 patients with ACS with and without ST-segment elevation was performed. The association between baseline haemoglobin and major bleeding or ischaemic events was examined using multiple regression model.



were 30-day rates of major bleeding, death, and death/myocardial infarction (MI) analysed according to baseline haemoglobin levels. Baseline haemoglobin level independently predicted the risk of overall, procedure-related, and non-procedure-related major bleedings at 30 days [odds ratio (OR) 0.94, 95% CI 0.90-0.98; OR 0.94, 95% CI 0.90-0.99; and OR 0.89, 95% CI 0.83-0.95, respectively, per 1 g/dL haemoglobin increment above 10 g/dL]. In addition, a curvilinear relationship between baseline haemoglobin levels and death at 30 days was observed with a 6% decrease in the risk for every 1 g/dL haemoglobin increment above 10 g/dL up to 15.9 g/dL (OR 0.94, 95% CI 0.90-0.98) and a 19% increase above this value (OR 1.19, 95% CI, 0.98-1.43). A similar relationship for the composite outcome of death/MI was observed.



A low baseline haemoglobin level is an independent predictor of the risk of major bleeding in ACS as well as of the risk of death and death and MI. Among other predictors of bleeding risk, baseline haemoglobin should be taken into account in patients presenting with ACS.
The influence of neuropsychological rehabilitation on symptomatology and quality of life following brain injury: a controlled long-term follow-up.

To establish whether, following acquired brain injury, intensive post-acute neuropsychological rehabilitation could have long-term beneficial effects.



A group of 37 adults who had suffered cerebrovascular accidents or traumatic brain injuries and who had undergone a rehabilitation programme were followed up 12-22 years post-injury, together with a non-rehabilitated control group of 13 adults, matched for brain-injury and demographics characteristics. Both groups completed a set of questionnaires concerning broad aspects of psychological well-being. Significant others completed similar questionnaires.



The rehabilitation group showed significantly lower levels of brain injury symptoms and higher levels of competency at follow-up. They also rated internal locus of control and general self-efficacy as significantly higher than the control group. Anxiety and depression levels were significantly lower and quality of life significantly higher in the rehabilitation group for both the subjects themselves and for their significant others.



Within methodological limitations this study suggests that post-acute neuropsychological rehabilitation can have long-term beneficial effects.
Progress in understanding the role of carotid endarterectomy.

The North American Symptomatic Carotid Endarterectomy Trial (NASCET) was initiated because of genuine uncertainty about the appropriateness of the increasing popularity of this procedure. Evidence of this uncertainty was the geographic disparity in its application. In the United States it was performed 27 and 8 times as often on a population based calculation as in the United Kingdom and Canada respectively. As well, the numbers performed annually in the United States fluctuated widely. In 1980 approximately 70,000 were performed and the numbers for 1985 and 1988 were 107,000 and 68,000 respectively. A study initiated by the American Medicare to define the application of endarterectomy, agreed upon by a panel of experts in the field, tested its use against an "appropriateness index". It concluded that one-third of those who received the procedure were appropriate, one-third were not appropriate and one-third were of uncertain appropriateness. All of this uncertainty existed despite the fact that a voluminous literature describing scores of thousands of case reports had accumulated, two negative randomized trials of small size had been conducted and one million patients had been submitted to the procedure between 1954 when it was introduced and 1985.
Growth and lung function in Asian patients with cystic fibrosis.

The incidence of cystic fibrosis (CF) in Asians is rare. How these patients fare in terms of morbidity and mortality in the UK compared to their non-Asian peers is not well documented.



To retrospectively study annual reviews of 31 Asian CF patients from three London paediatric CF centres.



Disease severity was assessed by lung function, age at first infection with Pseudomonas aeruginosa, and body mass index (BMI). The Asian children were compared with 143 matched non-Asian patients with CF. Matching criteria used were same sex and treatment centre as the Asian index patient. In addition, the controls were matched so that their date of birth, date of diagnosis, and date at annual review were within 12 months of the index patient.



There was no significant difference in age at diagnosis or age at annual review between the Asian and non-Asian children. Mean Z-scores for FEV1 and FVC were significantly lower for the Asian girls. There was no significant difference in Z-scores for BMI between the Asian children and their controls. Age at first isolation of Pseudomonas aeruginosa in Asian girls was significantly later than for their controls (8.3 years compared to 5.6 years for non-Asian girls).



While the Asian boys' lung function seems comparable with that of their non-Asian peers, the Asian girls emerge as a potentially vulnerable group and more work is required to discover why this is the case.
Longstanding neuropathic pain after spinal cord injury is refractory to transcranial direct current stimulation: A randomized controlled trial

Neuropathic pain remains one of the most difficult consequences of spinal cord injury (SCI) to manage. It is a major cause of suffering and adds to the physical, emotional, and societal impact of the injury. Despite the use of the best available treatments, two thirds of people experiencing neuropathic pain after SCI do not achieve satisfactory pain relief. This study was undertaken in response to a recent clinical trial reporting short-term, clinically significant reductions in neuropathic SCI pain with primary motor cortex transcranial direct current stimulation (tDCS). In this investigation, we aimed to build on this previous clinical trial by extending the assessment period to determine the short-, medium-, and long-term efficacy of tDCS for the treatment of neuropathic pain after SCI. We found that, contrary to previous reports, after 5 tDCS treatment periods, mean pain intensity and unpleasantness rating were not significantly different from initial assessment. That is, in this trial tDCS did not provide any pain relief in subjects with neuropathic SCI pain (n=10). A similar lack of effect was also seen after sham treatment. Because the injury duration in this study was significantly greater than that of previous investigations, it is possible that tDCS is an effective analgesic only in individuals with relatively recent injuries and pain. Future investigations comparing a range of injury durations are required if we are to determine whether this is indeed the case.
The efficacy of surgical decompression before 24 hours versus 24 to 72 hours in patients with spinal cord injury from T1 to L1 – with specific consideration on ethics: a randomized controlled trial

There is no clear evidence that early decompression following spinal cord injury (SCI) improves neurologic outcome. Such information must be obtained from randomized controlled trials (RCTs). To date no large scale RCT has been performed evaluating the timing of surgical decompression in the setting of thoracolumbar spinal cord injury. A concern for many is the ethical dilemma that a delay in surgery may adversely effect neurologic recovery although this has never been conclusively proven. The purpose of this study is to compare the efficacy of early (before 24 hours) verse late (24-72 hours) surgical decompression in terms of neurological improvement in the setting of traumatic thoracolumbar spinal cord injury in a randomized format by independent, trained and blinded examiners.



In this prospective, randomized clinical trial, 328 selected spinal cord injury patients with traumatic thoracolumbar spinal cord injury are to be randomly assigned to: 1) early surgery (before 24 hours); or 2) late surgery (24-72 hours). A rapid response team and set up is prepared to assist the early treatment for the early decompressive group. Supportive care, i.e. pressure support, immobilization, will be provided on admission to the late decompression group. Patients will be followed for at least 12 months posttrauma.



This study will hopefully assist in contributing to the question of the efficacy of the timing of surgery in traumatic thoracolumbar SCI.
Reliability and validity of the Korean version of the coronary revascularization outcome questionnaire

People with ischemic heart disease have increased drastically, and their health-related quality of life (HRQOL) has been increasingly important. The Coronary Revascularization Outcome Questionnaire (CROQ) is a widely used tool to assess the quality of life in patients with coronary artery disease. The purpose of this study was to rigorously examine the psychometric properties of the CROQ in patients who had undergone percutaneous coronary intervention (PCI).



The CROQ was translated into Korean. A total of 209 patients before PCI and 169 patients after PCI were recruited from a university hospital in Korea and completed questionnaires. In terms of statistical analyses, internal consistency, concurrent validity with using the Short Form 12 (SF-12) and Seattle Angina Questionnaire-Korean version (SAQ-K), and construct validity using exploratory factor analysis were assessed. Effective size statistics were calculated.



The internal consistency coefficients for all subscales of the CROQ were above 0.70, except the domain of adverse effects. The concurrent validity was mostly supported by the pattern of association among CROQ-K, SAQ-K, and SF-12. The results of EFA showed the core items of the CROQ had 7 factors. Large effect sizes were observed for the symptoms and the psychosocial functioning scales.



The Korean version of the CROQ is a valid and reliable scale for assessing HRQOL in patients with coronary artery disease.
Phase II trial of intravenous lobradimil and carboplatin in childhood brain tumors: a report from the Children’s Oncology Group

Lobradimil is a synthetic bradykinin analog that rapidly and transiently increases the permeability of the blood-brain barrier (BBB). The combination of lobradimil and carboplatin was studied in pediatric patients with primary brain tumors in a phase II trial, the primary endpoints of which were to estimate the response rate and time to disease progression.  Patients were stratified by histology into five cohorts: brainstem glioma, high-grade glioma, low-grade glioma, medullobastoma/primitive neuroectodermal tumor (PNET), and ependymoma. Patients received carboplatin adaptively dosed to achieve a target AUC of 3.5 mg min/ml per day (7 mg·min/ml/cycle) intravenously over 15 min on 2 consecutive days and lobradimil 600 ng/kg ideal body weight/day on 2 consecutive days each 28 day cycle.  Forty-one patients, age 2–19 years, were enrolled; 38 patients, including 1 patient ultimately determined to have atypical neurocytoma, were evaluable for response. No objective responses were observed in the brainstem glioma (n=12) and high-grade glioma (n=9) cohorts, although two patients with high-grade glioma had prolonged disease stabilization (>6 months). The study was closed for commercial reasons prior to achieving the accrual goals for the ependymoma (n=8), medulloblastoma/PNET (n=6) and low-grade glioma (n=2) cohorts, although responses were observed in 1 patient with PNET and 2 patients with ependymoma.  The combination of lobradimil and carboplatin was inactive in childhood high-grade gliomas and brainstem gliomas.
Clinical study of neurorehabilitation in stroke using EEG-based motor imagery brain-computer interface with robotic feedback

This clinical study investigates the ability of hemiparetic stroke patients in operating EEG-based motor imagery brain-computer interface (MI-BCI). It also assesses the efficacy in motor improvements on the stroke-affected upper limb using EEG-based MI-BCI with robotic feedback neurorehabilitation compared to robotic rehabilitation that delivers movement therapy. 54 hemiparetic stroke patients with mean age of 51.8 and baseline Fugl-Meyer Assessment (FMA) 14.9 (out of 66, higher = better) were recruited. Results showed that 48 subjects (89%) operated EEG-based MI-BCI better than at chance level, and their ability to operate EEG-based MI-BCI is not correlated to their baseline FMA (r=0.358). Those subjects who gave consent are randomly assigned to each group (N=11 and 14) for 12 1-hour rehabilitation sessions for 4 weeks. Significant gains in FMA scores were observed in both groups at post-rehabilitation (4.5, 6.2; p=0.032, 0.003) and 2-month post-rehabilitation (5.3, 7.3; p=0.020, 0.013), but no significant differences were observed between groups (p=0.512, 0.550). Hence, this study showed evidences that a majority of hemiparetic stroke patients can operate EEG-based MI-BCI, and that EEG-based MI-BCI with robotic feedback neurorehabilitation is effective in restoring upper extremities motor function in stroke.
Ultrasonography for Diagnosis of Acute Appendicitis: Results of a Prospective Multicenter Trial

A prospective multicenter observational trial was performed to assess the performance and clinical benefit of ultrasonography of the appendix in the routine clinical examination. Included in the study were 2280 patients with acute abdominal pain from 11 surgical departments in Germany and Austria. Ultrasonography of the appendix was performed in 870 (38%) of the patients (range 16-85%). The overall sensitivity of ultrasonography of the appendix was 55% (13-90%), the specificity 95% (range 82-100%), positive predictive value 81% (50-100%), and negative predictive value 85% (68-96%). With respect to single ultrasound scan findings, adequate sensitivity (44%) was achieved only with the target phenomen, not with the other criteria. There were no correlations between the ultrasound findings of the appendix and the diagnostic accuracy of the clinician, the negative appendectomy rate, or the perforated appendix rate. From the study it can be concluded that there is no proven clinical benefit of ultrasound scanning of the appendix in the routine clinical diagnosis.