nils-herrmann/clean_scirepeval huggingface dataset:
Heart Rate Variability in Congenital Central Hypoventilation Syndrome

Heart rate variability was assessed in 12 patients with congenital central hypoventilation syndrome (CCHS) and in age- and sex-matched controls using SD of time intervals between R waves (R-R intervals), R-R interval histograms, spectral analysis, and Poincaré plots of sequential R-R intervals over a 24-h period using ambulatory monitoring. Mean heart rates in patients with CCHS were 103.3 ± 17.7 SD and in controls were 98.8 ± 21.6 SD (p > 0.5, NS). SD analysis of R-R intervals showed similar results in both groups (CCHS 102.2 ± 36.0 ms versus controls 126.1 ± 43.3 ms; p > 0.1, NS). Spectral analysis revealed that, for similar epochs sampled during quiet sleep and wakefulness, the ratios of low-frequency band to high-frequency band spectral power were increased for 11 of 12 patients with CCHS during sleep, whereas a decrease in these ratios was consistently observed in all controls during comparable sleep states (χ2 = 20.31; p < 0.000007). During wakefulness, the ratios of low-frequency band to high-frequency band spectral power were similar in both patients with CCHS and controls. Poincaré plots displayed significantly reduced beat-to-beat changes at slower heart rates in the CCHS patients (χ2 = 24.0; p < 0.000001). The scatter of points in CCHS Poincare plots was easily distinguished from controls. AH CCHS patients showed disturbed variability with one or more measures. The changes in moment-to-moment heart rate variability suggest that, in addition to a loss of ventilatory control, CCHS patients exhibit a dysfunction in autonomic nervous system control of the heart.
Approximating the Girth

This paper considers the problem of computing a minimum weight cycle in weighted undirected graphs. Given a weighted undirected graph <i>G</i>(<i>V,E,w</i>), let <i>C</i> be a minimum weight cycle of <i>G</i>, let <i>w</i>(<i>C</i>) be the weight of <i>C</i> and let <i>w</i><sub><i>max</i></sub> (<i>C</i>) be the weight of the maximal edge of <i>C</i>. We obtain three new approximation algorithms for the minimum weight cycle problem:
 1. For integral weights from the range [1, <i>M</i>] an algorithm that reports a cycle of weight at most 4/3<i>w</i>(<i>C</i>) in <i>O</i>(<i>n</i><sup>2</sup> log <i>n</i>(log <i>n</i> + log <i>M</i>)) time.
 2. For integral weights from the range [1, <i>M</i>] an algorithm that reports a cycle of weight at most <i>w</i>(<i>C</i>) + <i>w</i><sub><i>max</i></sub> (<i>C</i>) in <i>O</i>(<i>n</i><sup>2</sup> log <i>n</i>(log <i>n</i> + log <i>M</i>)) time.
 3. For non-negative real edge weights an algorithm that for any ε > 0 reports a cycle of weight at most (4/3 + ε)<i>w</i>(<i>C</i>) in <i>O</i>(1/ε <i>n</i><sup>2</sup> log <i>n</i>(log log <i>n</i>)) time.
 In a recent breakthrough Vassilevska Williams and Williams [WW10] showed that a subcubic algorithm that computes the exact minimum weight cycle in undirected graphs with integral weights from the range [1, <i>M</i>] implies a subcubic algorithm for computing all-pairs shortest paths in directed graphs with integral weights from the range [− <i>M, M</i>]. This implies that in order to get a subcubic algorithm for computing a minimum weight cycle we have to relax the problem and to consider an approximated solution.
 Lingas and Lundell [LL09] were the first to consider approximation in the context of minimum weight cycle in weighted graphs. They presented a 2-approximation algorithm for integral weights with <i>O</i>(<i>n</i><sup>2</sup> log <i>n</i>(log <i>n</i> + log <i>M</i>)) running time. They also posed as an open problem the question whether it is possible to obtain a subcubic algorithm with a <i>c</i>-approximation, where <i>c</i> < 2. The current paper answers this question in the affirmative, by presenting an algorithm with 4/3-approximation and the same running time.
 Surprisingly, the approximation factor of 4/3 is not accidental. We show using the new result of Vassilevska Williams and Williams [WW10] that a subcubic combinatorial algorithm with (4/3 − ε)-approximation, where 0 < ε ≤ 1/3, implies a subcubic combinatorial algorithm for multiplying two boolean matrices.
Integrative Modeling of Macromolecular Assemblies from Low to Near-Atomic Resolution

While conventional high-resolution techniques in structural biology are challenged by the size and flexibility of many biological assemblies, recent advances in low-resolution techniques such as cryo-electron microscopy (cryo-EM) and small angle X-ray scattering (SAXS) have opened up new avenues to define the structures of such assemblies. By systematically combining various sources of structural, biochemical and biophysical information, integrative modeling approaches aim to provide a unified structural description of such assemblies, starting from high-resolution structures of the individual components and integrating all available information from low-resolution experimental methods. In this review, we describe integrative modeling approaches, which use complementary data from either cryo-EM or SAXS. Specifically, we focus on the popular molecular dynamics flexible fitting (MDFF) method, which has been widely used for flexible fitting into cryo-EM maps. Second, we describe hybrid molecular dynamics, Rosetta Monte-Carlo and minimum ensemble search (MES) methods that can be used to incorporate SAXS into pseudoatomic structural models. We present concise descriptions of the two methods and their most popular alternatives, along with select illustrative applications to protein/nucleic acid assemblies involved in DNA replication and repair.
Antifibrotic effect of aloe vera in viral infection-induced hepatic periportal fibrosis.

To investigate the anti-oxidative and anti-fibrotic effects of aloe vera in patients with liver fibrosis.



Aloe vera high molecular weight fractions (AHM) were processed by patented hyper-dry system in combination of freeze-dry technique with microwave and far infrared-ray radiation. Fifteen healthy volunteers as the control group and 40 patients were included. The patients were randomly subdivided into two equal groups: the conventional group was treated with placebo (starch), and AHM group was treated with 0.15 gm/d AHM, both for 12 consecutive weeks. The patients were investigated before and after treatment. Serum activity of aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP), hyaluronic acid (HA), transforming growth factor-β (TGF-β) and matrixmetalloproteinase-2 (MMP-2) were determined. The reduced glutathione (GSH) and malondialdehyde (MDA) levels in liver were assayed and the expression of hepatic α-smooth muscle actin (α-SMA) was identified by immunohistochemistry.



At the start of the study, the hematoxylin and eosin staining revealed fibro-proliferated bile ductules, thick fibrous septa and dense inflammatory cellular infiltration in the patients before treatment. The use of AHM for 12 wk significantly ameliorated the fibrosis, inhibited the inflammation, and resulted in minimal infiltration and minimal fibrosis compared to the conventional group. The enzyme activities of the liver (ALT, AST and ALP) were attenuated after treatment in both groups, and the decrease in the AHM group was more significant as compared with the conventional group. Similar to the AST, the MDA levels were significantly higher before treatment, and were attenuated after treatment in both groups. In contrast, the hepatic glutathione content in the patients were decreased significantly in the AHM group compared to the controls. The serum levels of the fibrosis markers (HA, TGF-β and MMP-2) were also reduced significantly after treatment. The expression of α-SMA was modified in patients before and after treatment as compared with the normal controls. In the conventional group, there was only thin and incomplete parenchymal α-SMA positive septum joining the thickened centrilobular veins, while in the AHM group, few α-SMA positive cells were present in sinusoid and lobule after treatment.



Oral supplementation with AHM could be helpful in alleviating the fibrosis and inflammation of hepatic fibrosis patients.
Dietary glucosinolate intake and risk of prostate cancer in the EPIC-Heidelberg cohort study.

Glucosinolates (GLS) are secondary plant metabolites occurring in cruciferous vegetables. Their biologically active break-down products show cancer preventive properties in animal and cell studies. So far, epidemiologic studies, using consumption of cruciferous vegetables as proxy for GLS intake, yielded inconsistent results. Here, we evaluated the association between dietary intake of GLS in comparison with consumption data of GLS-containing foods and the risk of prostate cancer. The study population comprised 11,405 male participants of the prospective EPIC-Heidelberg cohort study. During a mean follow-up time of 9.4 years, 328 incident cases of prostate cancer occurred. At recruitment, habitual food consumption was assessed by a validated food frequency questionnaire, and intake of individual GLS was estimated by means of a newly compiled database on food content of GLS. Adjusted hazard ratios (HR) for prostate cancer were calculated using the Cox proportional hazard model. Median daily intake of total GLS was 7.9 mg/day (interquartile range 5.1-11.9 mg/day). The risk of prostate cancer decreased significantly over quartiles of total GLS intake (multivariate HR [4th vs. 1st quartile] 0.68, 95% CI 0.48-0.97, p(trend) 0.03). Associations with GLS-containing food intake were weaker. Among GLS subgroups, aliphatic GLS showed the strongest inverse association with cancer risk. Analyses stratified by tumor stage and grade gave hint to inverse associations for localized and low-grade cancers. This study shows an inverse association between dietary intake of GLS and the risk of prostate cancer. Because this is the first prospective study using individual GLS intake data, confirmation in other studies is warranted.
Internal cardioversion of chronic atrial fibrillation during percutaneous mitral commissurotomy: insight into reversal of chronic stretch-induced atrial remodeling.

Mechanoelectrical feedback caused by atrial dilatation plays an important role in atrial fibrillation (AF). To test the hypothesis that remodeling is reversible by reducing atrial stretch, we investigated electrophysiological changes after a reduction of left atrial (LA) pressure in patients undergoing percutaneous balloon mitral commissurotomy (PBMC).



In 22 patients with chronic AF who were undergoing PBMC for mitral stenosis, internal cardioversion was successful in 19 patients (86%). Twelve patients with sinus rhythm acted as controls. Mean LA pressure was significantly reduced after PBMC (18.5+/-5.9 mm Hg versus 10.2+/-4.1 mm Hg; P<0.001). The effective refractory period (ERP), conduction delay (CD), and the index of heterogeneity (CoV) of the ERP and CD were compared. Changes in LA pressure were only significantly correlated with AF vulnerability (r=0.7; P=0.02) and CoV of CD (r=0.3; P=0.03). There were no significant changes in ERP and CD immediately after PBMC in the AF group. However, the overall CoV of ERP was reduced in the AF group after PBMC. There were homogenous, although not significant, increases in regional ERP in the control group immediately after PBMC. Atrial CD and CoV of CD were significantly reduced after PBMC in the control group; this was most prominent within the regions of the LA.



AF vulnerability and CoV of CD correlated significantly with LA pressure. A homogenous increase in regional ERPs could be demonstrated in the control group after an immediate reduction of atrial stretch, whereas the recovery course of electrical remodeling was prolonged and heterogenous in the AF group. Regional conductions were irreversible in patients with preexisting AF.
Comparison between single- and multi-sensor oesophageal temperature probes during atrial fibrillation ablation: thermodynamic characteristics.

Oesophageal temperature monitoring with single-sensor probe (SSP) has a variable ability to predict oesophageal ulceration as a consequence of pulmonary vein isolation (PVI). Multi-sensor self-expandable probes (MSPs) may offer improved thermal monitoring. The objective of this study was to compare the thermodynamic characteristics of both probes during PVI.



This prospective study enrolled 20 patients undergoing index PVI. Ten patients (group A) underwent dual monitoring with SSP and MSP and 10 control patients (group B) were monitored with SSP alone. Time to initial rise (>0.2°C), time to 1.0°C rise, peak temperature, and decay were recorded with each posterior wall lesion (20 W, 198 applications). The operator was blinded to the MSP temperature data and ablation was only interrupted when SSP temperature increased by ≥2°C. All patients underwent endoscopy within 24 h. Initial temperature increase was detected earlier with MSP (13.4 ± 7.5 vs. 30.5 ± 15.4 s; P < 0.001); led to shorter time to 1.0°C rise (18.5 ± 10.1 vs. 32.1 ± 12.0 s; P < 0.001); and higher change in peak temperature (1.6 ± 2.0 vs. 0.60 ± 0.53°C; P < 0.001). Decay time was similar between the probes (146.1 ± 35.3 vs. 150.4 ± 48.4 s; P = 0.89). The incidence of oesophageal ulceration was similar between the Groups A and B (5 and 4, respectively). Multi-sensor self-expandable probe provided greater sensitivity (100 vs. 60%) and similar specificity (60%) for detection of oesophageal ulceration. Five swine underwent oesophageal mapping before and after MSP placement without alteration in size or position.



Multi-sensor probes provide a superior thermodynamic profile. Its clinical value in reducing oesophageal injury requires further evaluation.
Melatonin to prevent migraine or tension-type headache in children

We designed a 3-month open label trial of melatonin prophylaxis in children with primary headache. After a one month baseline period without receiving preventive drugs, all children received a 3-month course of melatonin, 3 mg, administered orally, at bedtime. A total of 22 children were enrolled (10 boys, mean age 12.2±2.6 years, age range 6–16 years), 13 had recurrent migraine without aura, 1 with aura and 8 had chronic tension-type headache. When the trial ended, 14 of the 21 subjects reported that the headache attacks had decreased by more than 50% in respect to baseline and 4 of them reported having no headache attacks. After receiving melatonin for one month one subject dropped out because of excessive daytime sleepiness. Our promising results warrant randomized placebo-controlled trials in children to assess the real effectiveness of melatonin in preventing primary headache.
Effect of Antiepilepsy Drug Therapy on Ventricular Function in Children With Epilepsy: A Tissue Doppler Imaging Study

Impaired cardiac myocardial function may contribute to the risk for sudden unexpected death of a patient with epilepsy. This study aimed to investigate the effect of antiepilepsy drugs (AEDs) on cardiac function in pediatric epileptic patients using standard and tissue Doppler imaging (TDI) echocardiography. This hospital-based, prospective cross-sectional study investigated 52 epileptic children (mean age 9.3 ± 3.1 years) treated with AEDs (duration 2.4–10.0 years) and 36 healthy children (mean age 9.5 ± 4.0 years). In the epilepsy group, standard echocardiography showed increased left ventricular (LV) end-diastolic and end-systolic diameters, an increased LV mass index, and preserved ejection fraction. The patients also exhibited increased mitral peak A-wave velocity and mitral E-wave deceleration time as well as a decreased mitral E/A ratio. The E/Em ratio was significantly higher in the epilepsy group (5.6 ± 1.2) than in the control group (5.2 ± 1.1) (p = 0.016). In the epilepsy group, TDI showed an increased isovolumetric relaxation time and myocardial performance index (MPI). It also exhibited decreased early diastolic velocity (Em) and a decreased mitral annular displacement index in these patients. There were positive correlations between the LV lateral wall MPI (r = 0.231), septal MPI (r = 0.223), and LV mass index (p < 0.05) but no correlation with the duration of AED treatment. The authors detected subclinical ventricular dysfunction associated with AEDs at a preclinical stage. They suggest that TDI can be useful for determining the short- and long-term cardiac effects of AEDs.
Reproducibility of Parameters of Postocclusive Reactive Hyperemia Measured by Near Infrared Spectroscopy and Transcutaneous Oximetry

The purpose of this study was to investigate postocclusive hyperemic response using near infrared spectroscopy (NIRS) and transcutaneous oximetry TcpO2 Five minute arterial occlusion on the calf muscle was performed in six healthy volunteers (mean age 29, range 23-34 years, mean TcpO2 at rest 53 mmHg, range 47-58 mmHg, and ankle brachial index between 1 and 1.2). Oxygen partial pressure at rest, oxygen consumption VO2 during ischemia, recovery times and resaturation rates after arterial occlusion were determined and new parameters for evaluation of the level of vascular disorders of lower limbs are suggested. The reproducibility of the signals was studied by repeating the same protocol on each subject four to six times. Repeated measurements showed no significant difference among trials, indicating that the measurements were reproducible. The mean values of the coefficient of variability for suggested parameters varied between 6% and 30% (mean value 17%). Interindividual variations of parameters are higher and can be explained by differences in fat/muscle ratio and in the measured tissue volume of the NIRS signal. Simultaneous measurements of NIRS and TcpO2 showed different responses to ischemic conditions, due to the different physiological levels of oxygen assessment. The combined use of both methods yields deeper insight into conditions of blood flow and tissue oxygenation.
Degree of Trauma Differs for Major Osteoporotic Fracture Events in Older Men Versus Older Women.

To examine the degree of trauma in major osteoporotic fractures (MOF) in men versus women, we used data from 15,698 adults aged ≥65 years enrolled in the Osteoporotic Fractures in Men (MrOS) study (5994 men) and the Study of Osteoporotic Fractures (SOF) (9704 women). Participants were contacted tri-annually to ascertain incident fractures, which were confirmed by radiographic reports and coded according to degree of self-reported trauma. Trauma was classified as low (fall from ≤ standing height; fall on stairs, steps, or curb; minimal trauma other than fall [coughing, turning over]); moderate (collisions with objects during normal activity without associated fall); or high (fall from > standing height; severe trauma [motor vehicle accident, assault]). MOF included hip, clinical vertebral, wrist, and humerus fractures. Mean fracture follow-up was 9.1 years in SOF and 8.7 years in MrOS. A total of 14.6% of the MOF in men versus 6.3% of the MOF in women were classified as high trauma (p < 0.001); men versus women more often experienced fractures resulting from severe trauma as well as from fall > standing height. High-trauma fractures were more significantly common in men versus women at the hip (p = 0.002) and wrist (p < 0.001) but not at the spine or humerus. Among participants with MOF, the odds ratio of a fracture related to high-trauma fracture among men versus women was 3.12 (95% confidence interval [CI] 1.70-5.71) after adjustment for traditional risk factors. Findings were similar in analyses limited to participants with hip fractures (odds ratio [OR] = 3.34, 95% CI 1.04-10.67) and those with wrist fracture (OR = 5.68, 95% CI 2.03-15.85). Among community-dwelling older adults, MOF are more likely to be related to high trauma in men than in women. These findings are not explained by sex differences in conventional risk factors and may reflect a greater propensity among men to engage in risky behavior.
Long-term clinical follow-up of the multicentre, randomized study to test immunosuppressive therapy with oral prednisone for the prevention of restenosis after percutaneous coronary interventions: Cortisone plus BMS or DES veRsus BMS alone to EliminAte Restenosis (CEREA-DES).

To analyse the clinical outcome at 4 years in patients with coronary artery disease treated with bare metal stents (BMS) vs. BMS and oral prednisone, or drug-eluting stents (DES), all assuming similar adjunctive medical treatment.



Five Italian hospitals enrolled 375 non-diabetic, ischaemic patients without contraindications to dual anti-platelet treatment or corticosteroid therapy in a randomized controlled study. The primary endpoint was the event-free survival of cardiovascular death, myocardial infarction, and recurrence of ischaemia needing repeated target vessel revascularization at 1 year, and this was significantly lower in the BMS group (80.8%) compared with the prednisone (88.0%) and DES group (88.8%, P = 0.04 and 0.006, respectively). The long-term analysis of the primary endpoint was a pre-specified aim of the trial, and was performed at 1447 days (median, IQ range = 1210-1641). Patients receiving BMS alone had significantly lower event-free survival (75.3%) compared with 84.1% in the prednisone group (HR: 0.447; 95% CI: 0.25-0.80, P = 0.007) and 80.6% in DES patients (HR: 0.519; 95% CI: 0.29-0.93, P = 0.03). Prednisone-treated patients did not develop new treatment-related clinical problems. Drug-eluting stents patients suffered more very late stent thrombosis as a cause of spontaneous myocardial infarction. The need for target vessel revascularization remained lower in the prednisone and DES groups (13.6 and 15.2%, respectively), compared with BMS (23.2%).



The clinical benefits of prednisone compared with BMS only persisted almost unchanged at 4 years. Drug-eluting stents performed better than BMS at long-term, although the advantages observed at 1 year were in part attenuated because of the occurrence of very late stent thrombosis and late revascularizations.
Angiotensin-neprilysin inhibition versus enalapril in heart failure.

We compared the angiotensin receptor-neprilysin inhibitor LCZ696 with enalapril in patients who had heart failure with a reduced ejection fraction. In previous studies, enalapril improved survival in such patients.



In this double-blind trial, we randomly assigned 8442 patients with class II, III, or IV heart failure and an ejection fraction of 40% or less to receive either LCZ696 (at a dose of 200 mg twice daily) or enalapril (at a dose of 10 mg twice daily), in addition to recommended therapy. The primary outcome was a composite of death from cardiovascular causes or hospitalization for heart failure, but the trial was designed to detect a difference in the rates of death from cardiovascular causes.



The trial was stopped early, according to prespecified rules, after a median follow-up of 27 months, because the boundary for an overwhelming benefit with LCZ696 had been crossed. At the time of study closure, the primary outcome had occurred in 914 patients (21.8%) in the LCZ696 group and 1117 patients (26.5%) in the enalapril group (hazard ratio in the LCZ696 group, 0.80; 95% confidence interval [CI], 0.73 to 0.87; P<0.001). A total of 711 patients (17.0%) receiving LCZ696 and 835 patients (19.8%) receiving enalapril died (hazard ratio for death from any cause, 0.84; 95% CI, 0.76 to 0.93; P<0.001); of these patients, 558 (13.3%) and 693 (16.5%), respectively, died from cardiovascular causes (hazard ratio, 0.80; 95% CI, 0.71 to 0.89; P<0.001). As compared with enalapril, LCZ696 also reduced the risk of hospitalization for heart failure by 21% (P<0.001) and decreased the symptoms and physical limitations of heart failure (P=0.001). The LCZ696 group had higher proportions of patients with hypotension and nonserious angioedema but lower proportions with renal impairment, hyperkalemia, and cough than the enalapril group.



LCZ696 was superior to enalapril in reducing the risks of death and of hospitalization for heart failure.