nils-herrmann/clean_scirepeval huggingface dataset:
Intranasal insulin: the effects of three dose regimens on postprandial glycaemic profiles in type II diabetic subjects.

In both fasting normal and diabetic subjects, nasally administered insulin achieves significant falls in plasma glucose concentrations. Repeated administration before and during a meal has been necessary to lower postprandial glycaemic excursion in subjects with NIDDM. We have studied the use of Novolin Nasal which employs a non-irritant, lecithin-based enhancer as a vehicle for human insulin, on postprandial glucose profiles in NIDDM subjects to determine efficacy, optimal dose frequency, and tolerability. Seventeen NIDDM subjects (15 men, 2 women) participated in a randomized, partially blinded, placebo-controlled, crossover trial of three active treatment regimens (nasal insulin, 120 U at 0 min, 60 U at 0 and +20 min or 120 U at +20 min) in relation to a standardized mixed meal given at 0 min. All active treatments significantly reduced postprandial glucose concentrations compared to placebo. Intranasal insulin given at 0 min at a dose of 60 U or 120 U resulted in a 50% reduction in postprandial incremental glucose compared to placebo over the first 2 h, whereas treatment with 60 U both at 0 and 20 min lead to a 70% reduction over the 240 min postprandial period. Post-prandial intravenous insulin was the least effective. There were no episodes of symptomatic hypoglycaemia. Local tolerability was excellent with only four reports of transient nasal irritation out of a total of 68 doses. The delivery device was accurate with intra-device CV of delivered dose of 4.8%.(ABSTRACT TRUNCATED AT 250 WORDS)
Design, Modeling, and Evaluation of a Scalable Multi-level Checkpointing System

High-performance computing (HPC) systems are growing more powerful by utilizing more hardware components. As the system mean-time-before-failure correspondingly drops, applications must checkpoint more frequently to make progress. However, as the system memory sizes grow faster than the bandwidth to the parallel file system, the cost of checkpointing begins to dominate application run times. Multi-level checkpointing potentially solves this problem through multiple types of checkpoints with different costs and different levels of resiliency in a single run. This solution employs lightweight checkpoints to handle the most common failure modes and relies on more expensive checkpoints for less common, but more severe failures. This theoretically promising approach has not been fully evaluated in a large- scale, production system context. We have designed the Scalable Checkpoint/Restart (SCR) library, a multi-level checkpoint system that writes checkpoints to RAM, Flash, or disk on the compute nodes in addition to the parallel file system. We present the performance and reliability properties of SCR as well as a probabilistic Markov model that predicts its performance on current and future systems. We show that multi-level checkpointing improves efficiency on existing large-scale systems and that this benefit increases as the system size grows. In particular, we developed low-cost checkpoint schemes that are 100x-1000x faster than the parallel file system and effective against 85% of our system failures. This leads to a gain in machine efficiency of up to 35%, and it reduces the the load on the parallel file system by a factor of two on current and future systems.
Feasibility, safety and efficacy of an early aerobic rehabilitation program for patients after minor ischemic stroke: A pilot randomized controlled trial.

To examine the feasibility, safety and effectiveness of an early aerobic rehabilitation program for patients after minor ischemic stroke.



Randomized control trial.



Twenty-eight patients, 1-3 weeks post minor ischemic stroke (modified Rankin scale; mRS ≤ 2), were randomly assigned to intervention or control groups. Measures were taken at weeks 1 and 6. All participants were instructed in home practice to achieve strength and flexibility, and were asked to continue their normal community routine. Intervention group participants performed a supervised exercise training program twice a week for 6 weeks. Exercise capacity was evaluated by the 6-minute walk distance test (6MWD), and the modified Bruce treadmill test.



Eight subjects out of 14 participated in all 12 training sessions, one at less than 50% of the sessions, while five reached the highest stage of the program. No adverse events were noted during the intervention period. In the intention to treat analysis a significant improvement over time was seen for the functional parameters only. No interaction (group*time) was found. According to the per protocol analysis a significant interaction effect was found; only the intervention group participants showed a significant clinical change in the 6MWD test (412 ± 178 meters to 472 ± 196 meters, vs the control group 459 ± 116 meters to 484 ± 122 meters, p< 0.01).



An early supervised aerobic training after minor ischemic stroke is feasible and well tolerated and, in a per-protocol analysis, was associated with improved walking endurance. Further studies with a larger sample size are needed to assess the effect of such a program on functional abilities, prevention of risk factors, and recurrent stroke.
Associations of uric acid and gamma-glutamyltransferase (GGT) with obesity and components of metabolic syndrome in children and adolescents.

The combined effect of uric acid, gamma-glutamyltransferase (GGT) and cardiovascular risk factors clustering in the youth remains under-explored.



The objective of this study was to examine the association between uric acid, GGT, obesity and the individual components of metabolic syndrome in children and adolescents.



We performed a cross-sectional observational study of 2067 children and adolescents (875 boys and 1192 girls) aged 6-20 years who were healthy volunteers and were recruited from primary and secondary schools in Hong Kong between 2007 and 2008. Subjects were divided into two strata (75th percentile as cut-off) for comparison between odds of cardiovascular risk factors.



After adjustment by multivariable logistic regression, subjects in upper stratum, i.e., >75th percentile, of either serum uric acid or GGT levels were associated with obesity, low high-density lipoprotein cholesterol (HDL-C) level and high blood pressure (adjusted odds ratios [AOR] ranged from 1.63 to 5.82, all P < 0.005) compared with those in the lower stratum. There were combined effect for upper stratum of both uric acid and GGT in the association with obesity, low HDL-C and high blood pressure (AOR ranged from 2.60 to 10.69, all P < 0.05) after adjustment for age, sex and body mass index z-score (except for obesity status) as well as body height (for high blood pressure).



Uric acid and GGT have combined effect in association with obesity and other cardiovascular risk factors in children and adolescents.
Treatment goal-planning: Outcome findings of a British prospective multi-centre study of adolescent inpatient units

A set of 16 treatment goals, related to 4 areas of adolescent functioning, were defined and employed in the initial and discharge assessments of 276 patients, admitted to 4 inpatient units, examined during a multi-centre prospective study of adolescent psychiatric hospitalisations. At discharge, subjects showed a substantial improvement across all treatment goals; least improvement was observed amongst those goals most frequently targeted. The clinical investigators consider the treatment goal definitions used in this study a meaningful way of measuring psychiatric disturbances in adolescence as well as a useful measure of change in an inpatient population. Further development of the treatment goal definitions would produce a robust clinical and audit tool. Un ensemble de 16 buts de traitement, reliés à 4 aires de fonctionnement de l'adolescent, furent définis et utilisés lors de l'évaluation d'entrée et de sortie de 276 patients, admis dans 4 unités d'hospitalisation et examinés pendant une étude prospective multi-centrique sur les hospitalisations psychiatriques d'adolescents. à la sortie les sujets montraient une amélioration substantielle de tous les objectifs de traitement; les moins bonnes améliorations ont été observées parmi les objectifs plus fréquemment recherchés. Les investigateurs cliniques considèrent les définitions d'objectifs de traitement utilisées dans cette étude comme un moyen privilégié de mesure des troubles psychiatriques à l'adolescence et comme une mesure utile du changement dans une population hospitalisée. Des développements ultérieurs de définition des objectifs de traitement pourraient fournir un outil clinique et d'audit solide. 16 Therapieziele, die sich auf vier für Jugendliche relevante Bereiche beziehen, wurden definiert und bei den Aufnahme- und Entlassungsuntersuchungen von 276 Patienten aus vier Kliniken während einer prospektiven multizentrischen Studie über stationäre psychiatrische Behandlungen bei Jugendlichen angewandt.  Entlassungszeitpunkt zeigten die Patienten eine wesentliche Besserung bei allen Therapieszielen; wobei die geringste Besserung wurde bei den am häufigsten angestrebten Zielen beobachtet. Die klinischen Untersucher betrachten die Definitionen der Behandlungsziele, die in dieser Studie angewandt wurden, als einen sinnvollen Ansatz zur Messung psychiatrischer Störungen in der Adoleszenz und zur Erfassung der Veränderungen bei stationären Patienten. Eine weitere Entwicklung der Definitionen von Behandlungszielen könnte ein solides klinisches und Prüfungsinstrument hervorbringen.
EPIC-Heart: The cardiovascular component of a prospective study of nutritional, lifestyle and biological factors in 520,000 middle-aged participants from 10 European countries

EPIC-Heart is the cardiovascular component of the European Prospective Investigation into Cancer and Nutrition (EPIC), a multi-centre prospective cohort study investigating the relationship between nutrition and major chronic disease outcomes. Its objective is to advance understanding about the separate and combined influences of lifestyle (especially dietary), environmental, metabolic and genetic factors in the development of cardiovascular diseases by making best possible use of the unusually informative database and biological samples in EPIC. Between 1992 and 2000, 519,978 participants (366,521 women and 153,457 men, mostly aged 35–70 years) in 23 centres in 10 European countries commenced follow-up for cause-specific mortality, cancer incidence and major cardiovascular morbidity. Dietary information was collected with quantitative questionnaires or semi-quantitative food frequency questionnaires, including a 24-h dietary recall sub-study to help calibrate the dietary measurements. Information was collected on physical activity, tobacco smoking, alcohol consumption, occupational history, socio-economic status, and history of previous illnesses. Anthropometric measurements and blood pressure recordings were made in the majority of participants. Blood samples were taken from 385,747 individuals, from which plasma, serum, red cells, and buffy coat fractions were separated and aliquoted for long-term storage. By 2004, an estimated 10,000 incident fatal and non-fatal coronary and stroke events had been recorded. The first cycle of EPIC-Heart analyses will assess associations of coronary mortality with several prominent dietary hypotheses and with established cardiovascular risk factors. Subsequent analyses will extend this approach to non-fatal cardiovascular outcomes␣and to further dietary, biochemical and genetic factors.
Temporal Trends and Outcomes of Patients Undergoing Percutaneous Coronary Interventions for Cardiogenic Shock in the Setting of Acute Myocardial Infarction: A Report From the CathPCI Registry.

The purpose of this study was to examine the temporal trends in demographics, clinical characteristics, management strategies, and in-hospital outcomes in patients with acute myocardial infarction complicated by cardiogenic shock (CS-AMI) who underwent percutaneous coronary intervention (PCI) from the Cath-PCI Registry (2005 to 2013).



The authors examined contemporary use and outcomes of PCI in patients with CS-AMI.



The authors used the Cath-PCI Registry to evaluate 56,497 patients (January 2005 to December 2013) undergoing PCI for CS-AMI. Temporal trends in clinical variables and outcomes were assessed.



Compared with cases performed from 2005 to 2006, CS-AMI patients receiving PCI from 2011 to 2013 were more likely to have diabetes, hypertension, dyslipidemia, previous PCI, dialysis, but less likely to have chronic lung disease, peripheral vascular disease, or heart failure within 2 weeks (p < 0.01). Between 2005 and 2006 to 2011 and 2013, intra-aortic balloon pump use decreased (49.5% to 44.9%; p < 0.01), drug-eluting stent use declined (65% to 46%; p < 0.01), and the use of bivalirudin increased (12.6% to 45.6%). Adjusted in-hospital mortality; increased (27.6% in 2005 to 2006 vs. 30.6% in 2011 to 2013, adjusted odds ratio: 1.09, 95% confidence interval: 1.005 to .173; p = 0.04) for patients who were managed with an early invasive strategy (<24 h from symptoms).



Our study shows that despite the evolution of medical technology and use of contemporary therapeutic measures, in-hospital mortality in CS-AMI patients who are managed invasively continues to rise. Additional research and targeted efforts are indicated to improve outcomes in this high-risk cohort.
Prevention and Treatment of Hypertension Study (PATHS): effects of an alcohol treatment program on blood pressure.

To determine whether blood pressure is reduced for at least 6 months with an intervention to lower alcohol intake in moderate to heavy drinkers with above optimal to slightly elevated diastolic blood pressure, and whether reduction of alcohol intake can be maintained for 2 years.



A randomized controlled trial.



Six hundred forty-one outpatient veterans with an average intake of 3 or more alcoholic drinks per day in the 6 months before entry into the study and with diastolic blood pressure 80 to 99 mm Hg were randomly assigned to a cognitive-behavioral alcohol reduction intervention program or a control observation group for 15 to 24 months. The goal of the intervention was the lower of 2 or fewer drinks daily or a 50% reduction in intake. A subgroup with hypertension was defined as having a diastolic blood pressure of 90 to 99 mm Hg, or 80 to 99 mm Hg if recently taking medication for hypertension.



Reduction in average weekly self-reported alcohol intake was significantly greater (P<.001) at every assessment from 3 to 24 months in the intervention group vs the control group: levels declined from 432 g/wk at baseline by 202 g/wk in the intervention group and from 445 g/wk by 78 g/wk in the control group in the first 6 months, with similar reductions after 24 months. The intervention group had a 1.2/0.7-mm Hg greater reduction in blood pressure than the control group (for each, P = .17 and P = .18) for the 6-month primary end point; for the hypertensive stratum the difference was 0.9/0.7 mm Hg (for each, P = .58 and P = .44).



The 1.3 drinks per day average difference between changes in self-reported alcohol intake observed in this trial produced only small nonsignificant effects on blood pressure. The results from the Prevention and Treatment of Hypertension Study (PATHS) do not provide strong support for reducing alcohol consumption in nondependent moderate drinkers as a sole method for the prevention or treatment of hypertension.
Parametric triangular Bézier surface interpolation with approximate continuity

A piecewise quintic interpolation scheme with approximate G1 continuity is presented. For a given triangular mesh of arbitrary topology, one quintic triangular Bézier patch is constructed for each data triangle. Although the resulting surface has G1 continuity at the data vertices, we only require approximate G1 continuity along the patch boundaries so as to lower the patch degree. To reduce the normal discontinuity along boundaries, neighbouring patches are adjusted to have identical normals at the middle point of their common boundary. In most cases, the surfaces generated by this scheme have the same level of visual smoothness compared to an existing sextic G1 continuous interpolation scheme. Further, using the new boundary construction method presented in this paper, better shape quality is observed for sparse data sets than the surfaces of the original G1 continuous scheme, upon which the new scheme is based.
Randomized controlled trial of an intravitreous dexamethasone drug delivery system in patients with diabetic macular edema.

To evaluate the safety and efficacy of a dexamethasone intravitreous drug delivery system (DDS) in eyes with diabetic macular edema (DME).



Patients with persistent macular edema (> or = 90 days' duration) were randomized to treatment with 700 microg or 350 microg of dexamethasone DDS or observation. One eye from each patient was designated as the study eye. The analysis is of the eyes in this study with DME (n = 171).



The primary outcome measure was the proportion of eyes that achieved an improvement in best-corrected visual acuity (BCVA) of 10 letters or more from baseline at day 90. Other outcome measures included fluorescein leakage, central retinal thickness, and safety parameters.



At day 90, a BCVA improvement of 10 letters or more was seen in more eyes in the 700-microg group (33.3%) and 350-microg group (21.1%) than the observation group (12.3%; P = .007 vs 700-microg group). At day 180, a BCVA improvement of 10 letters or more was seen in 30% of eyes in the 700-microg group, 19% in the 350-microg group, and 23% in the observation group (P > or = .4 for treated vs observed eyes). There were also significantly greater improvements in central retinal thickness and fluorescein leakage in treated eyes than observed eyes (P = .03; day 90). Dexamethasone DDS was well tolerated.



In eyes with persistent DME, treatment with 700 microg of intravitreal dexamethasone DDS is well tolerated and produces significant improvements in BCVA, central retinal thickness, and fluorescein leakage compared with observation (statistically significant at day 90).


APPLICATION TO CLINICAL PRACTICE
Dexamethasone DDS, 700 microg, may have potential as a treatment for persistent DME.
Selection of Postacute Stroke Rehabilitation Facilities: A Survey of Discharge Planners From the Northeast Cerebrovascular Consortium (NECC) Region.

The process of determining the level of care and specific postacute care facility for stroke patients has not been adequately studied. The objective of this study was to better understand the factors that influence postacute care decisions by surveying stroke discharge planners. Requests were sent to discharge planners at 471 hospitals in the Northeast United States to complete an online survey regarding the factors impacting the selection of postacute care. Seventy-seven (16%) discharge planners completed the online survey. Respondents were mainly nurses and social workers and 73% reported ≥20 years healthcare experience. Patients and families were found to be significantly more influential than physicians (P < 0.001) and other clinicians (P = 0.04) in influencing postdischarge care. Other clinicians were significantly more influential than physicians (P < 0.001). Insurance and quality of postacute care were the factors likely to most affect the selection of postacute care facility. Insurance was also identified as the greatest barrier in the selection of level of postacute care (70%; P < 0.001) and specific postacute care facility (46%; P = 0.02). More than half reported that pressure to discharge patients quickly impacts a patients' final destination. Nonclinical factors are perceived by discharge planners to have a major influence on postacute stroke care decision making.
Impact evaluation of Swiss Medical Board reports on routine care in Switzerland: a case study of PSA screening and treatment for rupture of anterior cruciate ligament.

Evidence-based recommendations play an important role in medical decision-making, but barriers to adherence are common. In Switzerland, the Swiss Medical Board (SMB) publishes evidence reports that conclude with recommendations. We assessed the impact of two SMB reports on service provision (2009: Recommendation of conservative treatment as first option for rupture of the anterior cruciate ligament of the knee; 2011: Recommendation against PSA screening for prostate cancer).



We performed an observational study and assessed quantitative data over time via interrupted times series analyses. The primary outcome was the quarterly number of performed prostate-specific antigen (PSA) tests and the annual rates of surgical ACL repair in patients with ACL rupture. Data were adjusted for time trends and relevant confounders.



We analysed PSA tests in 662,874 outpatients from 2005-2013 and treatment data in 101,737 patients with knee injury from 1990-2011. For the number of PSA tests, the secular trend before the intervention showed a continuous but diminishing increase over time. A statistically significant reduction in tests was estimated immediately after the intervention, but a later return to the trend before the intervention cannot be ruled out. The rate of surgical ACL repair had already declined after the late 1990s to about 55% in 2009. No relevant additional change emerged in this secular trend after the intervention.



Despite some evidence of a possible change, we did not find a sustained and significant impact of SMB recommendations in our case study. Further monitoring is needed to confirm or refute these findings.