nils-herrmann/clean_scirepeval huggingface dataset:
Presentation and Clinical Outcomes of Choledochal Cysts in Children and Adults: A Multi-institutional Analysis.

Choledochal cysts (CCs) are rare, with risk of infection and cancer.



To characterize the natural history, management, and long-term implications of CC disease.



A total of 394 patients who underwent resection of a CC between January 1, 1972, and April 11, 2014, were identified from an international multi-institutional database. Patients were followed up through September 27, 2014. Clinicopathologic characteristics, operative details, and outcome data were analyzed from May 1, 2014, to October 14, 2014.



Resection of CC.



Management, morbidity, and overall survival.



Among 394 patients, there were 135 children (34.3%) and 318 women (80.7%). Adults were more likely to present with abdominal pain (71.8% vs 40.7%; P < .001) and children were more likely to have jaundice (31.9% vs 11.6%; P < .001). Preoperative interventions were more commonly performed in adults (64.5% vs 31.1%; P < .001), including endoscopic retrograde pancreatography (55.6% vs 27.4%; P < .001), percutaneous transhepatic cholangiography (17.4% vs 5.9%; P < .001), and endobiliary stenting (18.1% vs 4.4%; P < .001)). Type I CCs were more often seen in children vs adults (79.7% vs 64.9%; P = .003); type IV CCs predominated in the adult population (23.9% vs 12.0%; P = .006). Extrahepatic bile duct resection with hepaticoenterostomy was the most frequently performed procedure in both age groups (80.3%). Perioperative morbidity was higher in adults (35.1% vs 16.3%; P < .001). On pathologic examination, 10 patients (2.5%) had cholangiocarcinoma. After a median follow-up of 28 months, 5-year overall survival was 95.5%. On follow-up, 13 patients (3.3%), presented with biliary cancer.



Presentation of CC varied between children and adults, and resection was associated with a degree of morbidity. Although concomitant cancer was uncommon, it occurred in 3.0% of the patients. Long-term surveillance is indicated given the possibility of future development of biliary cancer after CC resection.
Effects of polyunsaturated omega-3 fatty acids on responsiveness to dual antiplatelet therapy in patients undergoing percutaneous coronary intervention: the OMEGA-PCI (OMEGA-3 fatty acids after pci to modify responsiveness to dual antiplatelet therapy) study.

The purpose of this study was to investigate whether omega-3 polyunsaturated fatty acids (PUFAs) are able to modify platelet responsiveness to dual antiplatelet therapy in stable coronary artery disease patients undergoing percutaneous coronary intervention (PCI).



Although previous studies have suggested antiplatelet properties of omega-3 polyunsaturated fatty acids, it is unknown whether they can enhance platelet inhibition on standard aspirin and clopidogrel treatment.



The OMEGA-PCI (OMEGA-3 Fatty Acids After PCI to Modify Responsiveness to Dual Antiplatelet Therapy) study was an investigator-initiated, prospective, single-center, double-blind, placebo-controlled, randomized study. Patients receiving standard dual antiplatelet therapy (aspirin 75 mg/day and clopidogrel 600 mg loading dose followed by 75 mg/day) were randomly assigned to receive the addition of 1 g of omega-3 ethyl esters (n = 33) or placebo (n = 30) for 1 month. Platelet function was measured serially by light transmission aggregometry (adenosine diphosphate and arachidonic acid [AA] were used as agonists) and assessment of the phosphorylation status of the vasodilator-stimulated phosphoprotein at baseline, 12 h, 3 to 5 days, and 30 days after randomization.



The P2Y(12) reactivity index was significantly lower, by 22.2%, after 1 month of treatment with omega-3 polyunsaturated fatty acids compared with placebo when used in addition to dual antiplatelet therapy (p = 0.020). Maximal platelet aggregation induced by 5 and 20 micromol/l adenosine diphosphate was lower by 13.3% (p = 0.026) and 9.8% (p = 0.029), respectively, after 1 month of treatment with omega-3 polyunsaturated fatty acids compared with placebo. Platelet aggregation after AA stimulation was low and did not change significantly throughout the study. There were no cases of aspirin resistance during follow-up that was suggestive of good compliance with the medication.



The addition of omega-3 ethyl esters to the combination of aspirin and clopidogrel significantly potentiates platelet response to clopidogrel after percutaneous coronary intervention.
Validation of the asthma impact survey, a brief asthma-specific quality of life tool

The Asthma Impact Survey (AIS-6) is a new six question asthma outcome tool for which information on validity has not been published. To provide validation for the AIS-6 as a brief asthma-specific quality of life tool. Surveys were sent to a random sample of members of a large managed care organization who were at least 35 years of age and in the two-year period preceding the survey had either (1) at least one documented asthma-related medical encounter, or (2) at least a 6 months supply of asthma medication dispensed. In addition to the AIS-6, the survey included a validated quality of life tool [the mini-Asthma Quality of Life Questionnaire (AQLQ)]; a validated asthma control questionnaire [the Asthma Therapy Assessment QuestionnaireTM (ATAQ)]; a validated symptom severity scale (AOMS); and information regarding demographics, co-morbidities, asthma severity, and asthma management. The results of the AIS-6 were compared to the results of the other tools by means of correlation and factor analysis. Independent predictors of AIS-6 and AQLQ scores were determined by multiple stepwise linear regression analyses. AIS-6 scores were significantly related to female sex, educational level, income, smoking, body mass index (BMI), COPD, steroid use, and hospitalization history in bivariate analyses. The AIS-6 score significantly correlated (r =  − 0.84, p < 0.0001) with the AQLQ total score and loaded on the three factors (activity, symptoms, and concern/bother) reflected by the survey information and on which the AQLQ also loaded. Significant but somewhat smaller correlations were found between the AIS-6 and the ATAQ (r = 0.70, p < 0.0001) and the AOMS (r = 0.55, p < 0.0001). Independent predictors were the same for the AIS-6 and AQLQ and included oral steroid use, COPD history, BMI, female sex, educational level, and hospitalization in the past year. These data support the validity of the short six-question AIS-6 as an asthma-specific quality of life tool.
Effect of a Motivational Intervention on Exercise Behavior in Persons with Schizophrenia Spectrum Disorders

Ninety seven outpatients with schizophrenia spectrum disorders (SSDs) were randomly assigned to the Walk, Address Sensations, Learn About Exercise, Cue Exercise Behavior for SSDs (WALC-S), a motivational intervention designed to increase exercise in SSDs (n = 48), or a time and attention control group (TAC, n = 49). WALC-S and TAC groups met weekly for 4 weeks before a 16 week walking program was offered to all subjects. We compared the exercise attendance, persistence and compliance of the groups during the walking program. WALC-S recipients attended more walking groups, for more weeks and walked more minutes than those receiving TAC. Percent of WALC-S or TAC groups attended was significantly correlated with overall attendance (r = 0.38, P = 0.001) and persistence (r = −.29, P = 0.01), as well as number of minutes walked. This study is among the first to examine interventions designed to enhance exercise motivation in SSDs.
The RAPID protocol enhances patient recovery after both laparoscopic and open colorectal resections

Enhanced recovery after surgery (ERAS) programs can accelerate recovery and shorten the hospital stay after colorectal resections. The RAPID (remove, ambulate, postoperative analgesia, introduce diet) protocol is a simplified ERAS program that consists of a simplified, user-friendly single-page pro forma schedule. This study aimed to evaluate the impact of the RAPID protocol on patients undergoing both laparoscopic and open colorectal resections in two specialized colorectal units. A prospective, two-center study assessed 117 age-matched patients undergoing open or laparoscopic colorectal resection to compare the postoperative course for patients using the RAPID protocol with those treated in a traditional manner. Of the 117 patients studied, 70 underwent laparoscopic resection (55 with the RAPID protocol) and 47 underwent open resection (25 with the RAPID protocol). Patients undergoing laparoscopic resections with the RAPID protocol had a significantly shorter hospital stay (p = 0.01) and tolerance of a full diet (p = 0.002). Similarly, patients undergoing open resections with the RAPID protocol also have a significantly shorter hospital stay (p = 0.04). The RAPID protocol is a user-friendly, easy, and effective tool that facilitates earlier tolerance of diet and discharge from the hospital for patients undergoing laparoscopic or open colorectal resections.
"Tell me more": how semantic technologies can help refining internet image search

Several branches of computer vision heavily rely (but we could even say depend) on the availability of large datasets of labelled images. While such labeling is usually done by hand, a powerful help can be obtained from Internet and its related tools. In this paper we address the problem of automatically generating a set of images representing an object class, given the name of the class. We exploit semantic technologies, such as lexical resources and ontologies, in order to improve the search performances by using a standard web search engine. We will also discuss an application to the automatic building of a training set for a classification framework. Preliminary experiments are provided for 10 classes from the public CalTech256 dataset and results show an average increment in classification accuracy of about 10%.
Virtual machine-provided context sensitive page mappings

Context sensitive page mappings provide different mappings from virtual addresses to physical page frames depending on whether a memory reference occurs in a data or instruction context. Such differences can be used to modify the behavior of programs that reference their executable code in a data context. Previous work has demonstrated several applications of context sensitive page mappings, including protection against buffer-overrun attacks and circumvention of self-checksumming codes. We extend context sensitive page mappings to the virtual machine monitor, allowing operation independent of the guest operating system. Our technique takes advantage of the VMM's role in enforcing protection between guest operating systems to interpose on guest OS memory management operations and selectively introduce context sensitive page mappings.
 In this paper, we describe extensions to the Xen hypervisor that support context sensitive page mappings in unmodified guest operating systems. We demonstrate the utility of our technique in a case study by instrumenting and modifying self-checksumming tamper-resistant binaries. We further demonstrate that context sensitive page mappings can be provided by the VMM without incurring extensive overhead. Our measurements indicate only minor performance penalties stem from use of this technique. We suggest several further applications of VMM-provided context sensitive page mappings, including OS hardening and protection of processes from malicious applications.
Levodopa in Parkinsonism: the effects of withdrawal of anticholinergic drugs.

The results are reported of a trial in which 34 patients receiving a stable dose of levodopa for the treatment of idiopathic Parkinsonism, as well as anticholinergic drugs which they had been taking before the introduction of levodopa, underwent withdrawal of their anticholinergic remedies. Withdrawal was gradual over four weeks in 17 patients (group 1) and abrupt in the remaining 17 (group 2).Only 11 out of 34 patients on stable levodopa therapy were able to tolerate withdrawal of anticholinergic drugs for more than eight weeks. The main reasons for the resumption of these remedies were subjective increases in slowness in 20 (59%), tremor in 15 (44%), and recurrence of hypersalivation in 5 (15%). Hypersalivation was the single feature which was most significantly and adversely influenced by anticholinergic withdrawal in patients on levodopa irrespective of whether withdrawal was sudden or gradual. It is suggested that the synergism which seems to exist between anticholinergic remedies and levodopa may be due to inhibition of dopamine inactivation by anticholinergic drugs, thus ensuring continual utilization, or alternatively, to a primary central anticholinergic effect.Objective and more severe subjective deterioration occurred only on sudden withdrawal. Hence we would advise that if for any reason anticholinergic drugs are to be withdrawn in patients receiving a stable dosage of levodopa this must be done slowly. Conversely it would appear from our results that the introduction of anticholinergic drugs in patients treated initially with levodopa is likely to produce additional benefit, particularly when the maximum tolerated dose of levodopa is small.
Reduced glutamate neurotransmission in patients with Alzheimer's disease–an in vivo 13C magnetic resonance spectroscopy study

Cognitive impairment in Alzheimer's disease (AD) is not fully explained. PET indicates reduced cerebral metabolic rate for glucose. Since glutamate neurotransmission (GNT) consumes more than 80% of the ATP generated from metabolism, a pilot study was carried out to determine the neuronal tricarboxylic acid cycle (TCA) based on the hypothesis that reduced GNT could contribute to cognitive impairment in AD. Three AD patients with cognitive impairment (mini-mental state exam: 24 vs 30, P<0.05) and significant reduction in both N-acetyl aspartate (NAA)/Creatine (Cr) (P<0.009) and NAA/myo-inositol (mI) ratio (P<0.01), and three age-matched controls each received 0.014–0.016 g/kg/min 99%1–13C glucose IV. Quantitative 1H and proton-decoupled 13C MR brain spectra were acquired from combined posterior-parietal white matter and posterior-cingulate gray matter every 5 min for 140 min. 13C magnetic resonance spectroscopy (MRS) measures of glucose oxidation and neuronal TCA rate, including prolonged time to 13C enrichment of glutamate (Glu2) (P<0.004) and bicarbonate (HCO3) (P<0.03) as well as reduced relative enrichment of Glu2/Glu4 between 60 and 100 min (P<0.04), were significantly different in AD patients vs. controls. 13C measures of GNT, glutamine (Gln)2/Glu2 (P<0.02) and rates of glutamate enrichment (Glu2/glucose: 0.34 vs 0.86, P=ns and Glu4/glucose 0.26 vs 0.83, P=ns), were also reduced. 13C MRS measures of neuronal TCA cycle, glucose oxidation and GNT were significantly correlated with measures of neuronal integrity: NAA/Cr, [NAA] and mI/NAA as determined by 1H MRS (R 2=0.73–0.95; P<0.05–0.01), suggesting that impairment of GNT may be a contributing factor in the cognitive impairment characteristic of AD.
Whole-body vibration as a mode of dyspnoea free physical activity: a community-based proof-of-concept trial

The potential of whole-body vibration (WBV) as a mode of dyspnoea free physical activity for people with chronic obstructive pulmonary disease (COPD) is unknown among community-based settings. Furthermore, the acute effects of WBV on people with COPD have not been profiled in community-based settings. The aim of this community-based proof-of-concept trial was to describe acute effects of WBV by profiling subjective and objective responses to physical activity. Seventeen community-dwelling older adults with COPD were recruited to participate in two sessions; WBV and sham WBV (SWBV). Each session consisted of five one-minute bouts interspersed with five one-minute passive rest periods. The gravitational force was ~2.5 g for WBV and ~0.0 g for SWBV. Reliability of baseline dyspnoea, heart rate, and oxygen saturation was first established and then profiled for both sessions. Acute responses to both WBV and SWBV were compared with repeated measures analysis of variance and repeated contrasts. Small changes in dyspnoea and oxygen saturation lacked subjective and clinical meaningfulness. One session of WBV and SWBV significantly increased heart rate (p ≤ 0.02), although there was no difference among WBV and SWBV (p = 0.67). This community-based proof-of-concept trial showed that a session of WBV can be completed with the absence of dyspnoea for people with COPD. Furthermore, there were no meaningful differences among WBV and SWBV for heart rate and oxygen saturation. There is scope for long-term community-based intervention research using WBV given the known effects of WBV on peripheral muscle function and functional independence.
Validation of the Rossmax S150 wrist blood pressure monitor for home blood pressure monitoring according to the European Society of Hypertension International Protocol revision 2010.

The present study aimed to evaluate the accuracy of the automated oscillometric wrist blood pressure monitor Rossmax S150 for home blood pressure monitoring according to the International Protocol of the European Society of Hypertension revision 2010.



Systolic and diastolic blood pressures were sequentially measured in 33 adult Chinese (16 women, mean age of 54 years) using a mercury sphygmomanometer (two observers) and the Rossmax S150 device (one supervisor). Ninety-nine pairs of comparisons were obtained from 33 participants for judgments in two parts with three grading phases. Data analysis was carried out using the ESHIP analyzer.



The Rossmax S150 device achieved the targets in part 1 of the validation study. The number of absolute differences between device and observers within 5, 10, and 15 mmHg was 70/99, 90/99, and 97/99, respectively, for systolic blood pressure, and 84/99, 98/99, and 99/99, respectively, for diastolic blood pressure. The device also achieved the criteria in part 2 of the validation study. Twenty-six and 29 participants for systolic and diastolic blood pressure, respectively, had at least two of the three device-observers differences within 5 mmHg (required ≥ 24). Three and two participants for systolic and diastolic blood pressure, respectively, had all three device-observers comparisons greater than 5 mmHg.



The Rossmax wrist blood pressure monitor S150 has passed the requirements of the International Protocol revision 2010, and hence can be recommended for home use in adults.
Side-effects of post-treatment biopsies in prostate cancer patients treated with endocrine therapy alone or combined with radical radiotherapy in the Scandinavian Prostate Cancer Group-7 randomized trial.

Post-treatment prostate biopsy side-effects were evaluated in patients with locally advanced prostate cancer on endocrine therapy alone or combined with radiotherapy in the Scandinavian Prostate Cancer Group-7 randomized trial.



One-hundred and twenty patients underwent transrectalultrasound-guided biopsy, and were requested to complete a questionnaire on side-effects occurring within 7 days' follow-up.



The questionnaire was returned by 109 patients (91%) (endocrine therapy only 52%, combined endocrine therapy and radiotherapy 48%). Previous therapy had no significant influence on pain, urinary flow, haematuria or haematospermia. Pain at biopsy was reported in 63% (mild, 57%; moderate, 5.6%; severe, one patient) and pain at follow-up in 31% (mild, 27%; moderate, four patients). Haematuria (mean duration 2.2 days) was reported in 41%, and reduced urinary flow in 20% (mild, 18%; severe: four patients; no patient had urinary retention). Haematospermia was scarce. No patient reported urinary tract infection. Rectal bleeding occurred in 18% in the endocrine and 35% in the combined therapy group (p = 0.047), with a mean duration of 1.6 and 2.2 days, respectively (p = 0.031). In logistic regression analysis, a trend towards increased rectal bleeding was found in patients on combined endocrine therapy and radiotherapy (odds ratio 2.4, p = 0.050).



Patient-reported post-treatment prostate biopsy side-effects were mild and self-limiting.
Long-term followup for rheumatoid arthritis patients in a multicenter outcomes study of silicone metacarpophalangeal joint arthroplasty.

Rheumatoid arthritis (RA) often results in deformities at the metacarpophalangeal (MCP) joints. Patients with severe deformities can be treated by silicone metacarpophalangeal joint arthroplasty (SMPA). The objective of the study is to prospectively compare long-term outcomes for an SMPA surgical and a nonsurgical cohort of RA patients.



A total of 67 surgical and 95 nonsurgical patients with severe subluxation and/or ulnar drift of the fingers at the MCP joints were recruited from 2004-2008 in this multicenter prospective cohort study. Patients could elect to undergo SMPA or not. Outcomes included the Michigan Hand Outcomes Questionnaire (MHQ), Arthritis Impact Measurement Scales 2 (AIMS2), grip/pinch strength, Jebsen-Taylor Test, ulnar deviation, extensor lag, and arc of motion measurements at the MCP joints.



There was no significant difference in the mean age, race, education, and income at baseline between the 2 groups. Surgical subjects had worse MHQ function and functional measurements at baseline. At 3 years, the mean overall MHQ score and the MHQ function, activities of daily living, aesthetics, and satisfaction scores showed significant improvement in the surgical group compared to the nonsurgical group. Ulnar deviation, extensor lag, and arc of motion in the MCP and proximal interphalangeal joints also improved significantly in the surgical group. No improvement was seen in the mean AIMS2 scores and grip/pinch strength. Complications were minimal with a fracture rate of 9.5%.



RA patients with poor baseline functioning showed long-term improvement in hand function and appearance following treatment with SMPA compared to nonsurgical controls.
Economic Evaluation of Lenograstim (Glycosylated rHuG-CSF) in the Treatment of Inflammatory Breast Cancer for Germany and Italy

Data from a French placebo-controlled double-blind trial in 120 female patients treated with high dose fluorouracil, epirubicin and cyclophosphamide (HD-FEC) chemotherapy for inflammatory breast cancer were used to assess the economic impact of adjunctive lenograstim therapy. The analysis compared direct costs of treatment, with or without lenograstim, with reference to the Social Security (Germany) or to the National Health Service (Italy). Resource utilisation differed between the 2 treatment groups. The lenograstim group reported 32% fewer antibiotic therapy days (9.8 days vs 14.6; p = 0.01) and 24% fewer inpatient days for any reason other than chemotherapy (7.4 ‘excess’ days vs 9.8). By reducing infection-related morbidity associated with a high dose chemotherapy regimen, lenograstim decreased treatment costs by DM 1794 and ItL 1.2 million, excluding the cost of lenograstim itself. Since lenograstim patients reported fewer chemotherapy delays (16.4 vs 30.5%) and, hence, benefited from 1.2 (p = 0.04) more chemotherapy days, the related cost was DM 1519 and ItL 0.9 million higher than for the placebo group. This cost difference would be expected to be smaller if the placebo group patients had been followed until completion of their full chemotherapy regimen. Assuming that the costs of chemotherapy were the same for both groups, the direct cost saving for the lenograstim group would be 30% in Germany and 34% in Italy.