nils-herrmann/clean_scirepeval huggingface dataset:
Comparison of Helisal Rapid Blood Test and 14C-Urea Breath Test in Determining Helicobacter pylori Status and Predicting Ulcer Disease in Dyspeptic Patients

Noninvasive tests for Helicobacter pylori are used increasingly. Our aim was to compare the Helisal Rapid Blood (HRB) test and 14C-urea breath test (UBT) for determining H. pylori status and predicting ulcer disease.Three hundred fifty-one consecutive patients with dyspepsia (mean age 40 yr; range 16–77 yr) had an HRB test and UBT followed by endoscopy with biopsies of the antrum and body for histology and antral urease slide test (CLO test). Patients were excluded if they had previously confirmed ulcer disease, gastric surgery, or anti-H. pylori therapy or were taking nonsteroidal anti-inflammatory drugs.Sixty-three percent of the patients were “gold standard”H. pylori positive (positive CLO test, positive staining), 34% were gold standard negative (negative CLO test, negative staining), and 3% had conflicting CLO test and histology. The UBT was superior to HRB for determining H. pylori status (sensitivity 98%vs 92%, p= 0.04; specificity 100%vs 69%, p < 0.001). The specificity of the HRB decreased with increasing patient age (74% for age < 46 yr; 57% for age ≥46 yr). A negative UBT was superior to a negative HRB test for predicting the absence of ulcer disease (47%vs 36%; p < 0.01). A positive UBT was similar to a positive HRB in predicting the presence of ulcer disease (92%vs 84%; p= 0.23).Conclusions:The HRB test is inferior to the UBT for determining H. pylori status. The tests have a similar ability to predict the presence of ulcer disease when positive, but a negative UBT is a better predictor of the absence of ulcer disease.
Orthostatic hypotension and anti-hypertensive therapy in the elderly.

The effect of withdrawing or continuing anti-hypertensive therapy on orthostatic blood pressure change in elderly hypertensive subjects was examined. Subjects meeting criteria for therapy withdrawal had supine and standing blood pressure measurements taken on treatment, and at 1, 3, 6, 9 and 12 months off treatment whilst receiving standard non-pharmacological advice to lower blood pressure. Subjects not meeting blood pressure criteria for treatment withdrawal or were unwilling to stop treatment had blood pressure measurements taken after 6 and 12 months whilst also receiving non-pharmacological advice. Orthostatic hypotension was defined as a mean systolic blood pressure fall > or = 20 mmHg on standing from a supine position. Forty-seven subjects (median age 76 years, range 65-84 years) had treatment withdrawn. Thirteen subjects (median age 73 years, range 68-82 years) continued on their treatment. Twelve months after treatment withdrawal there was a significant reduction in the number demonstrating orthostatic hypotension from 11 (23%) to four (11%) (P < 0.05), whilst the group continuing on treatment showed no change. In the withdrawal group those with orthostatic hypotension on treatment (n = 11) were older (79 versus 74 years, P = 0.05), had higher prewithdrawal systolic blood pressure (164 +/- 21 versus 147 +/- 17 mmHg, P = 0.02) compared to those without, although there was no difference in body mass index, gender, number or type of anti-hypertensive drugs taken. In elderly hypertensive subjects withdrawal of anti-hypertensive therapy and institution of non-pharmacological treatment can over several months reduce the prevalence of orthostatic hypotension.
Effectiveness of sequential combined treatment in comparison with treatment as usual in preventing relapse in alcohol dependence.

The aim of this study was to compare the effectiveness of the sequential combined treatment (SCT) and treatment as usual (TU) in relapse prevention in a sample of alcohol-dependent patients, during 180 days of outpatient treatment.



209 alcohol-dependent patients who could attend with an informant adult were randomized to either TU or SCT. The primary outcome measure was time to first relapse, defined as the consumption of any amount of alcohol during the 180 days of follow-up. Secondary outcome measures included maximum duration of continuous abstinence (MDCA), cumulative abstinence duration (CAD), quality of life (ARPQ) and blood test markers of alcohol consumption.



The SCT approach was more effective than TU. The Kaplan-Meier abstinent proportion at the end of the 180 days was 78% for the SCT group and 59% for the TU group (P<0.01). The mean time to first relapse was 150 days for SCT and 123 days for TU (P<0.01). The relative risk reduction of relapse was 62% for SCT after adjustment in multiple Cox regression (P<0.01). SCT had more MDCA (P<0.05) and more CAD (P<0.05). Therapy sessions lasted slightly longer for SCT than TU (mean 13 min versus 10 min).



SCT can result in better outcomes than TU in the outpatient treatment of alcohol dependence.
Clinical predictors of atrial fibrillation recurrence in the Gruppo Italiano per lo Studio della Sopravvivenza nell'Infarto Miocardico-Atrial Fibrillation (GISSI-AF) trial.

Atrial fibrillation (AF) is a common arrhythmia that frequently recurs after restoration of sinus rhythm (SR). Identifying risk factors for recurrence may help define the best strategy for secondary prevention.



The GISSI-AF trial enrolled 1,442 patients in SR with at least 2 documented AF episodes in the previous 6 months or after cardioversion in the last 2 weeks. Patients were randomized to valsartan or placebo; all other treatments for AF or underlying heart diseases were allowed. Primary end points were time to first recurrence of AF and proportion of patients with >1 AF episode during 1-year follow-up. We evaluated clinical and electrocardiographic baseline characteristics of all patients to identify independent predictors for AF recurrence using a Cox multivariable model.



Risk factors for AF recurrence were a history of 2 or more AF episodes in the previous 6 months, independent of the modality of SR restoration, spontaneous (HR 1.42, 95% CI 1.14-1.77, P = .002), or by cardioversion (HR 1.19, 95% CI 1.01-1.40, P = .038), and a lower heart rate during SR (HR 0.99, 95% CI 0.99-1.00, P = .052). The risk factors were the same for >1 AF recurrence. Patients treated with amiodarone had a lower risk for both end points (P < .0001 and P = .017), whereas those on diuretics had a greater risk (P = .009 and P = .003).



In the GISSI-AF study population, AF history had significant prognostic value independent of the modality of SR restoration. Amiodarone and diuretic treatment affected the rate of AF recurrence.
Impact of primary healthcare providers’ initial role security and therapeutic commitment on implementing brief interventions in managing risky alcohol consumption: a cluster randomised factorial trial

Brief interventions in primary healthcare are cost-effective in reducing drinking problems but poorly implemented in routine practice. Although evidence about implementing brief interventions is growing, knowledge is limited with regard to impact of initial role security and therapeutic commitment on brief intervention implementation.



In a cluster randomised factorial trial, 120 primary healthcare units (PHCUs) were randomised to eight groups: care as usual, training and support, financial reimbursement, and the opportunity to refer patients to an internet-based brief intervention (e-BI); paired combinations of these three strategies, and all three strategies combined. To explore the impact of initial role security and therapeutic commitment on implementing brief interventions, we performed multilevel linear regression analyses adapted to the factorial design.



Data from 746 providers from 120 PHCUs were included in the analyses. Baseline role security and therapeutic commitment were found not to influence implementation of brief interventions. Furthermore, there were no significant interactions between these characteristics and allocated implementation groups.



The extent to which providers changed their brief intervention delivery following experience of different implementation strategies was not determined by their initial attitudes towards alcohol problems. In future research, more attention is needed to unravel the causal relation between practitioners' attitudes, their actual behaviour and care improvement strategies to enhance implementation science.
Improved language performance subsequent to low-frequency rTMS in patients with chronic non-fluent aphasia post-stroke.

Low-frequency repetitive transcranial magnetic stimulation (rTMS) has emerged as a potential tool for neurorehabilitation and remediation of language in chronic non-fluent aphasia post-stroke. Inhibitory (1 Hz) rTMS has been applied to homologous language sites to facilitate behavioural language changes. Improvements in picture-naming performance and speech output over time have been reported.



Low-frequency (1 Hz) rTMS was applied to six real stimulation and six sham placebo patients for 20 min per day, for 10 days, and behavioural language outcome measures were taken at baseline (pre-stimulation) and 2 months post-stimulation.



The findings demonstrate treatment-related changes observed in the stimulation group when compared to the placebo control group at 2 months post-stimulation on naming performance as well as other aspects of expressive language and auditory comprehension.



These findings provide considerable evidence to support the theory of rTMS modulating mechanisms of transcallosal disinhibition in the aphasic brain and highlight the potential clinical applications for language rehabilitation post-stroke.
The risk of prostate cancer amongst South Asian men in southern England: the PROCESS cohort study.

J O U R N A L C O M P I L A T I O N © 2 0 0 9 B J U I N T E R N A T I O N A L | 1 0 3 , 5 5 3 – 5 5 5 | doi:10.1111/j.1464-410X.2009.08395.x 5 5 3 Asian men in southern England: the PROCESS cohort study. BJU Int 2008; 102 : 1407–12 2 Rastogi T, Devesa S, Mangtani P et al. Cancer incidence rates among South Asians in four geographic regions: India, Singapore, UK US.  2003 4 Martin FL, Grover PL. The initiation of breast and prostate cancer. Carcinogenesis 2002; 23 : 1095–102 5 Ben-Shlomo Y, Evans S, Ibrahim F et al. The risk of prostate cancer amongst Black Men in the United Kingdom: The PROCESS cohort study.
Definitive Radiotherapy for Squamous Cell Carcinoma of the Glottic Larynx.

Depending on the extent of disease, squamous cell carcinoma (SCC) of the glottis is managed with surgery, radiotherapy (RT), or a combination of these modalities. Patients with advanced disease may receive concomitant chemotherapy in conjunction with definitive or postoperative RT.



The treatment policies of the University of Florida and patient outcomes are reviewed.



The likelihood of cure after RT for carcinoma in situ (Tis) to T2 glottic SCC varies from 70% to 94% depending on tumor stage. Consideration should be given to adding weekly cisplatin for patients with T2b SCC because of the high local recurrence rate after RT alone. The probability of cure is about 65% to 80% for select low-volume (≤ 3.5 cc) T3 to T4 glottic SCC after RT. These patients should be considered for concomitant weekly cisplatin. Higher-volume tumors, particularly those with airway compromise, should be treated with laryngectomy and postoperative RT.



Definitive RT is an excellent treatment for select patients with laryngeal cancer.
Treatment-related changes in brain activation in patients with fibromyalgia syndrome

Little is known about the effects of successful treatment on brain function in chronic pain. This study examined changes in pain-evoked brain activation following behavioral extinction training in fibromyalgia patients. Using functional magnetic resonance imaging, brain activation to painful mechanical stimuli applied to the 2nd phalanx of the left 2nd digit (m. flexor digitorum) was assessed in 10 patients with fibromyalgia syndrome (FM) before and after behavioral extinction training. The behavioral treatment significantly reduced interference from pain in the FM patients. Mechanical pain threshold and pain tolerance increased significantly after treatment. Activation in the insula shifted bilaterally from a more anterior site before treatment to a more posterior location after treatment. The pre- to post-treatment reduction in both interference related to pain and pain severity were significantly associated with bilateral activation in pain-evoked activity in the posterior insula, the ipsilateral caudate nucleus/striatum, the contralateral lenticular nucleus, the left thalamus and the primary somatosensory cortex contralateral to the stimulated side. These data show a relation between successful behavioral treatment and higher activation bilaterally in the posterior insula and in the contralateral primary somatosensory cortex. Future studies should compare responders and non-responders for differential treatment effects and examine in more detail the mechanisms underlying these changes.
Levamisole in postoperative adjuvant immunochemotherapy for gastric cancer

The usefulness of LMS in postoperative immunochemotherapy of gastric cancer was investigated. In compliance with the protocol, MMC was given at a dose of 20 mg on the day of gastrectomy, and an additional 10 mg on the next day IV. The patients receiving 600 mg Tegafur daily were then divided into two groups according to whether LMS was also given or not. LMS was administered for 3 days before the operation in a daily dose of 150 mg and for 1 year or more after operation according to a schedule of 3 days' administration followed by an 11-day interval. The 2-year follow-up demonstrated that in stage III patients, the LMS (+) regimen was superior to the LMS (−) regimen, since the former prolonged the relapse-free interval significantly. The survival rate for stage III disease was also significantly higher in the LMS (+) than in the LMS (−) group. There was no significant difference in the incidence of subjective or objective side-effects between two groups. The incidence of agranulocytosis was comparable in the two groups.
Endovascular treatment of intracranial aneurysms with matrix detachable coils: midterm anatomic follow-up from a prospective multicenter registry.

Polyglycolic/polylactic acid-covered platinum coils have been proposed to reduce the rate of aneurysm recanalization after endovascular treatment. A prospective and multicenter registry was conducted in France to evaluate the safety and short-term and midterm efficacy of Matrix coils. This analysis focused on anatomic midterm results.



Two hundred thirty-six patients harboring 244 ruptured or unruptured aneurysms treated via endovascular approach by using Matrix coils were included in this registry. Treatment was totally or partially performed by using Matrix coils. Anatomic results were evaluated on postoperative and last-follow-up digital subtraction angiography (DSA) by using the Raymond scale. "Recanalization" was defined as worsening, and "progressive thrombosis" was defined as improvement on the Raymond scale.



Anatomic midterm follow-up was obtained in 165 of 236 patients (70%) harboring 171 aneurysms (range, 6-27 months; mean, 14 +/- 4 months). At midterm follow-up angiography, 79 aneurysms were completely occluded (46.2%), 43 had a neck remnant (25.1%), and 49 had an aneurysm remnant (28.7%). Of 171 aneurysms, recanalization was observed in 44 patients (25.7%), including major recanalization in 18 patients (10.5%). Recanalization was more frequent if the embolized volume of aneurysm was </=25%. Progressive thrombosis was observed in 52 aneurysms (30%). No bleeding or rebleeding was observed during the period of follow-up.



The efficacy of Matrix coils in preventing recanalization was not demonstrated in our series. In agreement with previous studies using bare platinum coils, volumic occlusion was an important feature for the prediction of aneurysm recanalization. A high percentage of progressive thrombosis in incompletely treated aneurysms was observed in our series, suggesting a biologic activity of Matrix coils.
Comprehensive intensive therapy for Chinese gestational diabetes benefits both newborns and mothers.

This study identified the impact of intensive therapy on neonatal outcomes in women with gestational diabetes mellitus (GDM) and determined the effects on the postpartum metabolic status of the mothers.



In total, 127 pregnant women with GDM were randomly selected to receive an intensive treatment regimen, which included one-to-one education, lifestyle intervention, scheduled clinic visits, strict glucose control, and frequent glucose self-monitoring. Meanwhile, 148 age-matched pregnant women with GDM were selected as controls and given the standard treatment regimen. Pregnancy outcomes including parameters related to the GDM mothers and to their neonates were comparatively analyzed between the two treatment groups. GDM patient follow-up (range, 1-3 years after delivery) included an oral glucose tolerance test and measurements of lipid concentration and insulin secretion. The insulinogenic index (ΔInsulin(30 min)/ΔBlood glucose(30 min)) and homeostasis model assessment index of β-cell function and insulin resistance were calculated. The patients' demographic and anthropometric data were also recorded for comparative analysis.



Compared with GDM patients receiving standard treatment, GDM patients receiving intensive treatment had lower instances of premature delivery (2.4% vs. 8.3%, P<0.05) and neonatal care unit admission (21.3% vs. 33.3%, P<0.05) and lower neonatal birth weight (3.26±0.53 vs. 3.45±0.55 kg, P<0.0001). At follow-up, GDM patients from the intensive treatment group had a smaller waist circumference (75.83±3.11 vs. 78.34±4.20 cm, P<0.01), lower 30-min glucose levels after a 75-g glucose load (8.26±1.85 vs. 9.46±2.74 mmol/L, P<0.05), and higher high-density lipoprotein levels (1.30±0.24 vs. 1.18±0.23 mmol/L, P<0.05).



The intensive GDM treatment regimen led to healthier outcomes for the women, the neonates, and the birth event and was associated with better maternal metabolic situations in the months and years after delivery.
Evaluation of hand bone loss by digital X-ray radiogrammetry as a complement to clinical and radiographic assessment in early rheumatoid arthritis: results from the SWEFOT trial

To investigate hand bone loss (HBL) measured by digital X-ray radiogrammetry (DXR) in patients with early rheumatoid arthritis (RA) receiving different treatment regimens, and to evaluate if DXR change rates during the first 12 months correlate with radiological damage after 24 months.



From the total SWEFOT trial population, 159 patients had hand radiographs correctly timed and taken with same modality to be analyzed with DXR. All patients started treatment with methotrexate. After 3-4 months, patients with DAS28 > 3.2 were randomized to add sulfasalazine and hydroxychloroquine (triple therapy) or infliximab (MTX + INF). Those with DAS28 ≤3.2 were followed in regular care. Radiographic progression over 24 months was scored according to the Sharp van der Heijde score (SHS) and defined as >5 increase in T-SHS over 24 months. Hand bone mineral density (BMD) was measured by DXR at inclusion and 12 months and a change ≥2.5 mg/cm2/month was used as a cut-off for HBL.



In the MTX responders, triple therapy, and MTX + INF groups, the proportions with HBL were 4.1%, 22.2% and 16.4%, respectively (p = 0.01), and the mean (SD) radiological progression in these groups was 3.91 (6.72), 7.40 (14.63) and 2.72 (4.55) respectively (p = 0.06). Patients with HBL had significantly greater risk for radiographic progression, compared with patients without HBL (odds ratio 3.09, 95% CI =1.20-7.79, p = 0.02).



Non-responders to MTX had a significantly greater risk of HBL than MTX-responders, despite the add-on therapies. Patients with HBL during the 12 months had greater risk of radiographic progression after 24 months. Evaluation of HBL may help to identify patients who are at risk of radiographic progression.
Inductance 101: Analysis and Design Issues

With operating frequencies approaching the gigahertz range, inductance is becoming an increasingly important consideration in the design and analysis of on-chip interconnect. In this paper, we give a tutorial overview of the analysis and design issues related to on-chip inductance effects.We explain the complexity of the current flow in VLSI circuits. We discuss the applicability of the PEEC approach in a detailed circuit model of the signal and power grid interconnect, switching devices, power pads and the package. Fur-ther, we explain techniques that can be used to speed-up simulation of the large PEEC model. We then discuss a simplified model that uses the so-called loop inductance approach, and compare it with the detailed model.We present experimental results, obtained from simulations of industrial circuits, for both the PEEC and loop models. We also cover design techniques that can help tackle the on-chip inductance issues.
Intensity-modulated extended-field chemoradiation plus simultaneous integrated boost in the pre-operative treatment of locally advanced cervical cancer: a dose-escalation study.

To investigate the feasibility and determine the recommended pre-operative intensity-modulated radiotherapy (IMRT) dose of extended-field chemoradiation along with simultaneous integrated boost (SIB) dose escalation.



A radiation dose of 40 Gy over 4 weeks, 2 Gy/fraction, was delivered to the tumour and the lymphatic drainage (planning target volume, PTV3), which encompassed a volume larger than standard (common iliac lymphatic area up to its apex, in front of the L3 vertebra), concurrently with chemotherapy (cisplatin and 5-fluorouracil). Radiation dose was escalated to the pelvis (PTV2) and to the macroscopic disease (PTV1) with the SIB-IMRT strategy. Three dose levels were planned: Level 1 (PTV3: 40/2 Gy; PTV2: 40/2 Gy; PTV1: 45/2.25 Gy), Level 2 (PTV3: 40/2 Gy; PTV2: 45/2.25 Gy; PTV1: 45/2.25 Gy) and Level 3 (PTV3: 40/2 Gy; PTV2: 45/2.25 Gy; PTV1: 50/2.5 Gy). All treatments were delivered in 20 fractions. Patients were treated in cohorts of between three and six per group using a Phase I study design. The recommended dose was exceeded if two of the six patients in a cohort experienced dose-limiting toxicity within 3 months from treatment.



19 patients [median age: 46 years; The International Federation of Gynecology and Obstetrics (FIGO) stage IB2: 3, IIB: 10, IIIA-IIIB: 6] were enrolled. Median follow-up was 24 months (9-60 months). The most common grade 3/4 toxicity was gastrointestinal (GI) (diarrhoea, mucous discharge, rectal/abdominal pain). At Levels 1 and 2, only one grade 3 GI toxicity per level was recorded, whereas at Level 3, two grade 3 GI toxicities (diarrhoea, emesis and nausea) were recorded.



The SIB-IMRT technique was found to be feasible and safe at the recommended doses of 45 Gy to PTV1 and PTV2 and 40 Gy to PTV3 in the pre-operative treatment of patients with locally advanced cervical cancer. Unfortunately, this complex technique was unable to safely escalate dose beyond levels already achieved with three-dimensional conformal radiotherapy technique given acute GI toxicity.


ADVANCES IN KNOWLEDGE
A Phase I radiotherapy dose-escalation trial with SIB-IMRT technique is proposed in cervical cancer. This complex technique is feasible and safe at the recommended doses.
Frequent outpatient contact and decreasing medication affordability in patients with diabetes from 1997 to 2004.

D espite significant changes in treatment standards for diabetes, there has been little improvement in overall rates of metabolic control (1–5). In recent years, diabetes medical regimen complexity has also increased markedly, with the proportion of U.S. patients taking five or more prescription medicines nearly doubling (from 18 to 30%) from 1994 to 2003 (6). Given the persistent difficulty in achieving ideal metabolic control and the increasing complexity of medical care, further insight into current diabetes outpatient management is required.