nils-herrmann/clean_scirepeval huggingface dataset:
A placebo-controlled study of the modafinil added to risperidone in chronic schizophrenia

In recent years, evidence suggests that modafinil may be useful for certain symptom domains of schizophrenia, especially for the negative and cognitive symptoms. However, the results are not consistent. This study was designed to investigate the effect of modafinil added to risperidone in patients with chronic schizophrenia in a double blind and randomized clinical trial. Participants were inpatients males (35) and females (11), ages 20–49 years at two teaching psychiatric hospital in Iran. All patients were in the active phase of the illness and met DSM-IV-TR criteria for schizophrenia. Patients were allocated in a random fashion 23 patients to risperidone 6 mg/day plus modafinil 200 mg/day and 23 patients to risperidone 6 mg/day plus placebo. The principal measure of outcome was the positive and negative syndrome scale (PANSS). Patients were assessed by a psychiatrist at baseline and after 2, 4, 6 and 8 weeks after the start of medication. The modafinil group had significantly greater improvement in the negative symptoms as well as PANSS total scores over the 8-week trial. Therapy with 200 mg/day of modafinil was well tolerated and no clinically important side effects were observed. The present study indicates modafinil as a potential adjunctive treatment strategy for treatment of schizophrenia particularly the negative symptoms. Nevertheless, results of larger-controlled trials are needed before recommendation for broad clinical application can be made.
Optimal plasma progranulin cutoff value for predicting null progranulin mutations in neurodegenerative diseases: a multicenter Italian study.

Recently, attention was drawn to a role for progranulin in the central nervous system with the identification of mutations in the progranulin gene (GRN) as an important cause of frontotemporal lobar degeneration. GRN mutations are associated with a strong reduction of circulating progranulin and widely variable clinical phenotypes: thus, the dosage of plasma progranulin is a useful tool for a quick and inexpensive large-scale screening of carriers of GRN mutations.



To establish the best cutoff threshold for normal versus abnormal levels of plasma progranulin.



309 cognitively healthy controls (25-87 years of age), 72 affected and unaffected GRN+ null mutation carriers (24-86 years of age), 3 affected GRN missense mutation carriers, 342 patients with neurodegenerative diseases and 293 subjects with mild cognitive impairment were enrolled at the Memory Clinic, IRCCS S. Giovanni di Dio-Fatebenefratelli, Brescia, Italy, and at the Alzheimer Unit, Ospedale Maggiore Policlinico and IRCCS Istituto Neurologico C. Besta, Milan, Italy. Plasma progranulin levels were measured using an ELISA kit (AdipoGen Inc., Seoul, Korea).



Plasma progranulin did not correlate with age, gender or body mass index. We established a new plasma progranulin protein cutoff level of 61.55 ng/ml that identifies, with a specificity of 99.6% and a sensitivity of 95.8%, null mutation carriers among subjects attending to a memory clinic. Affected and unaffected GRN null mutation carriers did not differ in terms of circulating progranulin protein (p = 0.686). A significant disease anticipation was observed in GRN+ subjects with the lowest progranulin levels.



We propose a new plasma progranulin protein cutoff level useful for clinical practice.
Comparison of contrast-enhanced ultrasonography versus baseline ultrasound and contrast-enhanced computed tomography in metastatic disease of the liver: diagnostic performance and confidence

The aim of this study was to compare contrast-enhanced ultrasonography (CEUS) to baseline US and contrast-enhanced computed tomography (CT) in metastatic disease of the liver diagnosed or suspected by US during presurgical staging or postsurgical follow-up for primary malignancies.  Two hundred-fifty-three patients considered suitable for US due to the complete explorability of the liver and with one to five proven or suspected liver metastases at baseline US were included. All patients underwent US before and after microbubble injection, and multiphase contrast-enhanced CT. Independent panels of readers reviewed US and CT scans and recorded liver metastases according to a 5-grade scale of diagnostic confidence. Sensitivity, specificity (diagnostic performance) and area under the receiver operating characteristics (ROC) curve (diagnostic confidence) were calculated.  Reference standards revealed no metastases in 57/253, more than five in 59/253, and one to five in 137/253 patients. In patients with one to five metastases, CEUS versus baseline US revealed more metastases in 64/137 and the same number in 73/137 patients while CEUS versus CT revealed more metastases in 10/137, the same number in 99/137, and lower number in 28/137. Sensitivity, specificity, and area under ROC curve of CEUS (83%, 84%, 0.929, respectively) differed from baseline US (40%, 63%, 0.579, respectively; P<0.01) while did not differ from CT (89%, 89%, 0.945, respectively; P>0.05).  CEUS improved liver metastases diagnosis in comparison with baseline US while it revealed similar diagnostic performance and confidence to contrast-enhanced CT in patients considered suitable for US and with proven or suspected liver metastases at baseline US.
The Impact of Husbands' Prostate Cancer Diagnosis and Participation in a Behavioral Lifestyle Intervention on Spouses' Lives and Relationships With Their Partners.

A prostate cancer diagnosis affects the patient and his spouse. Partners of cancer patients are often the first to respond to the demands related to their husband's illness and thus are likely to be the most supportive individuals available to the patients. It is therefore important to examine how spouses react and handle their husband's prostate cancer diagnosis.



The aim of this study was to explore how the prostate cancer diagnosis and the participation in their partners' behavioral lifestyle intervention program influenced the spouses' life, their relationship with their partner, and how they handle the situation.



Interviews were recorded with 8 spouses of potential low-risk prostate cancer patients on active surveillance as part of a clinical self-management lifestyle trial.



We identified 3 phases that the spouses went through: feeling insecure about their situation, coping strategies to deal with these insecurities, and feeling reassured.



The framework of a clinical trial should include mobilizing spousal empowerment so that they can take on an active and meaningful role in relation to their husband's disease. The observations here substantiate that the framework of active surveillance in combination with a lifestyle intervention in 1 specific prostate cancer clinical trial can mobilize spousal empowerment.



Creating well-designed clinical patient programs that actively involve the spouse appears to promote empowerment (meaning, self-efficacy, positive impact, and self-determination) in spouses. Spousal participation in clinical patient programs can give spouses relief from anxieties while recognizing them as a vital support for their husband.
Making pull-based graph processing performant

Graph processing engines following either the push-based or pull-based pattern conceptually consist of a two-level nested loop structure. Parallelizing and vectorizing these loops is critical for high overall performance and memory bandwidth utilization. Outer loop parallelization is simple for both engine types but suffers from high load imbalance. This work focuses on inner loop parallelization for pull engines, which when performed naively leads to a significant increase in conflicting memory writes that must be synchronized.
 Our first contribution is a scheduler-aware interface for parallel loops that allows us to optimize for the common case in which each thread executes several consecutive iterations. This eliminates most write traffic and avoids all synchronization, leading to speedups of up to 50X.
 Our second contribution is the Vector-Sparse format, which addresses the obstacles to vectorization that stem from the commonly-used Compressed-Sparse data structure. Our new format eliminates unaligned memory accesses and bounds checks within vector operations, two common problems when processing low-degree vertices. Vectorization with Vector-Sparse leads to speedups of up to 2.5X.
 Our contributions are embodied in Grazelle, a hybrid graph processing framework. On a server equipped with four Intel Xeon E7-4850 v3 processors, Grazelle respectively outperforms Ligra, Polymer, GraphMat, and X-Stream by up to 15.2X, 4.6X, 4.7X, and 66.8X.
[Assessment of the management of community-acquired pneumonia in adults outpatients].

There is limited information about the effectiveness of the treatment of community-acquired pneumonia (CAP) in Chilean emergency rooms.



To assess the treatment of CAP in emergency rooms at the Viña del Mar Health Service in Chile.



Prospective study of immunocompetent adult patients consulting for a CAP in emergency rooms. Those that required hospital admission were considered ineligible. The initial clinical and laboratory assessment, antimicrobial treatment and their condition after 30 days of follow up, were recorded.



Three hundred eleven adult patients aged 57+/-22 years (152 males), were evaluated. Patients with class I CAP (40% of cases) were treated with Clarithromycin (71.8%) or Amoxicillin (26.6%) for 10 days. Patients with class II CAP (60%) were treated with Amoxicillin-clavulanate (80.7%) or Levofloxacin (18.2%) for 10 days. Three hundred eight patients (99%) were cured without need of hospital admission; three patients (1%) were subsequently hospitalized because of clinical failure of ambulatory treatment. Overall, three patients (1%) died; all deaths occurred during or immediately after hospitalization and were related to the severity of lung infection but not to the choice of antibiotic treatment.



The outpatient management of CAP by general practitioners working at emergency rooms was clinically effective with low rates of hospital admission and mortality.
Long-term proton pump induced hypergastrinaemia does induce lineage-specific restitution but not clonal expansion in benign Barrett's oesophagus in vivo.

Barrett's oesophagus is a common premalignant lesion caused partly by acid reflux. Although the requisite therapy, proton pump inhibitors (PPIs), have been implicated in the progression of Barrett's oesophagus in animal models, harmful effects of prolonged PPI therapy in Barrett's oesophagus is both inconclusive and controversial. We therefore aimed to test the role of PPI-induced hypergastrinaemia in vitro and see whether any biological parameters were useful surrogates of long-term therapy in man.



We undertook detailed serological and tissue assessment of gastrin and CCK(2) receptors in 90 patients randomised to different doses of PPI therapy during a detailed 2-year follow-up. We also undertook a comprehensive study of cell models to study the consequential biological effects of gastrin on the mucosa.



Gastrin and its cognate receptor CCK(2)R were expressed highest in the stomach, then less in Barrett's oesophagus and least in squamous oesophagus (SqE) (n=20 paired t-test, p<0.01). Analysis of the change in Barrett's oesophagus segment length change in 70 patients who were randomised to high or low PPI dose showed no difference over 2 years (n=70 t-test, p=0.8). Prolonged PPI use did, however, increase the serum gastrin, (36 pg/ml+/-57 pg/ml to 103 pg/ml+/-94 pg/ml (paired t test, p<0.05)). In vitro gastrin also induced changes in OE33(E)(cckr) Barrett's oesophagus cells, but not OE21(E)(cckr) squamous cells, transfected with CCK(2)R; migration was induced by 1 ng/ml of gastrin but proliferation only increased with 100 ng/ml (paired t-test, p<0.01) and both were abolished by antagonists.



While the short-term effects of gastrin enhance epithelial restitution in Barrett's oesophagus (but not squamous mucosa) there is no clinical evidence that Barrett's oesophagus length expands over time. This study, which is the largest and longest term randomised controlled trial of gastrin biology in Barrett's oesophagus, is further proof of the clinical safety of PPI therapy.
Dosimetric benefits of placing dose constraints on the brachial plexus in patients with nasopharyngeal carcinoma receiving intensity-modulated radiation therapy: a comparative study

This study aimed to evaluate whether placing dose constraints on the brachial plexus (BP) could provide dosimetric benefits in patients with nasopharyngeal carcinoma (NPC) undergoing intensity-modulated radiation therapy (IMRT). Planning CT images for 30 patients with NPC treated with definitive IMRT were retrospectively reviewed. Target volumes, the BP and other critical structures were delineated; two separate IMRT plans were designed for each patient: one set no restrictions for the BP; the other considered the BP as a critical structure for which a maximum dose limit of ≤66 Gy was set. No significant differences between the two plans were observed in the conformity index, homogeneity index, maximum dose to the planning target volumes (PTVs), minimum dose to the PTVs, percentages of the volume of the PTVnx and PTVnd receiving more than 110% of the prescribed dose, or percentages of the volume of the PTVs receiving 95% and > 93% of the prescribed dose. Dose constraints significantly reduced the maximum dose, mean dose, V45, V50, V54, V60, V66 and V70 to the BP. Dose constraints significantly reduced the maximum dose to the BP, V45, V60 and V66 in both N0-1 and N2-3 disease; however, the magnitude of the dosimetric gain for each parameter between N0-1 and N2-3 disease was not significantly different, except for the V60 and V66. In conclusion, placing dose constraints on the BP can significantly decrease the irradiated volume and dose, without compromising adequate dose delivery to the target volume.
Arrhythmia Termination Versus Elimination of Dormant Pulmonary Vein Conduction as a Procedural End Point of Catheter Ablation for Paroxysmal Atrial Fibrillation

Pulmonary vein isolation (PVI) is still associated with a substantial number of arrhythmia recurrences in paroxysmal atrial fibrillation (AF). This prospective, randomized study aimed to compare 2 different procedural strategies.



A total of 152 patients undergoing de novo ablation for paroxysmal AF were randomized to 2 different treatment arms. The procedure in group A consisted of PVI exclusively. In this group, all isolated PVs were challenged with adenosine to reveal and ablate dormant conduction. In group B, PVI was performed with the patient either in spontaneous or in induced AF. If AF did not terminate with PVI, ablation was continued by targeting extra-PV AF sources with the desired procedural end point of termination to sinus rhythm. Primary study end point was freedom from arrhythmia during 1-year follow-up. In group A, adenosine provoked dormant conduction in 31 (41%) patients with a mean of 1.6±0.8 transiently recovered PVs per patient. Termination of AF during PVI was observed in 31 (65%) patients, whereas AF persisted afterward in 17 (35%) patients. AF termination occurred in 13 (76%) patients by AF source ablation. After 1-year follow-up, significantly more group B patients were free of arrhythmia recurrences (87 versus 68%; P=0.006). During redo ablation, the rate of PV reconduction did not differ between both groups (group A: 55% versus group B: 61%; P=0.25).



Elimination of extra-PV AF sources after PVI is superior to sole PV isolation with the adjunct of abolishing potential dormant conduction.
Repeated-dose pharmacokinetics of inhaled ciclesonide (CIC-HFA) in Japanese children with bronchial asthma: a phase I study.

Ciclesonide (CIC) is a highly safe, inhaled corticosteroid (ICS) that is converted into a pharmacologically active metabolite (des-isobutyryl-ciclesonide); this metabolite, in turn, exerts a local anti-inflammatory effect on lung tissue. The present study was undertaken to analyze the pharmacokinetics of des-isobutyryl-ciclesonide in the serum of Japanese children with bronchial asthma treated by repeated doses of CIC and to compare the data thus obtained with those obtained for Caucasian children with bronchial asthma.



Eight Japanese children with bronchial asthma were treated for 7 days with CIC-hydrofluoroalkalane (CIC-HFA) 200 μg/day administered by a metered-dose inhaler. The study was designed to assess the pharmacokinetics after 7-day repeated administration by which the steady state can be achieved, based on the results of an earlier study involving healthy Japanese adult males who received 7-day repeated administration of CIC-HFA. Blood was sampled at multiple time points on Day 7 of treatment for measurement of the serum des-isobutyryl-ciclesonide level.



The pharmacokinetic parameters (AUC from time zero to last observed concentration [AUC(t)], AUC over the dosage interval τ at steady state [AUC(ss)], maximum concentration [C(max)], and terminal elimination half-life [T(1/2)]) and the temporal changes in the serum levels of des-isobutyryl-ciclesonide after repeated administration of CIC-HFA (200 μg/day) in Japanese children with bronchial asthma differed only slightly from those in Caucasian children with bronchial asthma. No serious adverse events were noted during the study period. Additionally, no abnormalities were detected in the serum cortisol level, other laboratory parameters, or vital signs.



Our results suggest that there is little difference in the pharmacokinetics of des-isobutyryl-ciclesonide up on repeated administration of CIC-HFA between Japanese and Caucasian children with bronchial asthma. And our study suggests that CIC-HFA (200 μg/day, once daily) can be administered safely for 7 days, without raising any safety concerns.
A Model of Fluid Flow in Solid Tumors

Solid tumors consist of a porous interstitium and a neoplastic vasculature composed of a network of capillaries with highly permeable walls. Blood flows across the vasculature from the arterial entrance point to the venous exit point, and enters the tumor by convective and diffusive extravasation through the permeable capillary walls. In this paper, an integrated theoretical model of the flow through the tumor is developed. The flow through the interstitium is described by Darcy's law for an isotropic porous medium, the flow along the capillaries is described by Poiseuille's law, and the extravasation flux is described by Starling's law involving the pressure on either side of the capillaries. Given the arterial, the venous, and the ambient pressure, the problem is formulated in terms of a coupled system of integral and differential equations for the vascular and interstitial pressures. The overall hydrodynamics is described in terms of hydraulic conductivity coefficients for the arterial and venous flow rates whose functional form provides an explanation for the singular behavior of the vascular resistance observed in experiments. Numerical solutions are computed for an idealized case where the vasculature is modeled as a single tube, and charts of the hydraulic conductivities are presented for a broad range of tissue and capillary wall conductivities. The results in the physiological range of conditions are found to be in good agreement with laboratory observations. It is shown that the assumption of uniform interstitial pressure is not generally appropriate, and predictions of the extravasation rate based on it may carry a significant amount of error.
Safety and Efficacy of Nucleic Acid Polymers in Monotherapy and Combined with Immunotherapy in Treatment-Naive Bangladeshi Patients with HBeAg+ Chronic Hepatitis B Infection

Previous in vivo studies have suggested that nucleic acid polymers (NAPs) may reduce circulating levels of HBsAg in the blood by blocking its release from infected hepatocytes and that this effect may have clinical benefit. NAP treatment, was evaluated in two clinical studies in patients with HBeAg positive chronic HBV infection. The REP 101 study examined REP 2055 monotherapy in 8 patients and the REP 102 study examined REP 2139-Ca, in monotherapy in 12 patients, 9 of which transitioned to short term combined treatment with pegylated interferon alpha 2a or thymosin alpha 1. In both studies NAP monotherapy was accompanied by 2-7 log reductions of serum HBsAg, 3-9 log reductions in serum HBV DNA and the appearance of serum anti-HBsAg antibodies (10-1712 mIU / ml). Eight of the 9 patients transitioning to combined treatment with immunotherapy (pegylated interferon or thymosin alpha 1) in the REP 102 study experienced HBsAg loss and all 9 patients experienced substantial increases in serum anti-HBsAg antibody titers before withdrawal of therapy. For 52 weeks after removal of REP 2055 therapy, rebound of serum viremia (HBV DNA > 1000 copies / ml, HBsAg > 1IU / ml) was not observed in 3 / 8 patients. Suppression of serum virema was further maintained for 290 and 231 weeks in 2 of these patients. After withdrawal of all therapy in the 9 patients that transitioned to combination therapy in the REP 102 study, 8 patients achieved HBV DNA < 116 copies / ml after treatment withdrawal. Viral rebound occurred over a period of 12 to 123 weeks in 7 patients but was still absent in two patients at 135 and 137 weeks of follow-up. Administration tolerability issues observed with REP 2055 were rare with REP 2139-Ca but REP 2139-Ca therapy was accompanied by hair loss, dysphagia and dysgeusia which were considered related to heavy metal exposure endemic at the trial site. These preliminary studies suggest that NAP can elicit important antiviral responses during treatment which may improve the effect of immunotherapy. NAPs may be a potentially useful component of future combination therapies for the treatment of chronic hepatitis B.
Electroanatomic versus fluoroscopic mapping for catheter ablation procedures: a prospective randomized study.

The aim of this prospective randomized study was to compare the routine use of electroanatomic imaging (CARTO) with that of conventional fluoroscopically guided activation mapping (conventional) in an unselected population referred for catheter ablation. We sought to compare the two approaches with respect to procedure outcome and duration, radiation exposure, and cost.



All patients undergoing catheter ablation (with the exception of complete AV nodal ablation) were prospectively randomized to either a CARTO or conventional procedure for mapping and ablation. One hundred two patients were randomized. Acute procedural success was similar with either strategy (CARTO vs conventional 43/47 vs 51/55, P > 0.5), as was procedure duration (144 [58] vs 125 [48] min, P = 0.07 (mean [SD]). CARTO was associated with a substantial reduction in fluoroscopy time (9.3 [7.6] vs 28.8 [19.5] min, P < 0.001) and radiation dose (6.2 [6.1] vs 20.8 [32.7] Gray, P = 0.003). CARTO cases used fewer catheters (2.5 [0.7] vs 4.4 [1.1], P < 0.001), but catheter costs were higher (13.8 vs 9.3 units, P < 0.001, where one unit is equivalent to the cost of a nonsteerable quadripolar catheter).



For all catheter ablation procedures, even when a center's "learning curve" for CARTO is included, procedure duration and outcome are similar for CARTO and conventional procedures. CARTO is associated with drastically reduced fluoroscopy time and radiation dose. Although fewer catheters are used with CARTO, catheter costs remain higher.