nils-herrmann/clean_scirepeval huggingface dataset:
Tissue characteristics and anatomic distribution of cardiac metastases among patients with advanced systemic cancer assessed by cardiac magnetic resonance (CMR)

The population comprised consecutive adults (≥18 yo) with metastatic systemic neoplasms who underwent contrast-enhanced CMR between 1/2012 8/2015. Patients with primary cardiac neoplasms were excluded. CMR was performed using 1.5T (88%) and 3T (12%) clinical (GE) scanners. A standard contrast-enhanced CMR protocol was applied: Cine-CMR (SSFP) was used to assess cardiac structure and morphology. DE-CMR (IR-GRE, TI 250-350 msec, 0.2 mmol/kg gadolinium) was used for tissue characterization; long TI (600 msec) DE-CMR was employed to confirm tissue properties of visualized masses. CMET was defined using established criteria as a discrete, irregularly contoured mass with discrete borders independent of cardiac chambers, myocardium, or central catheters. CMET was further categorized based on enhancement pattern (absent, diffuse, heterogeneous enhancement with patchy hypoenhancement). Transthoracic echocardiography (echo), if performed clinically within 30 days of CMR, was used to test conventional imaging for CMET.  115 patients (57 ± 15 yo, 54% male) with metastatic extra-cardiac primary neoplasms were studied; 29% (n=33) had CMET on CMR. Sarcoma (21% [n=7]) and melanoma (12% [n=4]) were the two leading primary cancer etiologies; atypical primaries also occurred (n=3 pancreatic, n=1 gastrointestinal stromal, n=1 CNS). CMET location markedly varied (45% RV | 27% LV | 18% RA | 12% LA | 27% pericardial); 21% of cases involved multiple cardiac locations. 76% were due to hematogenous or lymphatic spread; 24% were due to direct invasion. DE-CMR demonstrated CMET enhancement in 83% of cases; enhancement pattern was variable (54% heterogeneous, 46% diffuse). CMET often occurred in absence of pericardial (27%) or pleural (48%) effusions. 67% of the population underwent echo within 30 (6.7 ± 8.0) days of CMR, including 61% (n=20) of patients with CMET by CMR. As shown (Table 1), echo provided limited diagnostic sensitivity for CMET, whether assessed on a per-patient (75%) or per-location (74%) basis, despite excellent specificity (≥98%). Echo performance varied based on CMET morphology and location; CMET detected by CMR but missed by echo were either intra-myocardial (n=2) or in locations suboptimally evaluated via transthoracic ultrasound (n=2 posterior LA | n=1 RV outflow tract).
Variable effects of American ginseng: a batch of American ginseng (Panax quinquefolius L.) with a depressed ginsenoside profile does not affect postprandial glycemia

We have repeatedly reported that American ginseng (AG) with a specific ginsenoside profile significantly decreases postprandial glycemia. Whether this effect is reproducible using AG with a different profile is unknown. We therefore investigated the effect of a different batch of AG on glycemia following a 75 g oral glucose tolerance test ( Using a randomized, single blind design, 12 normal subjects (six males and six females, aged 31±3 y, body mass index (BMI) 28±2 kg/m2) received 6 g AG or placebo 40 min before a 75 g OGTT. The protocol followed the guidelines for the OGTT, with venous blood samples drawn at −40, 0, 15, 30, 45, 60, 90 and 120 min. Ginsenosides in the AG were assessed by established methods for HPLC-UV.Results: Repeated measures analysis of variance demonstrated that there was no significant effect of the AG on incremental plasma glucose (PG) or insulin (PI) or their areas under the curve Indices of insulin sensitivity (insulin sensitivity index (ISI)) and release (ΔPI30-0/ΔPG30-0) calculated from the OGTT were also unaffected. The AG contained 1.66% total ginsenosides, 0.90% (20S)-protopanaxadiol (PPD) ginsenosides, and 0.75% (20S)-protopanaxatriol (PPT) ginsenosides, with the following key ratios: PPD:PPT of 1.2, Rb1:Rg1 of 8.1, and Rb2:Rc of 0.18.Conclusion: The present batch of AG was unable to reproduce the postprandial hypoglycemic effects we observed previously. Possible explanations for this discrepancy include marked decrements in total ginsenosides and the key ratios PPD:PPT, Rb1:Rg1, and Rb2:Rc. These data suggest that the ginsenoside profile of AG might play a role in its hypoglycemic effects. The involvement of other components cannot, however, be precluded.
Role of dipstick in detection of haeme pigment due to rhabdomyolysis in victims of Bam earthquake.

Avoiding life-threatening complications of rhabdomyolysis depends on early diagnosis and prompt management. The aim of this study was to evaluate the role of urinary dipstick test in the detection of haeme pigment in patients who were at risk of acute renal failure (ARF) due to rhabdomyolysis after suffering injury in the Bam earthquake. Serum creatine phosphokinase (CPK) level was used as the gold standard for prediction of ARF. ARF developed in 8 (10%) of 79 patients studied. We found no significant differences in the sensitivity, specificity and accuracy of dipstick urine and serum CPK tests for identifying patients who were at risk of ARF. However, dipstick urine test is an easy test that can be performed quickly at an earthquake site.
Cold snare polypectomy versus cold forceps polypectomy for diminutive and small colorectal polyps: a randomized controlled trial.

The optimal technique for removal of diminutive or small colorectal polyps is debatable.



To compare the complete resection rates of cold snare polypectomy (CSP) and cold forceps polypectomy (CFP) for the removal of adenomatous polyps ≤7 mm.



Prospective randomized controlled study.



A university hospital.



A total of 139 patients who were found to have ≥1 colorectal adenomatous polyps ≤7 mm.



Polyps were randomized to be treated with either CSP or CFP. After the initial polypectomy, additional EMR was performed at the polypectomy site to assess the presence of residual polyp tissue.



Absence of residual polyp tissue in the EMR specimen of the polypectomy site was defined as complete resection.



Among a total of 145 polyps, 128 (88.3%) were adenomatous polyps. The overall complete resection rate for adenomatous polyps was significantly higher in the CSP group compared with the CFP group (57/59, 96.6% vs 57/69, 82.6%; P = .011). Although the complete resection rates for adenomatous polyps ≤4 mm were not different (27/27, 100% vs 31/32, 96.9%; P = 1.000), the complete resection rates for adenomatous polyps sized 5 to 7 mm was significantly higher in the CSP group compared with the CFP group (30/32, 93.8% vs 26/37, 70.3%; P = .013).



Single-center study.



CSP is recommended for the complete resection of colorectal adenomatous polyps ≤7 mm. (
Major eye diseases and risk factors associated with systemic hypertension in an adult Chinese population: the Beijing Eye Study.

To assess the relationship of hypertension with major eye diseases and other ocular parameters.



Population-based study.



The Beijing Eye Study is a population-based study that included 4439 Chinese subjects examined at the baseline examination in 2001; there was a follow-up examination in 2006, in which 3251 subjects participated, of whom 3222 had blood pressure measurements.



All participants underwent an ophthalmic examination, anthropometric measurements, and blood pressure measurement. Hypertension was defined as a systolic blood pressure >or=140 mmHg and/or diastolic blood pressure >or=90 mmHg, and/or self-reported current treatment for hypertension with antihypertensive medication.



Blood pressure and ocular parameters, including intraocular pressure and prevalence of major ophthalmic diseases.



Mean age of participants in the present study was 60.4+/-10.0 years. Hypertension was present in 1500 (46.6%) of the 3222 subjects who had their blood pressure measured. In multiple regression analysis, hypertension was associated with higher intraocular pressure (beta = 0.39; 95% confidence interval [CI], 0.12-0.66; P = 0.005), focal arteriolar narrowing (odds ratio [OR], 1.78; 95% CI, 1.34-2.36; P<0.001), arteriovenous nicking (OR, 1.50; 95% CI, 1.11-2.04; P = 0.009), generalized retinal arteriolar narrowing (OR, 1.65; 95% CI, 1.30-2.09; P<0.001), retinal vein occlusions (OR, 2.86; 95% CI, 1.21-6.80; P = 0.02), and diabetic retinopathy (OR, 1.90; 95% CI, 1.08-3.31; P = 0.02). Hypertension was not significantly associated with the prevalence of open-angle glaucoma (P = 0.19), angle-closure glaucoma (P = 0.15), age-related macular degeneration (AMD) (P = 0.73), nuclear cataract (P = 0.88), posterior subcapsular cataract (P = 0.30), cortical cataract (P = 0.10), or area of alpha zone (P = 0.05) or beta zone of parapapillary atrophy (P = 0.95).



In Chinese persons, while controlling for other systemic parameters, hypertension was associated with increased intraocular pressure, retinal microvascular abnormalities, and prevalence of retinal vein occlusion and diabetic retinopathy. Hypertension was not associated significantly with AMD, age-related cataract, or glaucoma.
Phase I trial of docetaxel, cisplatin and concurrent radical radiotherapy in locally advanced oesophageal cancer

Locally advanced oesophageal cancer (LAEC) is associated with poor survival and more effective treatments are needed. The aim of this phase I trial was to assess the maximum tolerated dose (MTD) of a novel weekly docetaxel and cisplatin regimen concurrent with radical radiotherapy.Patients with unresectable, non-metastatic LAEC were eligible. Treatment comprised docetaxel 15–30 mg m−2 per week and cisplatin 15–30 mg m−2 per week in six planned dose levels (DLs) in 3–6 patient cohorts with 50 Gy radiotherapy in 25 fractions. Maximum tolerated dose was based on defined dose-limiting toxicities (DLTs) during therapy and 2 weeks post therapy.A total of 24 patients were enrolled. There were two DLTs: grade 3 fever in DL1 (docetaxel 15 mg m−2, cisplatin 15 mg m−2) and grade 3 nausea in DL2 (20 mg m−2, 15 mg m−2). These DLs were each expanded to six patients without further DLTs. The most common acute toxicity was grade 3 radiation oesophagitis (37.5%). There were no grade 4 toxicities, and haematologic toxicity was minimal. Cisplatin and docetaxel dose intensity was 100% at the highest dose level (DL6). A MTD was not reached in this trial. Tumour overall response rate was 50% (33% complete, 17% partial).Conclusion:Cisplatin and docetaxel each 30 mg m−2 per week concurrent with 50 Gy radiotherapy is recommended for use in phase II clinical trials in oesophageal cancer.
Joint damage in rheumatoid arthritis: radiological assessments and the effects of anti-rheumatic drugs

Joint damage is a major problem in the long-term course of rheumatoid arthritis. It is usually assessed radiologically. In this review the methods of measuring the radiological changes are outlined, and the effects of anti-rheumatic drugs on radiological progression summarised. Two methods of scoring radiographs have become standard techniques; these are the Sharp index and the Larsen index. They both concentrate on cartilage loss and erosive damage in the hands and wrists. Investigations of the effects of drugs upon the radiological progression of rheumatoid arthritis include: indirect studies evaluating the inter-relationships between clinical, laboratory and radiological variables; placebo-controlled studies of slow-acting drugs and similarly controlled studies without a placebo group; open studies evaluating the long-term effects of treatment of slow-acting drugs. Only slow-acting drugs such as gold have been persistently considered to have a possible effect on reducing radiological progression. Unfortunately the therapeutic studies use a wide range of different radiological assessment techniques, and the incomparability is therefore difficult. None of the studies give a good indication that there is a marked reduction in joint damage by slow-acting drugs. On balance studies do suggest minor effects on the process of progression. Instead of debating how strong the evidence of such minor effect really is, it is concluded that rheumatologists should look towards novel therapeutic approaches to induce a major reduction in the rate of damage.
Nurse-led follow-up care for head and neck cancer patients: a quasi-experimental prospective trial

The aim of this study was to compare conventional medical follow-up with follow-up containing additional nursing consultations regarding the psychosocial adjustment and health-related quality of life (HRQOL) of head and neck cancer patients. Using a quasi-experimental design, patients were enrolled consecutively into two groups. Experimental care covered six 30-min bimonthly nursing follow-up consultations during the first year posttreatment. Data were collected at posttreatment months 1 (baseline), 6, and 12 for both groups. The intervention group was significantly worse at baseline, based on two of the seven adjustment scales and on the majority of HRQOL scales. However, their outcome at 6 and 12 months was consistent with that of the group which received conventional follow-up. Thus, the intervention group had a larger improvement in scores, and this was significant for one of the seven adjustment scales and 19 of the 33 HRQOL scales at 6 and 12 months, respectively. Most of the differences in HRQOL scales were clinically relevant at 6 months. These results suggest that nurse-led consultations for patients with head and neck cancer have a positive effect, primarily with respect to HRQOL. Nurse-led follow-up leads to a similar psychosocial adjustment as conventional follow-up, even among patients who showed worse performance at the start of follow-up. Thus, nurse-led follow-up may be a cost-effective way to improve follow-up care for this patient group.
Effect of pravastatin on total kidney volume, left ventricular mass index, and microalbuminuria in pediatric autosomal dominant polycystic kidney disease.

In autosomal dominant polycystic kidney disease (ADPKD), progressive kidney cyst formation commonly leads to ESRD. Because important manifestations of ADPKD may be evident in childhood, early intervention may have the largest effect on long-term outcome. Statins are known to slow progressive nephropathy in animal models of ADPKD. This randomized double-blind placebo-controlled phase III clinical trial was conducted from 2007 to 2012 to assess the effect of pravastatin on height-corrected total kidney volume (HtTKV) and left ventricular mass index (LVMI) by magnetic resonance imaging (MRI) and urine microalbumin excretion (UAE) in children and young adults with ADPKD.



There were 110 pediatric participants with ADPKD and normal kidney function receiving lisinopril who were randomized to treatment with pravastatin or placebo for a 3-year period with evaluation at 0, 18, and 36 months. The primary outcome variable was a ≥ 20% change in HtTKV, LVMI, or UAE over the study period.



Ninety-one participants completed the 3-year study (83%). Fewer participants receiving pravastatin achieved the primary endpoint compared with participants receiving placebo (69% versus 88%; P=0.03). This was due primarily to a lower proportion reaching the increase in HtTKV (46% versus 68%; P=0.03), with similar findings observed between study groups for LVMI (25% versus 38%; P=0.18) and UAE (47% versus 39%; P=0.50). The percent change in HtTKV adjusted for age, sex, and hypertension status over the 3-year period was significantly decreased with pravastatin (23% ± 3% versus 31% ± 3%; P=0.02).



Pravastatin is an effective agent to slow progression of structural kidney disease in children and young adults with ADPKD. These findings support a role for early intervention with pravastatin in this condition.
A randomized study of tenofovir disoproxil fumarate in treatment-experienced HIV-1 infected adolescents.

There are few data on the safety and antiviral activity of tenofovir disoproxil fumarate (TDF) in HIV-1 infected adolescents.



A randomized, double-blinded, placebo-controlled study was conducted. Ninety adolescents (12 to <18 years) who were viremic while receiving antiretroviral treatment were randomized to receive TDF 300 mg (mean, 216.8 mg/m(2)) or placebo in combination with an optimized background regimen (OBR) for 48 weeks. The primary efficacy endpoint was time-weighted average change in plasma HIV-1 RNA from baseline at week 24



Eighty-seven subjects (45 TDF, 42 placebo) received the study drug. Through week 24, the median time-weighted average change in plasma HIV-1 RNA was not different between the TDF and placebo groups (-1.6 versus -1.6 log(10)copies/mL, P = 0.55). The percentages of subjects who achieved HIV-1 RNA <400 copies/mL were similar at week 24 (40.9 versus 41.5%). One fourth of subjects in the TDF and placebo groups (24.4 versus 28.6%) had at least 3 active agents in the OBR. Many subjects in both groups had baseline genotypic resistance to TDF (48.9 versus 33.3%). TDF was generally safe and well tolerated. There were no statistically significant differences in changes of renal function and bone mineral density between the 2 groups.



This study of TDF in combination with an OBR in antiretroviral-experienced adolescents did not meet its primary or secondary efficacy endpoints. The effectiveness of the OBR and baseline genotypic resistance to TDF in both groups may have confounded the efficacy findings. No clinically relevant TDF-related renal or bone toxicities were observed in this adolescent population.
Practicability of segmental stabilizing exercises in the context of a group program for the secondary prevention of low back pain. An explorative pilot study.

Segmental stabilizing exercises (SSE) for specific dysfunction of local muscles (m. transversus abdominis, m. multifidus, pelvic floor muscles and diaphragm pelvis) have been advocated in patients with low back pain (LBP). The specific aims of this study were to examine: 1) whether participants of a group program learn SSE; 2) whether they respond to SSE with a reduction in present LBP and 3) to what extent people report using SSE in daily living.



One-hundred nurses participated in this explorative pilot study. Data from a 12-week multimodal program including SSE as intervention for the prevention of LBP were analysed. The prone test was taken as an indicator for the participants' ability to perform SSE correctly. Present back pain was assessed on a numerical rating scale (0-10). A compliance questionnaire and a transfer questionnaire assessed compliance and transfer of SSE into daily living.



After the intervention, 72% of participants were able to perform SSE correctly as measured by the prone test. Between 48% and 78% of the participants with present LBP experienced a minimal, clinically important change (minimal clinical changes, [MCC]) while performing SSE. No strong interrelations between the ability to correctly perform SSE and the MCC of LBP could be identified. Participants reported exercising SSE for 12 min on average 4-5 days a week. At 3 months after the intervention, 76% of participants reported using SSE ''always'' in their work with patients.



First findings are that SSE can be learned by the majority of the participants of a group program for the prevention of LBP. Additionally, SSE reduces present LBP and so can help people with LBP learn to help themselves. We are unable to explain how participants benefited from SSE even when they were unable to perform SSE correctly, as measured by the prone test.
Urinary concentrations of ADAM 12 from breast cancer patients pre- and post-surgery vs. cancer-free controls: a clinical study for biomarker validation

The ADAMs (A Disintegrin and Metalloproteinases) are a family of multi-domain, zinc-dependent metalloproteinase enzymes. ADAM 12 has been previously associated with the onset and progression of breast cancer, and elevated levels of ADAM 12 have been previously found in the urine of breast cancer patients. Aims of the current study are: 1) establish the viability of urinary ADAM 12 as a diagnostic marker for breast cancer, and 2) explore the effects of surgical tumor removal on the levels of urinary ADAM 12. A total of 96 patients have been recruited for this study, including 50 patients diagnosed with cancer, and 46 age-matched controls. Commercially available ELISA kits for ADAM 12 were used to quantify the presence and concentration of this enzyme in the urine from cancer patients with ductal carcinoma in situ (DCIS) and invasive breast cancer (IBC) both prior to any treatment and approximately two weeks following surgery, as well as from controls. We find no statistically significant differences between the concentrations of ADAM 12 in the urine of breast cancer patients prior to treatment and that of their age-matched controls; however the concentration of ADAM 12, both alone and as a function of urine total protein, are significantly elevated following surgery (p < 0.0001). Patients who underwent a mastectomy have significantly higher urinary ADAM 12 concentrations than those who underwent a lumpectomy (significant at p = 0.0271). These findings suggest that urinary ADAM 12 may not correlate directly with the status and stage of breast cancer as previously thought; rather these increases may be a result of tissue injury and inflammation from biopsy and surgical resection. Results of this study may suggest a need for biomarkers to be evaluated carefully in the context of tissue damage.
Phase II Study of Cyclophosphamide, Epirubicin, Vincristine, Prednisone, and Etoposide (CEOP-E) for Aggressive Non-Hodgkin's Lymphoma

The main objectives of the current study were to evaluate the efficacy and safety of a CEOP-E regimen for patients with aggressive non-Hodgkin's lymphoma (NHL). Fifty-one consecutive patients with newly diagnosed aggressive NHL were enrolled in the study. Median age of patients was 57 (range, 18-75) yr old, and male to female ratio was 1.32:1. Diffuse large B cell lymphoma (68.8%) was the most common histological subtype. Thirty patients (58.8%) had Ann Arbor stage III or IV diseases at diagnosis. One course of chemotherapy consisted of an intravenous combination of cyclophosphamide 750 mg/m(2), epirubicin 50 mg/(2), vincristine 2 mg, etoposide 80 mg/(2) on day 1 and oral administration of 100 mg prednisone on days 1 to 5 (CEOP-E). A complete response or unconfirmed complete response was achieved in 31 (63.3%) out of 49 evaluated patients. With a median follow-up of 16.3 months, 26 events including relapse and death were observed. The estimated 2-yr survival rate for all patients and disease free survival rate for patients achieving complete response was 58.9% and 57.1%, respectively. Episodes of febrile neutropenia occurred in 5 (10.2%) patients. Transient episodes of ECG abnormality (1st degree AV block) were observed in 2 patients. Accordingly, the CEOP-E regimen produced comparable results to those of other regimens, including CHOP, in terms of the response rate and overall survival. The current regimen seemed to minimize the cardiac toxicity due to an accumulated dose of anthracycline in the treatment of aggressive NHL.