nils-herrmann/clean_scirepeval huggingface dataset:
Complete remission status before autologous stem cell transplantation is an important prognostic factor in patients with multiple myeloma undergoing upfront single autologous transplantation.

Upfront high-dose myeloablative chemotherapy followed by a single autologous stem cell transplantation (ASCT) is the standard therapy for patients under the age of 65 years with newly diagnosed multiple myeloma (MM). Because disease status after induction chemotherapy is variable, we evaluated the prognostic effect of disease status before ASCT, especially in patients who were initially chemosensitive. We retrospectively analyzed the initially chemosensitive MM patients (> or = partial remission [PR]) enrolled in the Korean Multiple Myeloma Working Party Web-based registration system (www.myeloma.or.kr). Between November 1996 and January 2007, 197 MM patients (median age 53 years) were treated with induction chemotherapy followed by a single ASCT. All patients received peripheral blood stem cell (PBSC) support after conditioning with melphalan (Mel) alone. We considered those patients with no detectable M-protein regardless of the result of immunofixation to be in complete remission (CR) in this study. The median follow-up times were 29.2 months (range, 5.4 to 103.8 months) from the day of diagnosis and 22.4 months (range, 0.4 to 96.0 months) from the day of ASCT. Before ASCT, 63 patients (32%) were in CR and 134 (68%) were in partial remission (PR). The patients in CR had significantly longer overall survival (OS) from the day of ASCT compared with those in PR (P = .0015). Among the patients who received induction chemotherapy with vincristine, adriamycin, and dexamethasone (n = 162), the same difference in OS was seen between those in CR and those in PR before ASCT (P = .0016). CR after ASCT also predicted longer OS (P = .0135); however, patients with continued CR after ASCT had significantly higher OS after ASCT compared with patient with induced CR after ASCT who were in PR before ASCT (P = .0178). Multivariate analysis indicated that remission status pre-ASCT (CR vs PR) is a significant prognostic factor for predicting OS after ASCT (P = .012, Cox proportional hazard analysis; odds ratio = 2.83; 95% confidence interval = 1.25 to 6.37). We conclude that patients with MM who are in CR before ASCT have a better OS than those in PR before ASCT. Continued CR after ASCT may be an important prognostic factor as well. Our findings suggest that the development of more effective induction regimens, including novel antimyeloma agents to improve initial response, should be pursued to enhance clinical benefits post-ASCT.
Abnormal brain activity in prefrontal brain regions in abstinent marijuana users

We used PET (15)O and a modified version of the Stroop task to determine if 25-day abstinent heavy marijuana (MJ) users have persistent deficits in executive cognitive functioning (ECF) and brain activity. Performance on a modified version of the Stroop task and brain activity was compared between 25-day abstinent, heavy marijuana users (n = 11), and a matched comparison group (n = 11). The 25-day abstinent marijuana users showed no deficits in performance on the modified version of the Stroop task when compared to the comparison group. Despite the lack of performance differences, the marijuana users showed hypoactivity in the left perigenual anterior cingulate cortex (ACC) and the left lateral prefrontal cortex (LPFC) and hyperactivity in the hippocampus bilaterally, when compared to the comparison group. These results suggest that marijuana users display persistent metabolic alterations in brain regions responsible for ECF. It may be that marijuana users recruit an alternative neural network as a compensatory mechanism during performance on a modified version of the Stroop task. These differences in brain activity may be a common denominator in the evolution of maladaptive behaviors such as substance abuse and other neuropsychiatric disorders.
A low power unsupervised spike sorting accelerator insensitive to clustering initialization in sub-optimal feature space

Online unsupervised spike sorting or clustering is an integral component of implantable closed-loop brain-computer-interface systems. Robust clustering performance against various non-idealities such as poor initialization and order-of-arrival of inputs are desirable while meeting the minimal area and power requirements for implants. We explore an online and unsupervised spike-sorting algorithm utilizing a low-overhead feature screening process that improves feature discriminability in the use of sub-optimal features for reducing hardware complexity. Based on the algorithm, an accelerator architecture that performs feature screening and clustering is devised and implemented in a 65-nm high-VTH CMOS, largely improving clustering accuracy even with poor clustering initialization. In the post-layout static timing and power simulation, the power consumption and the area of the accelerator are found to be 2.17 μW/ch and 0.052 μm2/ch, respectively, which are 53% and 25% smaller than the previous designs, while achieving the required throughput of 420 sorting/s at the supply voltage of 300mV.
AGEs/sRAGE, a novel risk factor in the pathogenesis of end-stage renal disease

Interaction of advanced glycation end products (AGEs) with its cell-bound receptor (RAGE) results in cell dysfunction through activation of nuclear factor kappa-B, increase in expression and release of inflammatory cytokines, and generation of oxygen radicals. Circulating soluble receptors, soluble receptor (sRAGE), endogenous secretory receptor (esRAGE) and cleaved receptor (cRGAE) act as decoy for RAGE ligands and thus have cytoprotective effects. Low levels of sRAGE and esRAGE have been proposed as biomarkers for many diseases. However sRAGE and esRAGE levels are elevated in diabetes and chronic renal diseases and still tissue injury occurs. It is possible that increases in levels of AGEs are greater than increases in the levels of soluble receptors in these two diseases. Some new parameters have to be used which could be an universal biomarkers for cell dysfunction. It is hypothesized that increases in serum levels of AGEs are greater than the increases in the soluble receptors, and that the levels of AGEs is correlated with soluble receptors and that the ratios of AGEs/sRAGE, AGEs/esRAGE and AGEs/cRAGE are elevated in patients with end-stage renal disease (ESRD) and would serve as an universal risk marker for ESRD. The study subject comprised of 88 patients with ESRD and 20 healthy controls. AGEs, sRAGE and esRAGE were measured using commercially available enzyme linked immune assay kits. cRAGE was calculated by subtracting esRAGE from sRAGE. The data show that the serum levels of AGEs, sRAGE, cRAGE are elevated and that the elevation of AGEs was greater than those of soluble receptors. The ratios of AGEs/sRAGE, AGEs/esRAGE and AGEs/cRAGE were elevated and the elevation was similar in AGEs/sRAGE and AGEs/cRAGE but greater than AGEs/esRAGE. The sensitivity, specificity, accuracy, and positive and negative predictive value of AGEs/sRAGE and AGEs/cRAGE were 86.36 and 84.88 %, 86.36 and 80.95 %, 0.98 and 0.905, 96.2 and 94.8 %, and 61.29 and 56.67 % respectively. There was a positive correlation of sRAGE with esRAGE and cRAGE, and AGEs with esRAGE; and negative correlation between sRAGE and AGEs/sRAGE, esRAGE and AGES/esRAGE, and cRAGE and AGES/cRAGE. In conclusion, AGEs/sRAGE, AGEs/cRAGE and AGEs/esRAGE may serve as universal risk biomarkers for ESRD and that AGEs/sRAGE and AGEs/cRAGE are better risk biomarkers than AGEs/esRAGE.
A Genealogy of Control Structures

The issue of program control structures has had a history of heated controversy. To put this issue on a solid footing, this paper reviews numerous theoretical results on control structures and explores their practical implications.
The classic result of Böhm and Jacopini on the theoretical completeness of if-then-else and while-do is discussed. Several recent ideas on control structures are then explored. These include a review of various other control structures, results on time/space limitations, and theorems relating the relative power of control structures under several notions of equivalence.
In conclusion, the impact of theoretical results on the practicing programmer and the importance of one-in, one-out control structures as operational abstractions are discussed. It is argued further that there is insufficient evidence to warrant more than if-then-else, while-do, and their variants.
Arteriovenous shunts and capillary blush as an early sign of basal ganglia infarction after successful mechanical intra-arterial thrombectomy in ischaemic stroke

Recent studies indicate an interest in early infarct assessment, mainly using post-interventional perfusion imaging. This work evaluated two specific angiographic signs for infarct prediction in the basal ganglia immediately after successful mechanical intra-arterial thrombectomy. In this retrospective study, 57 consecutive patients (mean ± SD age 67 ± 15 years) with acute occlusion of the proximal anterior circulation who underwent mechanical thrombectomy of the M1 segment of the middle cerebral artery were included. Two separate angiographic signs, early venous drainage and capillary blush, were identified and analysed regarding their statistical significance for infarct prediction within the basal ganglia. Four patients were excluded due to parenchymal haemorrhage. Forty-four of 53 patients developed infarction of the basal ganglia. Sensitivity/specificity were 93 %/27 %, respectively, for the capillary blush sign and 88 %/63 %, respectively, for the early venous drainage sign. Combining both signs increased the sensitivity and specificity to 88 % and 81 %, respectively, and increased the positive predictive value to 95 %. Both angiographic signs seem to predict the irreversible damage of tissue in the basal ganglia reliably despite successful recanalization of the middle cerebral artery in patients with ischaemic stroke. • Evaluation of success in neurointerventional procedures is mainly based on recanalization rates. • Two separate angiographic signs can predict infarction immediately after proximal MCA recanalization.  Combining both signs increases their specificity.
Development of a HIV-1 lipopeptide antigen pulsed therapeutic dendritic cell vaccine.

In the search for a therapeutic HIV-1 vaccine, we describe herein the development of a monocyte-derived dendritic cell (DC) vaccine loaded with a mixture of HIV-1-antigen lipopeptides (ANRS HIV-LIPO-5 Vaccine). LIPO-5 is comprised of five HIV-1-antigen peptides (Gag(17-35), Gag(253-284), Nef(66-97), Nef(116-145), and Pol(325-355)), each covalently linked to a palmitoyl-lysylamide moiety. Monocytes enriched from HIV-1-infected highly active antiretroviral therapy (HAART)-treated patients were cultured for three days with granulocyte-macrophage colony-stimulating factor and alpha-interferon. At day 2, the DCs were loaded with ANRS HIV-LIPO-5 vaccine, activated with lipopolysaccharide, harvested at day 3 and frozen. Flow cytometry analysis of thawed DC vaccines showed expression of DC differentiation markers: CD1b/c, CD14, HLA-DR, CD11c, co-stimulatory molecule CD80 and DC maturation marker CD83. DCs were capable of eliciting an HIV-1-antigen-specific response, as measured by expansion of autologous CD4(+) and CD8(+) T-cells. The expanded T-cells secreted gamma-IFN and interleukin (IL)-13, but not IL-10. The safety and immunogenicity of this DC vaccine are being evaluated in a Phase I/II clinical trial in chronically HIV-1-infected patients on HAART (
Physiologie evaluation of non-invasive pressure support ventilation in trauma patients with acute respiratory failure

To investigate the effectiveness of noninvasive (face mask) versus invasive (endotracheal tube) equal pressure values on blood gases and respiratory pattern and to evaluate the feasibility of using mask ventilation after the short term physiologic study. Open, prospective, physiologic study and uncontrolled clinical study. Intensive care unit of a trauma center. 22 intubated trauma patients were studied. Patients were intubated and ventilated in a pressure support mode (IPSV) of 13.5 ± 1.5 cmH2O and a post end-expiratory pressure (PEEP) of 5.8 ± 2.57 cmH2O. After a T-piece trial to assess patient’s ability to breath spontaneously, patients were switched over to noninvasive pressure support (NIPSV). The pressure levels were set as during IPSV. Blood gases and respiratory parameters were measured during IPSV, during the T-piece trial, and after 1 h of NIPSV After the physiologic study, all patients were asked if they wished to continue on NIPSV. The patient’s subjective compliance with IPSV and NIPSV was measured by means of an arbitrary score. A successful outcome was defined as no need for reintubation. IPSV and NIPSV showed no statistical differences for blood gas and respiratory parameters by using the same values of PSV (13 ± 5 vs 12.8 ± 1.7 cmH2O, NS) and PEEP (5.8 ± 2.5 and 5.2 ± 2.2 cmH2O NS). The median length of time on NIPSV was 47 h (range 6 to 144). All patients wished to continue on NIPSV, but 9 patients (40.9 %) were reintubated after 54 ± 54 h. Six of them died after 36 ± 13 days while still on mechanical ventilation. There was no statistically significant difference in compliance score between IPSV and NIPSV. NIPSV is comparable to IPSV in terms of blood gases and respiratory pattern. The clinical uncontrolled study indicates that NIPSV could be used in selected trauma patients.
Tranexamic acid to reduce blood loss after bilateral total knee arthroplasty: a prospective, randomized double blind study.

The effects of 2-dosage regimens of tranexamic acid (10 mg/kg and 15 mg/kg) on blood loss and transfusion requirement were compared to saline placebo in 60 patients undergoing concurrent bilateral total knee arthroplasty, with additional reinfusion autotransfusion from intraarticular drains. Mean blood loss was 462 mL in 15 mL/kg group, 678 mL in 10 mg/kg group, and 918 mL in controls (P < .01 vs 15 mg/kg). Blood available for autotransfusion was greatest in controls and least in 15 mg/kg group. Combined autologous and allogenic transfusion volumes were similar in the treatment groups and significantly less than controls (P < .01). With use of an autologous reinfusion strategy, the lower dose is sufficient to lead to a lesser allogenic transfusion requirement.
Efficacy and side effects of mianserin, a tetracyclic antidepressant.

Antidepressant drugs have been in extensive use for over 20 years. Initially 2 groups of compounds, the monoamine oxidase inhibitors (MAOI) and tricyclic compounds based on the imipramine configuration were widely used. In the early 1960's after a few years ofwide use, interest in the MAOI group fell following the recognition of a serious adverse effect. Blackwell (1963) described the occurrence of hypertensive crisis with occasional fatalities when these compounds were taken with certain foodstuffs. It is of interest, however, that in recent years there has been some resurgence of interest in these compounds and the suggestion that their dangers may have been exaggerated (Tyrer, 1979) or might be ameliorated by combination with tricyclics (Pare et al., 1982). Interest in the tricyclic group however has continued unabated and over the years at least 20 antidepressants based on the original imipramine configuration have been produced. There is now a widespread and extensive accumulated experience of these compounds and although they remain the most widely prescribed antidepressant, it is now clear that they have a number of serious disadvantages. The most important of these are cardiotoxicity, potential fatality in overdose, marked peripheral anticholinergic activity and reduction in seizure threshold (Blackwell, 1981a). As these disadvantages exist to some extent with all the tricyclics produced so far, there have, not surprisingly, been active attempts to produce different and safer antidepressant compounds. Over the last few years a number of different compounds have come into use as antidepressants and these constitute the 'second generation' antidepressant drugs. Included among these are; viloxazine and zimelidine, both bicyclic compounds; nomifensine, a tetrahydro-isoquinoline derivative; maprotiline, a bridged tricyclic compound and the tetracyclic compound mianserin. All differ somewhat in their actions on central neurotransmitter systems and differing claims are made that their antidepressant actions are relatively free from the adverse or unwanted effects of the tricyclics. These claims should be received with caution as there has been an insufficient experience in the use of many of them. Mianserin, however, is probably the most widely used of these compounds and considerable clinical experience of its use has been accumulated over the last few years.
Does removal of deep breathing exercises from a physiotherapy program including pre-operative education and early mobilisation after cardiac surgery alter patient outcomes?

The aim of this study was to establish whether removal of breathing exercises from a regimen including early mobilisation changes the incidence of post-operative pulmonary complications for patients after cardiac surgery. Two hundred and thirty patients undergoing open heart surgery at Monash Medical Centre, Melbourne, were enrolled in this randomised controlled trial. All patients received physiotherapy treatment pre-operatively and post-operatively for three days. Patients were mobilised as soon as possible after surgery. Breathing group (control) patients performed a set routine of deep breathing exercises at each physiotherapy visit while those in the intervention group did not perform this routine. Other than the breathing exercises, patient management was similar between groups in terms of assessment, positioning and mobility. The incidence of postoperative pulmonary complications, post-operative length of stay, oxyhaemoglobin saturation and pulmonary function were measured pre-operatively and post-operatively. Intention-to-treat analysis was performed for post-operative pulmonary complications and length of stay. Other data were analysed using t-tests, chi square and repeated measures analysis of variance. There were no significant differences between the groups in the primary dependent variables. It is concluded that removal of breathing exercises from the routine physiotherapy management of open heart surgery patients does not significantly alter patient outcome.
Time course of clinical response to venlafaxine: relevance of plasma level and chirality

Early clinical response to antidepressant treatment is an important therapeutic goal, considering the psychological, social and economic consequences of depression. The aim of the present study was to investigate the relationship between the time course of response and the concentration of venlafaxine (V), its active metabolite O-desmethylvenlafaxine (ODV) and enantiomeric ratios V(+)/V(−) and ODV(+)/ODV(−). Depressed inpatients (n=35) received V orally at a fixed 300 mg daily dose. Accepted comedication included clorazepate (maximum 60 mg/day), zopiclone (maximum 15 mg/day) and low-dose trazodone (maximum 200 mg/day). Severity of depression was assessed on days 0, 4, 7, 11, 14, 21 and 28 (Montgomery and Åsberg Depression Rating Scale). Blood samples were taken on day 14 and day 28 and submitted to stereoselective determination. All measurements reflected trough steady-state values. First, pattern analysis was used to provide a categorical perspective of clinical response (50% improvement from baseline depression score). Patients displaying non-response, transient response, early persistent response and delayed persistent response were compared with respect to racemic concentrations and enantiomeric ratios. Second, in a dimensional perspective, mixed-effects modelling was used to analyse severity of depression versus time curves with respect to the possible influence of concentrations and enantiomeric ratios. Comparison of patients with and without persistent response did not reveal any significant difference for V, ODV, V+ODV plasma levels or enantiomeric ratios. Persistent response was significantly associated with less frequent pre-study antidepressant medication and less frequent comedication with zopiclone (day 14) and clorazepate (day 28) during the study. Focus on patients with persistent response (n=19, 54.3%) indicated that early response, first observed before day 14, was associated with significantly higher V+ODV concentration than delayed response (median 725 ng/ml versus 554 ng/ml, P=0.023). No difference was found for pre-study medication or comedication during the study. Shorter time to onset of response was significantly associated with lower V(+)/V(−) enantiomeric ratio (rs=0.48, P<0.05). Mixed-effects modelling of depression severity versus time curves in patients with persistent response confirmed that either higher V+ODV plasma level or lower V(+)/V(−) ratio were significantly associated with more rapid decrease of depression score (likelihood ratio tests, P=0.012 and P=0.046, respectively). Considering its modest sample size, naturalistic design and limited observation period, the present study provided preliminary indication that earlier clinical response may occur with higher V+ODV plasma level, extending previous dose-response studies. The hypothesis was also raised that exposure to a more potent noradrenergic therapeutic moiety, as reflected by a lower V(+)/V(−) ratio, may be relevant to early improvement of depression.
Treatment of childhood Hodgkin's disease without radiotherapy.

To minimize the side effects of treatment in children with Hodgkin disease (HD), chemotherapy was given without radiotherapy.



From 1975 to 1984, 21 patients with HD having lymph nodes < 4 cm were treated with six MOPP courses. From 1984 to 1987, all children presenting with HD (n = 17) were given six ABVD courses. From 1987 to 1993 all children (n = 21) were treated with six alternating ABVD and MOPP courses.



MOPP-treated children showed an event-free survival (EFS) of 91%, overall survival, 100%; ABVD-treated children had an EFS of 70%, overall survival, 94%; ABVD-MOPP-treated children had an EFS of 91% and an overall survival of 91%. Two cases developed a second malignancy. Toxicity was low.



In children, ABVD-MOPP treatment gives a good survival, and toxicity is low. Radiotherapy is not needed to treat HD in children.
Parathyroid gland ultrasound patterns and biochemical findings after one-year cinacalcet treatment for advanced secondary hyperparathyroidism.

Cinacalcet efficacy is limited in severe secondary hyperparathyroidism (SHPT) and its effect on parathyroid gland (PTG) volume and morphology have not been sufficiently investigated. We evaluated the effect of cinacalcet treatment for one year on the laboratory parameters of calcium-phosphorus metabolism and PTG ultrasound (US) patterns in hemodialysis (HD) patients with severe SHPT and US results indicative of nodular hyperplasia. Thirteen HD patients with severe SHPT (intact parathyroid hormone >700 pg/mL), US/scintigraphic evidence of at least one PTG with a diameter >7 mm, and high surgical risk or refusal of surgery were included. The patients were treated with cinacalcet. The initial dose of 30 mg was increased up to 180 mg once daily. At baseline and after one year of cinacalcet treatment a neck US was performed, providing data on 22 parathyroid glands in eight patients. The mean diameter at baseline and at one year was 12.6 +/- 5.9 and 13.0 +/- 5.3 mm, respectively (P = 0.46). Similarly, the mean volume at baseline and at one year was 513.4 +/- 416.3 and 556.8 +/- 480.8 mm(3), respectively (P = 0.18). The US structural score remained unchanged in 16 parathyroid glands and increased in 6 (P < 0.03), while the vascular score remained unchanged in 16 parathyroid glands and decreased in 6 (P = 0.25). Thus it can be concluded that cinacalcet treatment for one year in HD patients with severe SHPT is not associated with significant changes in parathyroid gland US patterns.