nils-herrmann/clean_scirepeval huggingface dataset:
Hyponatremia and osteoporosis: reappraisal of a novel association

Age was a modifier of the independent association between hyponatremia and osteoporosis (OP). Risk of OP was the highest in the youngest age group as compared to older patients. A longer duration of hyponatremia revealed a similar association with OP in all anatomical sites. Epidemiologic studies provide conflicting results on the relationship between hyponatremia and OP. Our aim is to test the modification effect of age on the relationship between hyponatremia and OP at various anatomical sites in a large patient population. This is a cross-sectional observation of consecutive patients with available bone densitometry, demographic, clinical, and laboratory data from 2001 to 2013 at a single center. OP was defined as a bone mineral density of ≤2.5 standard deviations below the mean peak bone mass of young, healthy adults. Hyponatremia was defined as serum sodium ≤135 mmol/L. Multiple logistic regressions were used to calculate adjusted odds ratio (OR). Overall, 24,784 patients were included. There were 4549 males (18.4 %). Hyponatremia was present in 703 patients (2.8 %), femoral neck OP in 2603 (10.5 %), total hip OP in 1885 (7.5 %), and lumbar OP in 4830 (19.5 %). Total hip OP occurred in 17.6 % (n = 124) of patients with hyponatremia as compared to 6.6 % (n = 880) of patients with sodium level of “140–145” mmol/L (P < 0.001). After multivariable adjustments, hyponatremia was associated with 2.46-fold higher odds of total hip OP (95 % CI, 1.36 to 4.46) in age <55 years, 1.96-fold (1.13 to 3.41) in age 55 to 67 years, and 1.55-fold (1.13 to 2.12) in age >67 years (age-sodium category interaction P value = 0.002). Age appeared as a modifier of the independent association between hyponatremia and OP. Risk of OP was the highest in the youngest age group as compared to older patients.
Assessment of impulsivity and the development of self-control in students with attention deficit hyperactivity disorder.

We examined a combined approach of manipulating reinforcer dimensions and delay fading to promote the development of self-control with 3 students diagnosed with attention deficit hyperactivity disorder. First, we administered a brief computer-based assessment to determine the relative influence of reinforcer rate (R), reinforcer quality (Q), reinforcer immediacy (I), and effort (E) on the students' choices between concurrently presented math problems. During each session, one of these dimensions was placed in direct competition with another dimension (e.g., RvI involving math problem alternatives associated with high-rate delayed reinforcement vs. low-rate immediate reinforcement), with all possible pairs of dimensions presented across the six assessment conditions (RvQ, RvI, RvE, QvI, QvE, IvE). The assessment revealed that the choices of all 3 students were most influenced by immediacy of reinforcement, reflecting impulsivity. We then implemented a self-control training procedure in which reinforcer immediacy competed with another influential dimension (RvI or Qvl), and the delay associated with the higher rate or quality reinforcer alternative was progressively increased. The students allocated the majority of their time to the math problem alternatives yielding more frequent (high-rate) or preferred (high-quality) reinforcement despite delays of up to 24 hr. Subsequent readministration of portions of the assessment showed that self-control transferred across untrained dimensions of reinforcement.
Selective upregulation of endothelin B receptor gene expression in severe pulmonary hypertension.

The pulmonary circulation is an important site for the production and clearance of endothelin (ET)-1, a potent vasoactive and mitogenic peptide. Increased plasma ET-1 levels are observed in pulmonary arterial hypertension (PHT) and may contribute to the regulation of pulmonary vascular resistance, as well as to proliferative changes in the pulmonary vascular bed.



We prospectively assessed changes in plasma big ET-1 levels and changes in ET(A) and ET(B) receptor gene expression in 14 consecutive patients undergoing pulmonary thromboendarterectomy for thromboembolic PHT. Plasma big ET-1 levels were higher in patients with PHT (median, 2.2 pg/mL; 25th to 75th percentile, 1.5 to 3.0 pg/mL) compared with age-matched controls (median, 1.2 pg/mL; 25th to 75th percentile, 1.0 to 1.4 pg/mL; P=0.002). In addition to increased plasma big ET-1 levels, selective upregulation of ET(B) receptor mRNA transcripts and immunoreactive protein in the pulmonary artery was observed in the patients; however, ET(A) receptor gene expression was unaffected.



These data suggest that changes in the ET signaling system in PHT caused by thromboembolic disease are not limited to an increased production of ET-1: they also affect ET receptor gene expression.
Pharmacodynamic and Pharmacokinetic Study of Oral Curcuma Extract in Patients with Colorectal Cancer 1

Curcuma spp. extracts, particularly the dietary polyphenol curcumin, prevent colon cancer in rodents. In view of the sparse information on the pharmacodynamics and pharmacokinetics of curcumin in humans, a dose-escalation pilot study of a novel standardizedCurcuma extract in proprietary capsule form was performed at doses between 440 and 2200 mg/day, containing 36–180 mg of curcumin. Fifteen patients with advanced colorectal cancer refractory to standard chemotherapies receivedCurcuma extract daily for up to 4 months. Activity of glutathione S-transferase and levels of a DNA adduct (M1G) formed by malondialdehyde, a product of lipid peroxidation and prostaglandin biosynthesis, were measured in patients’ blood cells. Oral Curcuma extract was well tolerated, and dose-limiting toxicity was not observed. Neither curcumin nor its metabolites were detected in blood or urine, but curcumin was recovered from feces. Curcumin sulfate was identified in the feces of one patient. Ingestion of 440 mg ofCurcumaextract for 29 days was accompanied by a 59% decrease in lymphocytic glutathione S-transferase activity. At higher dose levels, this effect was not observed. Leukocytic M1G levels were constant within each patient and unaffected by treatment. Radiologically stable disease was demonstrated in five patients for 2–4 months of treatment. The results suggest that ( a) Curcumaextract can be administered safely to patients at doses of up to 2.2 g daily, equivalent to 180 mg of curcumin; ( b) curcumin has low oral bioavailability in humans and may undergo intestinal metabolism; and (c) larger clinical trials of Curcuma extract are merited.
Effectiveness of Housing First with Intensive Case Management in an Ethnically Diverse Sample of Homeless Adults with Mental Illness: A Randomized Controlled Trial

Housing First (HF) is being widely disseminated in efforts to end homelessness among homeless adults with psychiatric disabilities. This study evaluates the effectiveness of HF with Intensive Case Management (ICM) among ethnically diverse homeless adults in an urban setting. 378 participants were randomized to HF with ICM or treatment-as-usual (TAU) in Toronto (Canada), and followed for 24 months. Measures of effectiveness included housing stability, physical (EQ5D-VAS) and mental (CSI, GAIN-SS) health, social functioning (MCAS), quality of life (QoLI20), and health service use. Two-thirds of the sample (63%) was from racialized groups and half (50%) were born outside Canada. Over the 24 months of follow-up, HF participants spent a significantly greater percentage of time in stable residences compared to TAU participants (75.1% 95% CI 70.5 to 79.7 vs. 39.3% 95% CI 34.3 to 44.2, respectively). Similarly, community functioning (MCAS) improved significantly from baseline in HF compared to TAU participants (change in mean difference = +1.67 95% CI 0.04 to 3.30). There was a significant reduction in the number of days spent experiencing alcohol problems among the HF compared to TAU participants at 24 months (ratio of rate ratios = 0.47 95% CI 0.22 to 0.99) relative to baseline, a reduction of 53%. Although the number of emergency department visits and days in hospital over 24 months did not differ significantly between HF and TAU participants, fewer HF participants compared to TAU participants had 1 or more hospitalizations during this period (70.4% vs. 81.1%, respectively; P=0.044). Compared to non-racialized HF participants, racialized HF participants saw an increase in the amount of money spent on alcohol (change in mean difference = $112.90 95% CI 5.84 to 219.96) and a reduction in physical community integration (ratio of rate ratios = 0.67 95% CI 0.47 to 0.96) from baseline to 24 months. Secondary analyses found a significant reduction in the number of days experiencing problems due to alcohol use among foreign-born (vs. Canadian-born) HF participants at 24 months (ratio of rate ratios = 0.19 95% 0.04 to 0.88), relative to baseline. Compared to usual care, HF with ICM can improve housing stability and community functioning and reduce the days of alcohol related problems in an ethnically diverse sample of homeless adults with mental illness within 2-years.
Value of FGFR2 expression for advanced gastric cancer patients receiving pazopanib plus CapeOX (capecitabine and oxaliplatin)

The aim of this study was to use immunohistochemistry (IHC) to determine the effect of FGFR2 and VEGFR2 expression on treatment outcomes for patients with metastatic or recurrent advanced gastric cancer (AGC) receiving a combination of pazopanib with CapeOx (capecitabine and oxaliplatin). We conducted a single-arm, open-label phase II study to determine the efficacy and toxicity of the combination of pazopanib with CapeOx in 66 patients with metastatic or recurrent AGC (ClinicalTrials.gov NCT01130805). IHC analysis of FGFR2 and VEGFR2 was possible in 54 patients (81.8 %). Among 54 patients, the median age was 51.5 years (range 23–72 years). Male patients were 59.3 %. Seven patients (13.5 %) had tumor tissues that expressed FGFR2 by IHC. No patients had tumors that expressed VEGFR2. Among seven patients with tumors with FGFR2 expression, six achieved partial response (PR) with a 85.7 % response rate and one patient with stable disease. Among 47 patients with tumors without FGFR2 expression, one had complete response and 27 had PR (59.5 %). A significant difference in PFS was seen between patients who were positive and negative for FGFR2 using IHC (8.5 vs. 5.6 months, P = 0.050). By prognostic analysis for PFS, only FGFR2 status by IHC (positive vs. negative) had significant prognostic value for predicting PFS. FGFR2 expression by IHC might be a useful biomarker for predicting treatment outcomes of patients with metastatic or recurrent AGC treated with a combination of pazopanib and CapeOx.
Phase III trial of bortezomib, cyclophosphamide and dexamethasone (VCD) versus bortezomib, doxorubicin and dexamethasone (PAd) in newly diagnosed myeloma

We aimed at demonstrating non-inferiority of bortezomib/cyclophosphamide/dexamethasone (VCD) compared to bortezomib/doxorubicin/dexamethasone (PAd) induction therapy with respect to very good partial response rates or better (⩾VGPR) in 504 newly diagnosed, transplant-eligible multiple myeloma patients. VCD was found to be non-inferior to PAd with respect to ⩾VGPR rates (37.0 versus 34.3%, P=0.001). The rates of progressive disease (PD) were 0.4% (VCD) versus 4.8% (PAd; P=0.003). In the PAd arm, 11 of 12 patients with PD had either renal impairment (creatinine ⩾2 mg/dl) at diagnosis or the cytogenetic abnormality gain 1q21, whereas no PD was observed in these subgroups in the VCD arm. Leukocytopenia/neutropenia (⩾3°) occurred more frequently in the VCD arm (35.2% versus 11.3%, P<0.001). Neuropathy rates (⩾2°) were higher in the PAd group (14.9 versus 8.4%, P=0.03). Serious adverse events, both overall and those related to thromboembolic events, were higher in the PAd group (32.7 versus 24.0%, P=0.04 and 2.8 versus 0.4%, P=0.04). Stem cell collection was not impeded by VCD. VCD is as effective as PAd in terms of achieving ⩾VGPR rates with fewer PD and has a favorable toxicity profile. Therefore, VCD is preferable to PAd as induction therapy.
PTEN Reduced UVB-Mediated Apoptosis in Retinal Pigment Epithelium Cells

Age-related macular degeneration (AMD) is a leading cause of blindness and progressive loss of central vision in the elderly population. The important factor of AMD pathogenesis is the degeneration of retinal pigment epithelial (RPE) cells by oxidative stress. Inactivation of PTEN can disrupt intercellular adhesion in the RPE cells, but the mechanism of oxidative stress is less known. Here we presented evidence that UVB-mediated oxidative stress induced apoptosis in ARPE-19 cells. Downregulation of the expression of PTEN in UVB-irradiative RPE cells triggered DNA damage and increased the level of UVB-induced apoptosis by activating p53-dependent pathway. However, overexpression of PTEN increased cell survival by suppressing p-H2A in response to DNA damage and apoptosis. When using Pifithrin-α (one of p53 inhibitors), the level of p53-dependent apoptosis was significantly lower than untreated, which suggested that p53 was possibly involved in PTEN-dependent apoptosis. Thus, it elucidated the molecular mechanisms of UVB-induced damage in RPE cells and may offer an alternative therapeutic target in dry AMD.
The experiences of remote and rural Aboriginal Health Workers and registered nurses who undertook a postgraduate diabetes course to improve the health of Indigenous Australians.

This paper reports on an evaluation of an educational initiative that seeks to improve the diabetes health outcomes of a vulnerable group, Indigenous Australians residing in remote and rural New South Wales. In this context seven Aboriginal Health Workers (AHWs) and ten registered nurses (RNs) undertook an accredited Australian Diabetes Educators Association (ADEA) course. The aims of this study were to identify the beliefs, attitudes and experiences of this group concerning specialist diabetes training, strategies already used by managers and those that could be used to help consolidate the diabetes expertise of AHWs and RNs. The findings indicate specialist diabetes training and constructive support is required if AHWs and RNs are to develop from a novice to an expert. We concluded that the ADEA diabetes course is highly relevant to the needs of Indigenous Australians and that constructive support from managers and the university is most important in the development of diabetes expertise.
Posterior and anterior fixation of the urethra during robotic prostatectomy improves early continence rates.

To investigate whether posterior and anterior fixation of the vesicourethral anastomosis during robotic radical prostatectomy (RRP) helps to establish continence earlier.



Forty-seven consecutive patients undergoing RRP were randomized into two groups. The first group received a typical Van Velthoven vesicourethral anastomosis and the second group a modified anastomosis with posterior and anterior fixation. In this group the posterior fibrous tissues of the sphincter were sutured to the residual Denonvilliers' fascia. The anastomosis with two running sutures started at the 6 o'clock position on the bladder neck and continued upwards. Two-step stitching was done on the upper half of the anastomosis to ensure good stabilization of the bladder: a small portion of urethral stump followed by a deep haemostatic stitch on the plexus. Continence, as measured by patient self-reporting of the number of pads used per 24 h, was assessed 7 weeks after catheter removal, by telephone interview. The use of no pads or one pad was defined as "continent", two pads as "moderate incontinence" and more than two pads as "severe incontinence".



At catheter removal, more patients in the fixation group were continent than in the Van Velthoven group [9/23 (39%) vs 3/24 (12.5%), p = 0.036]. At 7 weeks, continence was even better in the fixation group [15/23 (65%) vs 8/24 (33%), p = 0. 029]. The mean pad usage was less in the fixation group (1.43 vs 2.25, p = 0.032).



The posterior and anterior fixation of the vesicourethral anastomosis during RRP results in an intact sphincteric mechanism, because no stretch is applied to the urethra, resulting in earlier continence.
Tissue Engineering: Step Ahead in Maxillofacial Reconstruction

Within the precedent decade, a new field of "tissue engineering" or "tissue regeneration" emerge that offers an innovative and exhilarating substitute for maxillofacial reconstruction. It offers a new option to supplement existing treatment regimens for reconstruction/regeneration of the oral and craniofacial complex, which includes the teeth, periodontium, bones, soft tissues (oral mucosa, conjunctiva, skin), salivary glands, and the temporomandibular joint (bone and cartilage), as well as blood vessels, muscles, tendons, and nerves. Tissue engineering is based on harvesting the stem cells which are having potential to form an organ. Harvested cells are then transferred into scaffolds that are manufactured in a laboratory to resemble the structure of the desired tissue to be replaced. This article reviews the principles of tissue engineering and its various applications in oral and maxillofacial surgery.
PReS-FINAL-2159: Tocilizumab (TCZ) dosing in juvenile idiopathic arthritis (JIA): optimising for different JIA type and body weight patients

TCZ, an IL-6R inhibitor, is effective in systemic and polyarticular juvenile idiopathic arthritis (sjia, pjia). BWadjusted, intravenous dosing regimens (TCZ8 mg/kg Q2W for sjia and Q4W for pjia) were assessed in Japanese phase 3 trials. As shown in Results, BW adjustment led to lower TCZ exposure with lower BW; thus, higher doses were proposed for patients (pts) with BW<30 kg in the global TENDER (sjia) and CHERISH (pjia) trials.
Genetic influences on mammographic density in Korean twin and family: the Healthy Twin study

Higher mammographic density is a strong risk factor for breast cancer. This study was conducted to determine the role of genetic factors on mammographic density measurements in Korean women. Study subjects were 730 women (122 monozygotic (MZ) twin pairs, 28 dizygotic (DZ) twin pairs, and 430 first degree relatives) from the Healthy Twin study. Mammographic density was measured using a computer-assisted method. Pairwise correlations of residual variance of each component of mammographic density were calculated within each pair of twins and family members. Quantitative genetic analysis was completed using SOLAR. Age and measured covariates accounted for 50% of the variation in dense area, 70% of non-dense area, and 67% of percent dense area. Fully adjusted heritability coefficients for dense area, non-dense area, and percent dense area were 0.76 (SE = 0.04), 0.69 (SE = 0.04) and 0.68 (SE = 0.04), respectively. Pairwise correlation coefficients of the adjusted residual variance of the mammographic density measures within MZ pairs and within DZ and sibling pairs combined were, respectively, 0.70 and 0.28 for dense area, 0.52 and 0.31 for non-dense area, and 0.58 and 0.24 for percent dense area. Covariance between dense and non-dense area had a significant genetic basis (correlation coefficient = −0.25, SE = 0.06). The same high heritability of mammographic density in Korean women as found in Western women supports a significant role of genetic determinants in breast cancer development. Genes that are responsible for familial correlation in mammographic density and have opposite effects on dense and non-dense mammographic areas need to be elucidated.
An investigation of medication adherence to 5-aminosalicylic acid therapy in patients with ulcerative colitis, using self-report and urinary drug excretion measurements.

Non-adherence to 5-aminosalicylic acid (5-ASA) medication can limit the established benefits of this therapy in ulcerative colitis (UC).



To determine rates and predictors of non-adherence to 5-ASA therapy in UC patients.



Medication adherence was assessed using self-report data and urinary drug excretion measurements. Participants completed a study-specific questionnaire and two validated questionnaires: Beliefs about Medicine Questionnaire (BMQ)-Specific and Satisfaction with Information about Medicines Scale.



A total of 169 participants provided self-report adherence data; 151 also provided urine samples. Adherence rates were 111/151 (68%) according to self-report and 90/151 (60%) according to urine analysis, but the two measures were not correlated (chi(2) = 0.12, P = 0.725). Logistic regression identified a significant association between self-reported non-adherence and younger age [odds ratio (OR) for increased age 0.954, 95% confidence interval (CI) 0.932-0.976] and also doubts about personal need for medication (OR for BMQ - Specific Necessity scores 0.578, 95% CI 0.366-0.913). For non-adherence based on urine analysis, only South Asian ethnicity was independently associated with non-adherence (OR 2.940, 95% CI 1.303-6.638).



Our observations confirm the difficulty of accurately assessing medication adherence. Nonmodifiable (younger age, South Asian ethnicity) and potentially modifiable (medication beliefs) predictors of non-adherence were identified.
Administrative Data Feedback for Effective Cardiac Treatment: AFFECT, a cluster randomized trial.

Hospital report cards are increasingly being implemented for quality improvement despite lack of strong evidence to support their use.



To determine whether hospital report cards constructed using linked hospital and prescription administrative databases are effective for improving quality of care for acute myocardial infarction (AMI).



The Administrative Data Feedback for Effective Cardiac Treatment (AFFECT) study, a cluster randomized trial.



Patients with AMI who were admitted to 76 acute care hospitals in Quebec that treated at least 30 AMI patients per year between April 1, 1999, and March 31, 2003.



Hospitals were randomly assigned to receive rapid (immediate; n = 38 hospitals and 2533 patients) or delayed (14 months; n = 38 hospitals and 3142 patients) confidential feedback on quality indicators constructed using administrative data.



Quality indicators pertaining to processes of care and outcomes of patients admitted between 4 and 10 months after randomization. The primary indicator was the proportion of elderly survivors of AMI at each study hospital who filled a prescription for a beta-blocker within 30 days after discharge.



At follow-up, adjusted prescription rates within 30 days after discharge were similar in the early vs late groups (for beta-blockers, odds ratio [OR], 1.06; 95% confidence interval [CI], 0.82-1.37; for angiotensin-converting enzyme inhibitors, OR, 1.17; 95% CI, 0.90-1.52; for lipid-lowering drugs, OR, 1.14; 95% CI, 0.86-1.50; and for aspirin, OR, 1.05; 95% CI, 0.84-1.33). In addition, adjusted mortality was similar in both groups, as were length of in-hospital stay, physician visits after discharge, waiting times for invasive cardiac procedures, and readmissions for cardiac complications.



Feedback based on one-time, confidential report cards constructed using administrative data is not an effective strategy for quality improvement regarding care of patients with AMI. A need exists for further studies to rigorously evaluate the effectiveness of more intensive report card interventions.