nils-herrmann/clean_scirepeval huggingface dataset:
Obesity at adolescence and gastric cancer risk

During the last few decades, prevalence of obesity has risen rapidly worldwide, markedly in children and adolescents. Epidemiologic studies have associated obesity to several cancer types, yet little is known for the effect of early life exposure to obesity on cancer risk in later life, especially in gastric cancer. Thus, the present study aimed to investigate the association of body mass index (BMI) of adolescence and the risk of gastric cancer. A multicenter case–control study was conducted between 2010 and 2014 in Korea with 1,492 incident gastric cancer cases and 1,492 controls matched by age and sex. The BMI at age 18 was calculated by using weight and height from questionnaire. The association with the risk of gastric cancer was evaluated using odds ratios by logistic regression model adjusted for potential confounding factors. Compared with BMI 21.75 kg/m2, higher BMI at age 18 was associated with higher risk of gastric cancer showing a nonlinear, threshold effect. Statistically significant odds ratio was observed in men with BMI higher than 25.3 kg/m2 (OR 1.13, 95 % CI 1.01–1.27) and in women with BMI 25.3 kg/m2 and above (OR 1.25, 95 % CI 1.01–1.55). Similar to some other cancer types, overweight or obese in adolescence was found to be associated with the increased risk of gastric cancer. The results imply for stratified approach of tactics in prevention of gastric cancer in different population.
Qualitatively and quantitatively evaluating harm-reduction goal setting among chronically homeless individuals with alcohol dependence.

Most treatment programs for alcohol dependence have prioritized alcohol abstinence as the primary treatment goal. However, abstinence-based goals are not always considered desirable or attainable by more severely affected populations, such as chronically homeless people with alcohol dependence. Because these individuals comprise a multimorbid and high-utilizing population, they are in need of more focused research attention that elucidates their preferred treatment goals. The aim of this secondary study was therefore to qualitatively and quantitatively document participant-generated treatment goals



Participants were currently or formerly chronically homeless individuals (N=31) with alcohol dependence who participated in a pilot of extended-release naltrexone and harm-reduction counseling. Throughout the treatment period, study interventionists elicited participants' goals and recorded them on an open-ended grid. In subsequent weeks, progress towards and achievement of goals was obtained via self-report and recorded by study interventionists. Conventional content analysis was performed to classify participant-generated treatment goals



Representation of the three top categories remained stable over the course of treatment. In the order of their frequency, they included drinking-related goals, quality-of-life goals and health-related goals. Within the category of drinking-related goals, participants consistently endorsed reducing drinking and alcohol-related consequences ahead of abstinence-based goals. Quantitative analyses indicated participants generated an increasing number of goals over the course of treatment. Proportions of goals achieved and progressed towards kept pace with this increase



Findings confirmed hypotheses that chronically homeless people with alcohol dependence can independently generate and achieve treatment goals towards alcohol harm reduction and quality-of-life improvement.
Achievement of NKF/K-DOQI recommended target values for bone and mineral metabolism in incident hemodialysis patients: results of the FARO-2 cohort.

Mineral Bone Disorders (MBD) is prevalent in hemodialysis (HD) patients and associated with increased cardiovascular mortality. The FARO-2 study evaluated the achievement of the NKF/K-DOQI guidelines on recommended target values for serum calcium (Ca), phosphorous (P) and intact parathyroid hormone (PTH) levels on survival in incident HD patients.



Data were collected by questionnaire from 568 incident HD patients followed prospectively over a 3-year period from 26 Italian dialysis units. The cumulative probability of time-to-death for CKD-MBD treatment characteristics was determined by the Kaplan-Meier curves.



Serum PTH levels (median values at 6 months vs. 36 months; 225 vs. 254 pg/ml), Ca (8.8 vs. 8.9 g/dl) and P (5.1 vs. 4.8 mg/dl) were not significantly different at 6 months versus follow-up. The majority of incident HD patients (60-70%) who were followed up for 36 months did not achieve the NKF/K-DOQI recommended target values. Survival rates were higher in patients on target for three parameters versus patients off target (survival at 24 months: at target 95.7% (95% CI: 84.0-98.9) versus not on target 71.1% (95% CI: 66.3-75.4, p < 0.01)). The 30.1% of patients on target for three MBD parameters at least once during the follow-up period had better survival rates compared to those not reaching these targets (survival at 24 months: at least once 88.0% (95% CI: 81.9-92.1); 67.7% (95% CI: 61.9-72.8, p < 0.01)).



Our findings indicate that incident HD patients who achieved target levels (for three MBD parameters) for at least one visit have a lower risk of mortality.
Bivalirudin is associated with improved clinical and economic outcomes in heart failure patients undergoing percutaneous coronary intervention: Results from an observational database.

Outcomes with bivalirudin compare favorably with heparin ± GPIIb/IIIa receptor inhibition (heparin ± GPI) during percutaneous coronary intervention (PCI). Patients with congestive heart failure (CHF) have increased risk for complications. The objective was to investigate clinical and economic outcomes for bivalirudin ± GPI vs. heparin ± GPI among PCI patients with CHF.



Using the Premier Hospital Database, PCI patients with CHF were stratified by anticoagulant: bivalirudin, bivalirudin ± GPI, heparin and heparin ± GPI. The probability of receiving bivalirudin ± GPI was estimated using individual and hospital variables. Using propensity scores, each bivalirudin ± GPI patient was matched to a heparin ± GPI patient. The primary outcome was in-hospital death. Bleeding rates, transfusion, length of stay and in-hospital cost were ascertained.



Overall, 116,313 patients at 315 hospitals received bivalirudin (n = 45,559) bivalirudin + GPI (n = 8,115), heparin (n = 27,972) or heparin + GPI (n = 34,667). Patients had STEMI (21.2%), NSTEMI (29.1%), unstable angina (16.6%), stable angina (5.7%) or other ischemic heart disease (24.2%). Of these, 79.1% of bivalirudin patients matched, resulting in 84,948 analyzed patients. Compared with heparin ± GPI patients, bivalirudin ± GPI patients had fewer deaths (3.3% vs. 3.9%; p < 0.0001), less clinically apparent bleeding (10.2% vs. 11.4%; p < 0.0001), clinically apparent bleeding with transfusion (2.7% vs. 3.2%, p <0.0001), and transfusion (8.5% vs. 9.8%, p < 0.0001). Patients receiving bivalirudin had shorter length of stay (6.3 vs. 6.8 days; p < 0.0001) and lower in-hospital cost (mean $26,706 vs. $27,166 [median $19,414 vs. $19,798]; p < 0.0001). In conclusion, this is the largest retrospective analysis of PCI patients with CHF and demonstrates bivalirudin ± GPI compared with heparin ± GPI is associated with lower inpatient rates of death, bleeding, and cost.
Phase II study of first-line chemotherapy with uracil-tegafur plus oral leucovorin in elderly (≥75 years) Japanese patients with metastatic colorectal cancer: SGOSG-CR0501 study

Oral uracil-tegafur and leucovorin (UFT/LV) therapy for elderly patients with metastatic colorectal cancer (mCRC) requires careful handling in Western countries because of a high incidence (≥20 %) of grade 3 diarrhea. However, its efficacy and safety for elderly Asian patients have not been investigated. In this multicenter cooperative phase II study, the eligibility criteria were: age of 75 years or older, no prior chemotherapy, and histologically confirmed colorectal cancer with one or more measurable lesions. UFT 300 mg/m2/day and LV 75 mg/day were administered orally for 28 days followed by a 7-day rest period. Twenty-one patients were enrolled in this study (prior to study termination after approval of bevacizumab), and all patients were eligible for efficacy and safety analysis. The median age was 79 years (range, 75–83 years). The majority of patients (95 %) had ECOG Performance Status 0 or 1. The overall response rate was 33 % (95 % confidence interval [CI], 18–53 %). The median progression-free and overall survivals were 5.3 months (95 % CI 4.0–7.9 months) and 18 months (95 % CI 13–21 months), respectively. Grade 3 or greater adverse events included anorexia (10 %), diarrhea (10 %), and leukopenia (5 %). These results were compatible with those seen in Japanese patients in a previous bridging study between Japan and the US, in which patients under 75 years old were evaluated. UFT/LV therapy was safe and feasible in elderly Japanese patients with mCRC, and further study of UFT/LV therapy in combination with bevacizumab is warranted.
Patients' Evaluation of the Quality of Diabetes Care (PEQD): development and validation of a new instrument.

To develop a brief measure of patients' evaluation of the quality of diabetes care and to study predictors of consumers' rating of the quality of diabetes care.



A prospective design.



176 adults with type 1 (39%) or type 2 (61%) diabetes.



Demographic variables, HbA1c, number of diabetes complications, satisfaction with diabetes care, diabetes related distress, and fear of hypoglycaemia were assessed by self-report. In addition, satisfaction with diabetes care and evaluations about quality of the care were measured at 16 month follow up. Statistical analysis comprised principal component analyses, Cronbach's alpha, t tests, Pearson's correlation, and linear regression analyses.



Results in the literature were used to develop the 14 items of the Patients' Evaluation of the Quality of Diabetes Care (PEQD) scale, assessing the most important aspects of the quality of diabetes care as delivered by the specialist in internal medicine (internist) and the diabetes nurse specialist (DNS). Two principal components analyses (internist/DNS) both yielded one 14 item factor with a high internal consistency. Satisfaction with diabetes care, fewer diabetes related complications, fewer treatment related problems, and a low level of worries about hypoglycaemia were predictors of a more positive evaluation of diabetes care delivered by the internist. Sociodemographic variables were not related to the patients' evaluations of the quality of diabetes care.



The PEQD comprises different aspects of quality of diabetes care and can be regarded as a suitable instrument for evaluating patients' judgements about the quality of their care.
Lightweight SIMT core designs for intelligent 3D stacked DRAM

In this work we present an analysis of the Harmonica stream multiprocessor, a light-weight, parameterized, open-source single-instruction-multiple-thread (SIMT) core designed for integration within 3D-stacked DRAM. We evaluate the range of Harmonica designs afforded by the architecture's parameter space in the role of a vault-level accelerator, augmenting a design similar to the Micron Hybrid Memory Cube into an array of compact accelerated DRAM channels. In this role, with a small SRAM cache, Harmonica cores are capable of providing the requisite small footprint, energy efficiency, latency tolerance, and bandwidth demand to perform well. The instruction set and microarchitecture of Harmonica are both novel, providing a lightweight interface for thread creation within the SIMT model and a simple design that issues a single warp per cycle, simplifying the register file design compared to high-performance GPUs, and providing parameters for attributes from the number of warps and threads per warp to the number of general purpose registers per thread. For our suite of analytics-oriented benchmarks, Harmonica cores consuming on the order of 100mW of power maintain a demand for an average of 12GB/s of bandwidth while tolerating the latency present in a DRAM-based memory system.
Insulin-induced vasodilatation and endothelial function in obesity/insulin resistance. Effects of troglitazone

Insulin resistance is associated with a decreased vasodilator response to insulin. Because insulin's vasodilator effect is nitric oxide dependent, this impairment may reflect endothelial dysfunction. Troglitazone, an insulin-sensitiser, might thus improve insulin-dependent and/or endothelium-dependent vascular function in insulin resistant obese subjects. For 8 weeks, fifteen obese subjects were treated with either 400 mg troglitazone once daily or placebo, in a randomised, double-blind, cross-over design. At the end of each treatment period, we measured forearm vasodilator responses (plethysmography) to intra-arterial administered acetylcholine and sodium nitroprusside; insulin sensitivity and insulin-induced vascular and neurohumoral responses (clamp); vasoconstrictor responses to N G-monomethyl-L-arginine (L-NMMA) during hyperinsulinaemia; and ambulatory 24-h blood pressure (ABPM). Baseline data (placebo) of obese subjects were compared with those obtained in lean control subjects. Obese subjects were insulin resistant compared with leans (whole-body glucose uptake: 26.8 ± 3.0 vs. 53.9 ± 4.3 μmol · kg–1· min–1, p < 0.001). Troglitazone improved whole-body glucose uptake (to 31.9 ± 3.3 μmol · kg–1· min–1, p = 0.028), and forearm glucose uptake (from 1.09 ± 0.54 to 2.31 ± 0.69 μmol · dL–1· min–1, p = 0.006). Insulin-induced vasodilatation was blunted in obese subjects (percent increase in forearm blood flow (FBF) in lean 66.5 ± 23.0 %, vs. 10.1 ± 11.3 % in obese, p = 0.04), but did not improve during troglitazone. Vascular responses to acetylcholine, sodium nitroprusside and L-NMMA did not differ between the obese and lean group, nor between both treatment periods in the obese individuals. In conclusion, in insulin resistant obese subjects, endothelial vascular function is normal despite impaired vasodilator responses to insulin. Troglitazone improved insulin sensitivity but it had no effects on endothelium-dependent and -independent vascular responses. These data do not support an association between insulin resistance and endothelial function.
Detection of human papillomavirus 16, 18, and 45 in women with ASC-US cytology and the risk of cervical precancer: results from the CLEAR HPV study.

The Aptima human papillomavirus (HPV) 16 18/45 Genotype (GT) assay (AHPV-GT) is a qualitative E6/ E7 oncogene messenger RNA test that detects HPV 16 and a pool of HPV 18 and 45. The CLEAR (Clinical Evaluation of APTIMA mRNA) study was the pivotal, prospective, multicenter US clinical study to validate the Aptima HPV (AHPV) assays.



In this analysis, we evaluated the clinical performance of AHPV and AHPV-GT assays for detection of cervical intraepithelial neoplasia grade 2 or more severe (CIN2 +) and grade 3 (CIN3) or adenocarcinoma in situ in 912 women with atypical squamous cells of undetermined significance (ASC-US) Papanicolaou result. 
Overall, the percent positive for hrHPV was 38.8% (354/912), of which 34.2% (121/354) were GT positive. Among hrHPV-positive women, the risks of CIN2 + were 37.0% for HPV 16 positives, 15.9% for HPV 18/45 positives, 14.3% for other hrHPV positives, and 2.2% for AHPV negatives. The risks of CIN3 + were 20.5% for HPV 16 positives, 9.1% for HPV 18/45 positives, 4.3% for other hrHPV positives, and 0.7% for HPV negatives.



We demonstrated that AHPV-GT is a reliable and effective test for cervical cancer risk stratification in women with an ASC-US cytology diagnosis.
Factors that influence the pharmacokinetics of lamotrigine in Japanese patients with epilepsy

Lamotrigine (LTG) is used to treat epilepsy. The variability of LTG pharmacokinetics among individuals may be attributed to polymorphisms in the genes of uridine diphosphate glucuronosyltransferases (UGTs) 1A4 and UGT2B7 and/or combination with other drugs. In this study, we evaluated the association between LTG concentrations and patient characteristics such as genetic polymorphisms and the co-administration of antiepileptic drugs. We recruited 122 patients with epilepsy. LTG concentrations were measured in blood samples from each patient under steady-state condition. We assessed the influence of multiple factors on LTG concentrations and derived a formula for predicting LTG concentrations using multiple linear regression analysis. We derived a formula to predict LTG concentrations that considers the daily dose of LTG, body weight, valproic acid concentration, phenytoin co-administration, and the co-administration of phenobarbital and/or carbamazepine as well as UGT1A4 142T>G and UGT2B7 -161C>T polymorphisms (adjusted coefficients of determination R 2 = 0.734). Furthermore, we used this formula to reveal a strong positive correlation between measured and predicted LTG concentrations (r 2 = 0.76, p < 0.001). We derived a formula that will be useful in clinical practice for predicting LTG concentrations in patients with epilepsy.
A cluster analytic examination of acculturation and health status among Asian Americans in the Washington DC metropolitan area, United States.

Previous studies reported mixed findings on the relationship between acculturation and health status among Asian Americans due to different types of acculturation measures used or different Asian subgroups involved in various studies. We aim to fill the gap by applying multiple measures of acculturation in a diverse sample of Asian subgroups. A cross sectional study was conducted among Chinese, Korean and Vietnamese Americans in Washington D.C. Metropolitan Area to examine the association between health status and acculturation using multiple measures including the Suinn-Lew Asian Self-Identity Acculturation (SL-ASIA) scale, clusters based on responses to SL-ASIA, language preference, length of stay, age at arrival in the United Sates and self-identity. Three clusters (Asian (31%); Bicultural (47%); and American (22%)) were created by using a two-step hierarchical method and Bayesian Information Criterion values. Across all the measures, more acculturated individuals were significantly more likely to report good health than those who were less acculturated after adjusting for covariates. Specifically, those in the American cluster were 3.8 times (95% Confidence Interval (CI): 2.2, 6.6) more likely and those in the Bicultural cluster were 1.7 times more likely (95% CI: 1.1, 2.4) to report good health as compared to those in the Asian cluster. When the conventional standardized SL-ASIA summary score (range:-1.4 to 1.4) was used, a one point increase was associated with 2.2 times greater odds of reporting good health (95% CI: 1.5, 3.2). However, the interpretation may be challenging due to uncertainty surrounding the meaning of a one point increase in SL-ASIA summary score. Among all the measures used, acculturation clusters better approximated the acculturation process and provided us with a more accurate test of the association in the population. Variables included in this measure were more relevant for our study sample and may have worked together to capture the multifaceted acculturation process.
Dose-response effect of oxygen on hyperinflation and exercise endurance in nonhypoxaemic COPD patients.

Dynamic hyperinflation contributes to exertional breathlessness and reduced exercise tolerance in chronic obstructive pulmonary disease (COPD) patients. This study examined whether oxygen supplementation results in a dose-dependent decrease in hyperinflation associated with functional and symptomatic improvement. Ten severe COPD patients without clinically significant oxygen (O2) desaturation during exercise, and seven healthy subjects, performed five exercise tests at 75% of maximally tolerated work rate. Inspired oxygen fraction (FI,O2) was varied (0.21, 0.3, 0.5, 0.75 and 1.0) among tests in a randomized order. Ventilation (V'E) was measured, and end-inspiratory (EILV) and end-expiratory (EELV) lung volume changes were assessed from inspiratory capacity manoeuvres. In the patients, compared to room air, endurance time increased with FI,O2=0.3 (mean+/-SEM 92+/-20%) and increased further with FI,O2=0.5 (157+/-30%). At isotime, compared to room air, there were significant reductions in dyspnoea score, EELV, EILV, V'E and respiratory frequency (fR) with FI,O2=0.3. Improved endurance time negatively correlated with change in EELV (r=0.48, p=0.002) and EILV (r=0.43, p=0.005). The dyspnoea rating decrease correlated with fR decrease. In healthy subjects, smaller V'E and fR decreases were observed at FI,O2=0.5, accompanied by more modestly increased endurance. Oxygen supplementation during exercise induced dose-dependent improvement in endurance and symptom perception in nonhypoxaemic chronic obstructive pulmonary disease patients, which may be partly related to decreased hyperinflation and slower breathing pattern. This effect is maximized at an inspired oxygen fraction of 0.5.
The Royal Marsden Hospital pilot tamoxifen chemoprevention trial

A pilot randomised placebo controlled trial using tamoxifen in healthy women at increased risk of developing breast cancer, has been undertaken in order to evaluate the problems of accrual, acute symptomatic toxicity, compliance, and safety as a basis for subsequent large national multicentre trials designed to test whether tamoxifen can chemoprevent breast cancer. From October 1986 until June 1993, 2012 healthy women with an increased risk of developing breast cancer, usually because of a strong family history, were randomly allocated to receive tamoxifen 20 mgs/day or placebo for up to 8 years if possible. Accrual remained high in spite of extensive informed consent regarding potential risk. Acute symptomatic toxicity was low for participants on tamoxifen or placebo and compliance remained correspondingly high with a predicted 77% of women on tamoxifen and 82% of women on placebo continuing medication at 5 years. There was a significant increase in hot flushes (34% versus 20%) mostly in premenopausal women (p < 0.005), vaginal discharge (16% versus 4%, p < 0.005), and menstrual irregularities (14% versus 9%, p < 0.005). The requirements for hormone replacement therapy for women on tamoxifen or placebo were the same. Safety monitoring indicates no adverse anti oestrogenic effects of tamoxifen. There was no obvious effect of tamoxifen on bone mineral densities (single photon radial absorption). The fibrinogen and antithrombin III were both lowered, resulting in no observed detrimental effect on the ratio of these clotting factors. There was a significant reduction in the serum cholesterol maintained out to 5 years. Annual pelvic assessment using transvaginal ultrasound indicates an increased incidence of uterine fibromata and benign ovarian cysts. These results have encouraged the commencement of the NSABP national trial in the USA, and the subsequent start of national trials in Italy and the UK, which together should provide sufficient evidence to evaluate the efficacy of tamoxifen for prevention of breast cancer.