nils-herrmann/clean_scirepeval huggingface dataset:
Daclizumab use in patients with pediatric multiple sclerosis.

Daclizumab, a humanized monoclonal antibody specific for the interleukin 2 receptor α chain, reduces clinical and magnetic resonance imaging disease activity in patients with adult-onset multiple sclerosis (MS) as monotherapy or add-on therapy with interferon.



To report the use of daclizumab in pediatric-onset MS.



Case series.



Two comprehensive pediatric MS centers.



Seven patients with pediatric-onset MS with clinical and magnetic resonance imaging disease activity despite first-line disease-modifying therapy.



Intravenous daclizumab, 1 mg/kg monthly.



Annualized relapse rates, Expanded Disability Status Scale scores, contrast-enhancing lesions, and adverse effects.



Treatment with daclizumab, primarily combined with interferon, was associated with reductions in annualized relapse rates and contrast-enhancing lesions and with reduction or stabilization of Expanded Disability Status Scale scores in each patient. However, 4 patients had relapses and new contrast-enhancing lesions during daclizumab treatment. No significant adverse effects occurred.



Daclizumab may be a safe and at least partially effective treatment option for patients with pediatric-onset MS with disease activity despite first-line disease-modifying therapy.
A validation study of the WHO analgesic ladder: a two-step vs three-step strategy

The aims of the present study were to verify whether an innovative therapeutic strategy for the treatment of mild-moderate chronic cancer pain, passing directly from step I to step III of the WHO analgesic ladder, is more effective than the traditional three-step strategy and to evaluate the tolerability and therapeutic index in both strategies. Patients aged 18 years or older with multiple viscera or bone metastases or with locally advanced disease were randomized. Pain intensity was assessed using a 0–10 numerical rating scale based on four questions selected from the validated Italian version of the Brief Pain Inventory. Treatment-specific variables and other symptoms were recorded at baseline up to a maximum follow-up of 90 days per patient. Fifty-four patients were randomized onto the study, and pain intensity was assessed over a period of 2,649 days. The innovative treatment presented a statistically significant advantage over the traditional strategy in terms of the percentage of days with worst pain ≥5 (22.8 vs 28.6%, p<0.001) and ≥7 (8.6 vs 11.2%, p=0.023). Grades 3 and 4 anorexia and constipation were more frequently reported in the innovative strategy arm, although prophylactic laxative therapy was used less in this setting. Our preliminary data would seem to suggest that a direct move to the third step of the WHO analgesic ladder is feasible and could reduce some pain scores but also requires careful management of side effects.
Histoplasmosis in Patients With Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome (HIV/AIDS)

Although discontinuation of suppressive antifungal therapy for acquired immunodeficiency syndrome (AIDS)-associated histoplasmosis is accepted for patients with immunologic recovery, there have been no published studies of this approach in clinical practice, and minimal characterization of individuals who relapse with this disease. We performed a multicenter retrospective cohort study to determine the outcome in AIDS patients following discontinuation of suppressive antifungal therapy for histoplasmosis. Ninety-seven patients were divided into a physician-discontinued suppressive therapy group (PD) (38 patients) and a physician-continued suppressive therapy group (PC) (59 patients). The 2 groups were not statistically different at baseline, but at discontinuation of therapy and at the most recent follow-up there were significant differences in adherence to therapy, human immunodeficiency virus (HIV) RNA, and urinary Histoplasma antigen concentration. There was no relapse or death attributed to histoplasmosis in the PD group compared with 36% relapse (p < 0.0001) and 5% death (p = 0.28) in the PC group. Relapse occurred in 53% of the nonadherent patients but not in the adherent patients (p < 0.0001). Sixty-seven percent of patients with initial central nervous system (CNS) histoplasmosis relapsed compared to 15% of patients without CNS involvement (p = 0.0004), which may be accounted for by nonadherence. In addition, patients with antigenuria above 2.0 ng/mL at 1-year follow-up were 12.82 times (95% confidence interval, 2.91-55.56) more likely to relapse compared to those with antigenuria below 2.0 ng/mL. Discontinuation of antifungal therapy was safe in adherent patients who completed at least 1 year of antifungal treatment, and had CD4 counts >150 cells/mL, HIV RNA <400 c/mL, Histoplasma antigenuria <2 ng/mL (equivalent to <4.0 units in second-generation method), and no CNS histoplasmosis.
Serum zinc level in depressed patients during zinc supplementation of imipramine treatment.

Recurrent major depression is associated with decreased blood zinc concentrations that may be increased by effective antidepressant therapy. Some clinical investigations point to alterations of the zinc level in blood as a potential marker of depression.



A placebo-controlled, double blind study of zinc supplementation to imipramine therapy was conducted on sixty patients fulfilling the DSM-IV criteria for major depression (18-55 years old, 40 females, 20 males). Moreover, a group of 25 healthy volunteers was recruited (16 females, 9 males). Blood samples were drawn for the assay of serum zinc once from the control subjects and four times (before, and then 2, 6 and 12 weeks after the beginning of treatment) from the depressed subjects.



We report that: 1) the serum zinc level was significantly lower (by 22%) in depressed patients than in healthy volunteers, 2) all groups demonstrated a gradual increase in zinc concentrations over the period of imipramine treatment with or without zinc supplementation, 3) treatment-resistant patients demonstrated lower concentrations of zinc (by 14%) than treatment-non-resistant patients, 4) zinc concentrations were higher in zinc-supplemented patients than in placebo-supplemented patients, 5) zinc supplementation increased zinc concentrations over the period of treatment, and 6) at a 12-week imipramine treatment, a significant negative correlation was demonstrated between the Montgomery-Asberg Depression Rating Scale and the serum zinc level together with a concomitant increase in serum zinc in patients in remission.



Serum zinc is a state marker of depression.
Robust image transmission over ATM networks based on scalable wavelet coding

Wen-Jyi Hwang Chung-Kun Wu Ching-Fung Chine Chung Yuan Christian University Department of Electrical Engineering Chungli, 32023 Taiwan E-mail: whwang@dec.ee.cycu.edu.tw  We present a novel method for scalable and robust image transmission over ATM networks. The algorithm is based on a scalable set partitioning in hierarchical trees (SSPIHT) coding scheme, in which the encoded image bit streams for packeting and transmission are divided into a number of layers. By accumulating different numbers of layers in the decoder side, images with different resolutions and distortions can be reconstructed. Decoders having different capacities therefore can share the same encoder. In addition, these layers have different degrees of significance so that transmission errors in insignificant layers will not cause severe degradation in performance for image reconstruction. Finally, we describe three basic schemes for the transmission of SSPIHT-encoded cells over ATM channels. Simulation results show that the algorithm is effective for the applications where robust and scalable transmissions are desired.
Ziprasidone vs clozapine in schizophrenia patients refractory to multiple antipsychotic treatments: The MOZART study

This 18-week, randomized, flexible-dose, double-blind, double-dummy trial evaluated ziprasidone as an alternative to clozapine in treatment-refractory schizophrenia patients. Patients had a DSM-IV diagnosis of schizophrenia, a history of resistance and/or intolerance to at least three acute cycles with different antipsychotics given at therapeutic doses, PANSS score >or=80, and CGI-S score >or=4. Patients were randomized to ziprasidone (80-160 mg/day, n=73) or clozapine (250-600 mg/day, n=74). On the primary ITT-LOCF analysis, baseline-to-endpoint decreases in PANSS total scores were similar in the ziprasidone (-25.0+/-22.0, 95% CI -30.2 to -19.8) and clozapine (-24.5+/-22.5, 95% CI -29.7 to -19.2) groups. A progressive and significant reduction from baseline in PANSS total score was observed from day 11 in both study arms. There were also significant improvements on PANSS subscales, CGI-S, CG-I, CDSS, and GAF, without between-drug differences. The two treatment groups had similar rates of early discontinuations due to AEs. AEs were mostly of similar mild-moderate severity in the two groups. There were also no detrimental effects on prolactin, renal and liver function, hematology, and cardiovascular parameters. However, ziprasidone but not clozapine showed a significant reduction of SAS and AIMS scores. Moreover, when compared with clozapine, ziprasidone also had a more favorable metabolic profile, with significant endpoint differences in weight, fasting glucose, total cholesterol, LDL cholesterol, and triglycerides. In conclusion, this trial indicates that both ziprasidone and clozapine, having comparable efficacy coupled with satisfactory general safety and tolerability, may be regarded as valuable options for the short-term treatment of difficult-to-treat schizophrenia patients with a history of multiple resistance and/or intolerance to antipsychotics. The more favorable metabolic profile of ziprasidone may represent an added value that could guide clinicians, at least in the presence of patients at high risk for metabolic disorders.
Review of Cross-cultural design for IT products and services by Pei-Luen Patrick Rau, Tom Plocher, & Yee-Yin Choong. (2013), CRC Press

The culture we are part of tells us what aspects of design constitute "good" both in terms of aesthetics and usability. When it comes to technologies, these factors must be addressed for a given item to be successfully adopted by and correctly used within a particular culture. To put these ideas into practice, consider the following: A given interface might be very easy for the members of a particular culture to use, but if its aesthetic appeal is so jarring that individuals avoid it almost instinctively (i.e., before they actually use it), then the benefits of that interface are lost. Similarly, an aesthetically appealing interface might entice the members of a given culture to try it, but if the interface is difficult to use, then the initially interested audience is likely to abandon it. Effective communication design for international contexts thus becomes a matter of recognizing and addressing both aspects associated with "good." And as online media increasingly link the world together via information technologies, the need to understand and address such factors becomes increasingly important.
Effects of exercise on bone mineral density in calcium-replete postmenopausal women with and without hormone replacement therapy

Osteoporosis is a major public health concern. The combination of exercise, hormone replacement therapy, and calcium supplementation may have added benefits for improving bone mineral density compared to a single intervention. To test this notion, 320 healthy, non-smoking postmenopausal women, who did or did not use hormone replacement therapy (HRT), were randomized within groups to exercise or no exercise and followed for 12 months. All women received 800 mg calcium citrate supplements daily. Women who exercised performed supervised aerobic, weight-bearing and weight-lifting exercise, three times per week in community-based exercise facilities. Regional bone mineral density (BMD) was assessed by dual energy X-ray absorptiometry. Women who used HRT, calcium, and exercised increased femoral neck, trochanteric and lumbar spine bone mineral density by approximately 1–2%. Trochanteric BMD was also significantly increased by ~1.0% in women who exercised and used calcium without HRT compared to a negligible change in women who used HRT and did not exercise. The results demonstrate that regional BMD can be improved with aerobic, weight-bearing activity combined with weight lifting at clinically relevant sites in postmenopausal women. The response was significant at more sites in women who used HRT, suggesting a greater benefit with hormone replacement and exercise compared to HRT alone.
Clinical and financial implications of emergency department visits for synthetic marijuana.

Many users believe that synthetic cannabinoids offer a safe and legal means of getting high. However, spikes in emergency department visits have been associated with use of synthetic cannabinoids. The purpose of the current study was to document emergency department visits from three large hospitals in one metropolitan area over a two month period.



This was a retrospective chart review examining 218 patients presenting to three inner city emergency departments between March and April 2014. Data collected included demographic information, information regarding ED diagnosis and treatment, signs and symptoms, ancillary testing, ED disposition, and cost of the medical treatment.



The majority of patients (75.7%) were discharged after ED workup, but 12.4% were admitted for medical treatment and 11.5% were admitted for psychiatric treatment. Ten patients (4.6%) were admitted to the ICU. Symptoms experienced most frequently include: hypertension, tachycardia, agitation, drowsiness, nausea, and confusion. Cluster analysis revealed four symptom clusters of individuals presenting after using synthetic cannabinoids: 1) confusion, hostility, agitation, 2) nausea, vomiting, abdominal pain, 3) drowsiness, and 4) the absence of these symptoms.



This study has three important findings. First, significant ED resources are being used to treat individuals presenting due to effects of synthetic cannabis. Second, synthetic cannabis is not a benign substance. Third, while the hostile and agitated user is generally presented in the media, this study finds significant heterogeneity in presentation. Further research is needed to fully understand the implications of synthetic cannabinoid use.
The Online Parent Information and Support project, meeting parents' information and support needs for home-based management of childhood chronic kidney disease: research protocol.

This article is a report of a protocol for studying the development and evaluation of an online parent information and support package for home-based care of children with chronic kidney disease stages 3-5. The study is funded by a National Institute of Health Research, Research for Patient Benefit Grant awarded (December 2010). Approval to undetake the study was obtained from the Department of Health National Research Ethics Service (June 2011).



Children with chronic kidney disease require skilled, home-based care by parents, supported by professionals. Parents have identified a need for continuously available online resources to supplement professional support, and structured resources tailored to parents' needs are highlighted by policy makers as key to optimizing care; yet, online resource provision is patchy with little evidence base.



Using mixed methods, we will (i) conduct parent/child/young person/professional/patient and parent volunteer focus groups to explore views on existing resources, (ii) collaboratively define gaps in provision, identify desirable components, develop/test resources and conduct a feasibility randomized controlled trial, and (iii) of usual professional support versus usual support supplemented by the package. Eighty parents of children with chronic kidney disease will be randomized. Primary outcomes will assess parents' self-efficacy and views of resources, using standardized measures at entry and 24 weeks, and semi-structured interviews at 24 weeks. We will finalize trial components for a later definitive trial.



By working collaboratively, we will derive a detailed insight into parents' information and support needs and experiences of using the package, and should see improved parental self-efficacy.
Measuring Psychological Consequences of Screening: Adaptation of the Psychological Consequences Questionnaire into Dutch

To assess the psychometric properties of a Dutch adaptation of an originally Australian instrument measuring the psychological impact of breast cancer screening.  The three subscales (emotional, physical, social) of the Psychological Consequences Questionnaire (PCQ) underwent formal linguistic and cultural translation. A total of 524 women under intensive surveillance because of increased breast cancer risk were asked to complete the questionnaire at 2 months prior to screening, at the day of the screening visit preceding the screening, and 1–4 weeks after screening. Acceptability, score distribution, internal consistency, scale structure, responsiveness to change and construct validity were analysed.  Response rates were high (98–94%) and there were very few missing answers and non-unique answers. All scales had Cronbach’s αs > 0.70. The physical and social subscale showed ceiling effects. The item-own scale correlations were only slightly higher than the corresponding item-other scale correlations. Factor analysis showed that the assumed three separate subscales were replicated in our study. Pre- and post-screening effect sizes for the emotional scale were larger than for the other two scales. All PCQ scales correlated with the scales of two other psychological measures (p ≤ 0.01). The emotional scale and the total PCQ score were able to differentiate between subgroups varying in affective risk perception (p ≤ 0.01).  The Dutch PCQ is useful in measuring psychological impact among women under intensive surveillance because of high breast cancer risk.
The Pediatric Measure of Participation (PMoP) short forms

Multi-center cross-sectional cohort study.The objectives of this study were to develop and validate short forms (SFs) of participation for child- and parent-reported outcomes following spinal cord injury (Three pediatric orthopedic hospitals in the United States.The expert panel used calibration data from the pediatric computerized adaptive test (CAT) development study (convenience sample of 381 children and adolescents with SCI and 322 parents or caregivers) to select SF items. The panel selected items for two domains (participation self—relevant to what I want to do; participation friends—relevant to what my friends do), with parent and child versions for each domain. Psychometric analyses included group reliability, Cronbach’s alpha, agreement (SFs and item banks), percent of sample with highest (ceiling) and lowest (floor) scores by level of lesion (paraplegia/tetraplegia), and test information function.Group reliability and Cronbach’s alpha values are acceptable (0.74–0.92) and agreement (intraclass correlation coefficients for SFs and total item banks) is strong (0.89–0.95). Floor effects were minimal for people with tetraplegia and paraplegia (0–1.19%). Ceiling effects were minimal for people with tetraplegia (0–3.13%) and slightly higher, but acceptable, for people with paraplegia (8.06–14.02%). Test information function for the SFs was sufficiently high over the range of scores for the majority of the sample.Pediatric Measure of Participation (PMoP) SFs are acceptable for use when CATs are not feasible.The study was funded by the Shriners Hospitals for Children Research Grant 79142 (Mulcahey, PI) and the Boston ROC Grant 5R24HD065688-05 (Jette, PI).
Effect of Intravitreal Injection of Methotrexate on Human Corneal Endothelial Cells.

To evaluate the toxic effect of intravitreal methotrexate on human corneal endothelium.



In this prospective noncomparative interventional case series, intravitreal injection of 400 μg methotrexate was performed in eyes with persistent diabetic macular edema. Corneal endothelial cell analyses and central corneal thickness measurements were performed before and 1, 3, and 6 months after injections, using noncontact specular microscopy.



Twenty one eyes of 18 patients with a mean age of 60.5 ± 6.8 years were evaluated. No statistically significant difference was found in endothelial cell density, coefficient of variation, average cell area, hexagonality, and central corneal thickness measurements before and after injections (P = 0.70, 0.39, 0.43, 0.64, and 0.67, respectively).



In this 6-month follow-up study, intravitreal injection of 400 μg methotrexate had no significant effect on corneal endothelial cell measurements performed by specular microscopy.
Toxicity of local, continuous and cyclic, high-dose bladder perfusion with recombinant and natural interleukin-2 in advanced cancer of the urinary bladder

We evaluated the toxicity of high-dose local interleukin-2 (IL-2) in 18 patients not eligible for standard treatment of advanced transitional cell bladder carcinoma. Seven received continuous high-dose local natural IL-2 via pump system in the bladder for up to 420 days. 11 received cyclic high-dose local natural IL-2 or recombinant IL-2 for up to 420 days. Treatment was well tolerated and, considering the low rate of toxicity, could be offered in an outpatient setting. Except for local contrast-media hypersensitivity, no serious side-effects were observed. This study provides a basis for the non-toxic use of local IL-2 in future studies to evaluate effectiveness of the treatment or prophylaxis of patients with superficial bladder cancer in order to prevent recurrences.
Influences of Plant Traits on Immune Responses of Specialist and Generalist Herbivores

Specialist and generalist insect herbivore species often differ in how they respond to host plant traits, particularly defensive traits, and these responses can include weakened or strengthened immune responses to pathogens and parasites. Accurate methods to measure immune response in the presence and absence of pathogens and parasites are necessary to determine whether susceptibility to these natural enemies is reduced or increased by host plant traits. Plant chemical traits are particularly important in that host plant metabolites may function as antioxidants beneficial to the immune response, or interfere with the immune response of both specialist and generalist herbivores. Specialist herbivores that are adapted to process and sometimes accumulate specific plant compounds may experience high metabolic demands that may decrease immune response, whereas the metabolic demands of generalist species differ due to more broad-substrate enzyme systems. However, the direct deleterious effects of plant compounds on generalist herbivores may weaken their immune responses. Further research in this area is important given that the ecological relevance of plant traits to herbivore immune responses is equally important in natural systems and agroecosystems, due to potential incompatibility of some host plant species and cultivars with biological control agents of herbivorous pests.