nils-herrmann/clean_scirepeval huggingface dataset:
Cost-effectiveness of early versus selectively invasive strategy in patients with acute coronary syndromes without ST-segment elevation.

The ICTUS trial compared an early invasive versus a selectively invasive strategy in high risk patients with a non-ST-segment elevation acute coronary syndrome and an elevated cardiac troponin T. Alongside the ICTUS trial a cost-effectiveness analysis from a provider perspective was performed.



A total of 1200 patients with a non-ST-segment elevation acute coronary syndrome and an elevated cardiac troponin T were randomized. An early invasive strategy was not superior to a selectively strategy. Total costs per patient were 1379 euros (95% CI 416-2356) more expensive in the early invasive group (13,364 euros) than in the selectively invasive group (11,985 euros). Costs of revascularization were the main determinant of the cost difference between the two groups. The incremental cost-effectiveness ratio of the extra costs per prevented cardiac event was minus 89,477 euros.



The overall results of the ICTUS study showed that an early invasive strategy was not superior to a selectively invasive strategy for patients with non-ST-segment elevation acute coronary syndrome and an elevated cardiac troponin T. This economic analysis of the ICTUS study showed that an early invasive strategy was slightly more expensive during the first year without gain in prevented cardiac events. In fact, we demonstrated a very moderate probability of the early invasive strategy being cost-efficient, even at a high level of willingness-to-pay.
Effects of toremifene and anastrozole on serum lipids and bone metabolism in postmenopausal females with estrogen receptor–positive breast cancer: the results of a 2-year multicenter open randomized study

The potential long-term adverse effects on quality of life have to be considered when selecting agents for adjuvant hormonal treatment for postmenopausal patients with estrogen receptor–positive breast cancer. We performed a 2-year multicenter randomized study to assess the differences in the time course effects between toremifene (TOR) and anastrozole (ANA) on serum lipid profiles and bone metabolism. This study assessed the serum levels of triglycerides (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), apolipoprotein A-1 (Apo A1), and apolipoprotein B (Apo B) as lipid profiles and bone-specific alkaline phosphatase (BAP) and the N-telopeptide of type-I collagen (NTX) as bone turnover markers in patients who received daily doses of 40 mg and 1 mg for TOR and ANA, respectively. A decreased serum level of TC, LDL-C, and Apo B was, respectively, observed at 6 months in 6.2, 12.9, and 13.8% of the patients who received TOR compared with the baseline. These decreases were maintained for at least 24 months. These lipid levels were not changed in those who received ANA. In the TOR patients, there was an increase in the serum level of HDL-C and Apo A1 at 6 months in 17.1 and 16.3%, respectively, which was maintained for at least 24 months, whereas these levels were almost stable in the patients who received ANA. Serum BAP decreased by 12.1% at 12 months and further decreased at 24 months and the serum NTX decreased by 22.0% at 6 months, which was maintained for at least 24 months in the patients who received TOR. In contrast, the serum BAP was increased by 26.0% at 6 months and by 29.2% at 12 months and the serum NTX increased by 21.3% at 24 months compared with baseline in those received ANA. However, the serum BAP increase was not significant at 24 months. TOR provides better effects than ANA in terms of lipid profiles and bone metabolism in postmenopausal females with early breast cancer.
Early development of turn-taking in vocal interaction between mothers and infants

Infants are known to engage in conversation-like exchanges from the end of the second month after birth. These 'protoconversations' involve both turn-taking and overlapping vocalization. Previous research has shown that the temporal organization of adult-infant turn-taking sequences is similar to that of adult verbal conversation. It has also been shown that young infants adjust the quality of their vocalization in response to the quality and timing of adult vocalization. We present new evidence of turn-taking interaction in infants aged between 8 and 21 weeks based on the analysis of 176 samples of naturalistic face-to-face interactions from 51 dyads. We found high levels of latched turns as well as frequent initiation of turn-taking by infants at these ages. Our data do not support the hypothesis that turn-taking ability increases with age between 2 and 5 months but do suggest that infants are active participants in turn-taking from the earliest age and that mothers adjust turn-taking formats to infants.
Detecting change in patients with stroke using the Berg Balance Scale.

The Berg Balance Scale (BBS) was designed to help determine change in functional standing balance over time. The purpose of this paper was to estimate the minimum detectable change score (MDC) using the standard error of measure (SEM), thereby providing a means to decide if genuine change had occurred. Calculation of the agreement regarding the presence of change as determined by the MDC and clinicians' perceptions was performed to give an indication of the validity of this criterion value. Forty-eight subjects who were receiving inpatient rehabilitation after stroke were assessed on consecutive days by two raters using the BBS. The MDC analysis suggests that a change of +/- 6 BBS points is necessary to be 90% confident of genuine change. Only 25/45 subjects showed agreement between the statistically derived presence of change and clinicians' perceptions of change. The lack of agreement may relate to the validity of the SEM/MDC methodology to determine the criterion BBS value, the heterogeneity of the subjects, or the use of clinician gestalt impressions of change.
Preliminary results of the Prostacox phase II trial in hormonal refractory prostate cancer.

To assess in a phase II open multicentre study the efficacy and tolerance of docetaxel administered every 14 days combined with celecoxib, in patients with hormone-refractory prostate cancer (HRPC), and to test the hypothesis that this therapeutic combination would improve overall survival.



In all, 48 patients were included with a mean age of 70.4 years and Gleason score of 7.5, all had a satisfactory Karnofsky performance-status score of 92% and a metastatic bone site was measurable in 77%. The mean delay between initial diagnosis and docetaxel administration was 45 months, with a median PSA level increase of 54.8 ng/mL. The therapeutic schedule was: docetaxel (50 mg/m(2)) administered every 14 days (one cycle of two injections at 2 week intervals (Day 1 = Day 28) with a total of six cycles) and simultaneously a daily oral fixed dose of celecoxib (800 mg).



In all, 237 cycles of docetaxel were administered with a dose reduction in 23 patients at the beginning of a cycle (day 1) and 36 in the middle of a cycle (day 14). The haematological toxicity included anaemia grade 1-2 (78%) and only 10% neutropenia grade 3-4. However, there was only a 15% improvement of pain intensity. The response rate for the total PSA level was 45.5 (30.4-61.1)%, the mean time to progression was 9.3 months and the tumour-response rate was 26.3%. In all, 75% of patients had an overall survival of >14.6 months.



Our results confirm the usefulness of docetaxel for HRPC treatment and show a significant reduction of haematological toxicity with bi-weekly docetaxel administration combined with celecoxib.
Brief psychoeducation for bipolar disorder: Impact on quality of life in young adults in a 6-month follow-up of a randomized controlled trial

There are scarce follow-up studies evaluating the role of psychoeducation in the treatment of bipolar disorder, especially in a young sample, with a recent diagnosis and that probably received a few previous interventions. This was a randomized clinical trial with young adults aged 18-29 years, who had been diagnosed with bipolar disorder through the Structured Clinical Interview for DSM (SCID). The evaluation of quality of life was carried out using the Medical Outcomes Survey 36-Item Short-Form Health Survey (MOS SF-36). All participants were randomized into two groups: combined intervention (psychoeducation plus medication) and treatment-as-usual (medication). The sample consisted of 61 patients divided in two groups (29 usual treatment; 32 combined intervention). The quality of life domains did not reveal statistically significant differences when comparing baseline, post-intervention and 6-month follow-up evaluations, which indicates that there is no difference between combined intervention and usual intervention regarding quality of life improvement. Both groups presented improvements in quality of life domains, except General Health and Bodily Pain, at post-intervention. Moreover, this improvement persisted at 6-month follow-up, except for the Role Physical Health domain, which remained reduced. Combined Psychoeducation plus pharmacological intervention is so effective in improving quality of life perception as it is pharmacological only intervention.
Physicochemical and Sensory Properties of Nanopowdered Chitosan-Added Maribo Cheese during Ripening

Nanopowdered chitosan (NPC) has high biological activities, such as blood cholesterol lowering effect and antidiabetic activity. This study is carried out to determine the effects of nano-powdered chitosan-added Maribo cheese (NCMC) for the physicochemical properties and sensory analysis during its ripening at 14℃ for 6 mon. From the results, the moisture and fat levels are not significantly influenced from the addition of chitosan (p>0.05), but ash contents increased with increasing chitosan concentrations and the protein contents decreased with increasing chitosan concentrations. In the short-chain fatty acids analysis during the ripening, the total production is initially 13.79 ppm in 0.2% NCMC and 13.81 ppm in control, and their levels have steadily increased to 59.94 and 53.11 ppm, respectively. For the color levels, the L* values decreased, while the a* and b* values significantly increased during ripening for all samples (p<0.05). In texture analysis, the hardness and gumminess of NCMC significantly decreased as compared to the control during ripening (p<0.05), while the cohesiveness, springiness and chewiness were not significantly different among the treatments (p>0.05). In sensory analysis, the butyric off-flavor and bitterness increased slightly with increasing concentrations of NCMC during ripening. The overall acceptability of 0.2% NCMC held the highest score amongst the samples during the ripening. From the results obtained, the 0.2% NCMC was preferred during the ripening and observed the possibility of functional cheese.
Effect of treatment environment on modified constraint-induced movement therapy results in children with spastic hemiplegic cerebral palsy: a randomized controlled trial.

To determine the effects of treatment environment (home and clinic) on results of modified constraint-induced movement therapy (modified CIMT) in children with spastic hemiplegic cerebral palsy.



In a single-blinded, randomized, controlled trial, 14 children with spastic hemiplegic cerebral palsy (5 females, 9 males; mean age: 74 months) received 15 hours of modified CIMT, occurring three times/week for 10 sessions every other day in two randomly assigned groups. Each session lasts one and half hours. Treatment environment for intervention group (n = 7) was home and for control group (n = 7) was clinic. Measures were conducted pre, post and 3 months after treatment period by pediatrics motor activity log and subtests 5 (upper limb coordination) and 8 (upper limb speed and dexterity) of Bruininks-Oseretsky test of motor proficiency. Sample randomization and data analysis by analysis of variance with repeated measures were conducted by SPSS-16 software in α level set at p < 0.05.



All subjects showed significant improvement (p < 0.01) in post-test measures except subtest 5 of Bruininks-Oseretsky test of motor proficiency. In contrast to clinic group, subjects in home showed significantly continued improvement at follow-up session in all measures.



Modified CIMT is effective in improving upper limb function in children with spastic hemiplegic cerebral palsy. In addition, more improved performance in home group places the practice in natural context as the preferred method for treatment of these children.
New diagnostic method for breast cancer based on clinical mammographic data and its clinical validation.

Recently, the numbers of patients with breast cancer have increased rapidly in Japan, and about 40,000 people contract the disease annually today. Therefore, secondary prevention by breast cancer screening has become an important issue. Presently, mammography is used frequently for the diagnosis of breast cancer, but the reading of mammograms is difficult, and physicians must attend training classes specified by the Central Committee on Quality Control of Mammographic Screening and obtain a license to perform screening. Assessment categories are used for the evaluation of mammograms. Although they provide a scale for the diagnosis of breast cancer, the interpretation of mammograms is dependent on the physician's subjective judgment, and the advent of an objective evaluation method is awaited.



We scored the size, shape, density, margin, border, and internal structure of mammographic images and evaluated the relationships of these scores with lesion categorization.



Since lesions could not be categorized by the analysis of any single item of mammographic images, the items were paired, and a new diagnostic system for breast cancer was prepared. When this system was applied, the diagnostic accuracy was very satisfactory, with a sensitivity of 100% (37/37) and a specificity of 92.9% (65/70) for category 5; 83.6% (51/61) and 97.8% (45/46), respectively, for category 4; and 88.9% (8/9) and 94.9% (93/98), respectively, for category 3.



In this study, findings concerning the margin and internal structure were important for the discrimination of category 5, and those concerning the size, shape, and density made major contributions to the discrimination of category 3.
Does treatment of Helicobacter pylori with antibiotics alone heal duodenal ulcer? A randomised double blind placebo controlled study.

Treatment of Helicobacter pylori infection prevents duodenal ulcer relapse. It has not been established if treatment of the infection heals duodenal ulcer.



To test the hypothesis that treatment of the infection was associated with healing of duodenal ulcer.



A randomised, double blind placebo controlled trial was performed to study the efficacy of an antibiotic only regimen consisting of 300 mg metronidazole, 500 mg amoxycillin, and 250 mg clarithromycin, each given four times daily for two weeks, in the healing of duodenal ulcer as assessed by endoscopy. Symptoms were controlled with acetaminophen and antacids.



Of 100 consecutive patients with endoscopically established duodenal ulcer, 97 with positive rapid urease test on antral biopsy specimens were admitted into the study and 81 completed the trial. Of these, 40 were randomised to receive antibiotics and 41 to receive placebo. Treatment with antibiotics resulted in 92.5% (95% confidence interval (95% CI) 84.3-100) healing at four weeks and 100% at eight and 12 weeks; the corresponding healing rates for placebo treatment were respectively, 36.6%, 61%, and 63.4% (95% CIs 21.8-51.3, 46.0-75.9, and 48.7-78.2 respectively). The differences between the two treatment groups were significant at p < 0.001 at each time point and by life table analysis. Clearance of H pylori as assessed by urease test on antral biopsy specimens at four weeks and eradication of the organism as determined by 13C-urea breath test at eight weeks were achieved in 85% and 62.5% of patients respectively. Duodenal ulcer healed at four weeks in 87.2% and 86.2% (95% CIs 76.7-97.7 and 73.7-98.8) of patients in whom H pylori clearance or eradication, was achieved, versus 42.9% and 51.9% (95% CIs 27.9-57.8 and 38.3-65.5; p < 0.001 and < 0.003 respectively) in whom these processes failed. Stepwise discriminant analysis on 32 clinical, personal, and endoscopic characteristics as well as H pylori clearance and eradication identified H pylori clearance as the most discriminative variable for the healing of duodenal ulcer at four weeks, followed by ulcer depth and eradication of the organism.



Treatment with an antibiotic only regimen was effective for the healing of duodenal ulcer, and clearance as well as eradication of H pylori contributed significantly to the healing. The results constituted the strongest evidence to date that H pylori infection was aetiologically related to duodenal ulceration, and support the concept of treating duodenal ulcer associated with H pylori as an infection and relieving its symptoms with acid reducing agents such as antacids.
A randomised trial of a 5 week, manual based, self-management programme for hypertension delivered in a cardiac patient club in Shanghai

In Shanghai there are 1.2 million people with hypertension, many of whom have difficulty in affording medical treatment. Community based, anti-hypertensive clubs have been created to provide health education but education alone is often ineffective. Lifestyle change programmes have shown some potential for reducing blood pressure but in previous trials have required specialist staff and extensive contact. We have previously demonstrated that self-management programmes delivered by health professionals, such as a nurse who has had short training in self-management techniques can change health behaviour and reduce symptoms. This study was designed to evaluate the benefits of a simple, cognitive-behavioural, self-management programme for hypertension based around a hypertension manual and delivered in the setting of a community anti-hypertensive club in Shanghai.



The method was a pragmatic randomised controlled trial with an intention-to-treat analysis. Adult patients with mild-to-moderate primary hypertension, waiting to join a neighbourhood anti-hypertension club, were randomised to the self-management programme or to an information only control procedure. They attended the group treatment sessions on 4 occasions over 5 weeks for education combined with goal setting for lifestyle change and an introduction to exercise. The main outcome measures were: changes in blood pressure; blood total cholesterol; diet; activity level and health related quality of life 1 month and 4 months after the end of treatment.



A total of 140 adults with mild-to-moderate primary hypertension took part. All of the main outcomes showed beneficial changes. Four months after the end of treatment the mean blood pressure differences between groups were systolic 10.15 mm Hg (P < 0.001, 95% CI 7.25-13.05), and diastolic 8.29 mmHg (P < 0.001, 95% CI 6.71-9.88). Patients in the intervention group also had significantly reduced weight, lowered blood total cholesterol, increased physical activity and improved quality of life.



Patients with mild-to-moderate primary hypertension attending a 5 week, group and manual based, cognitive-behavioural self-management programme, delivered through a voluntary club in Shanghai experienced a significant reduction in blood pressure.
The evolution of APL

This paper is a discussion of the evolution of the APL language, and it treats implementations and applications only to the extent that they appear to have exercised a major influence on that evolution. Other sources of historical information are cited in References 1-3; in particular, The Design of APL  provides supplementary detail on the reasons behind many of the design decisions made in the development of the language. Readers requiring background on the current definition of the language should consult APL Language .
 Although we have attempted to confirm our recollections by reference to written documents and to the memories of our colleagues, this remains a personal view which the reader should perhaps supplement by consulting the references provided. In particular, much information about individual contributions will be found in the Appendix to The Design of APL , and in the Acknowledgements in A Programming Language [10] and in APL\360 User's Manual [23]. Because Reference 23 may no longer be readily available, the acknowledgements from it are reprinted in
Artificial intelligence in medicine: a personal retrospective on its emergence and early function

Methods of artificial intelligence were gradually introduced into clinical decision-making research from 1970 to 1974. Evolving from pattern recognition and general A.I. problem-solving ideas, such methods helped researchers crystallize the notions of knowledge-based systems by the mid-1970s. In 1978 the early systems gave way to either second-generation frameworks for general consultative reasoning or to new, more sophisticated knowledge representations. This paper traces some of the major events in the early evolution of AIM systems, with emphasis on the developments at the Rutgers Resource, in which the author participated.
Short intensive sequential therapy followed by autologous stem cell transplantation in adult Burkitt, Burkitt-like and lymphoblastic lymphoma

The feasibility and efficacy of up-front high-dose sequential chemotherapy followed by autologous stem cell transplantation (ASCT) in previously untreated adults (median age 33 years; range 15–64) with Burkitt lymphoma (BL), Burkitt-like lymphoma (BLL) or lymphoblastic lymphoma (LyLy), both without central nervous system or extensive bone marrow involvement was investigated in a multicenter phase II study. Treatment consisted of two sequential high-dose chemotherapy induction courses incorporating prednisone, cyclophosphamide, doxorubicin, etoposide and mitoxantrone, without high-dose methotrexate or high-dose cytarabine. Patients with at least PR went on with BEAM and ASCT. Protocol treatment was completed by 23/27 (85%) BL/BLL and 13/15 (87%) LyLy patients. Median treatment duration until BEAM was 70 (range: 50–116) days. No toxic deaths occurred. Response to treatment was complete response (CR) 81% and partial response (PR) 11% for BL/BLL, CR 73% and PR 20% for LyLy. At a median follow-up of 61 months of patients still alive, six BL/BLL and eight LyLy patients have died. The actuarial 5-year overall and event-free survival estimates are 81 and 73% for BL/BLL vs 46 and 40% for LyLy patients. In conclusion, this short up-front high-dose sequential chemotherapy regimen, followed by ASCT is highly effective in adults with BL/BLL with limited bone marrow involvement, but less so in patients with LyLy.
Gemcitabine-oxaliplatin combination for ovarian cancer resistant to taxane-platinum treatment: a phase II study from the GINECO group

Advanced ovarian carcinoma in early progression (<6 months) (AOCEP) is considered resistant to most cytotoxic drugs. Gemcitabine (GE) and oxaliplatin (OXA) have shown single-agent activity in relapsed ovarian cancer. Their combination was tested in patients with AOCEP in phase II study. Fifty patients pre-treated with platinum–taxane received q3w administration of OXA (100 mg m–2, d1) and GE (1000 mg m–2, d1, d8, 100-min infusion). Patient characteristics were a : median age 64 years (range 46–79),and 1 (84%) or 2 (16%) earlier lines of treatment. Haematological toxicity included grade 3–4 neutropaenia (33%), anaemia (8%), and thrombocytopaenia (19%). Febrile neutropaenia occurred in 3%. Non-haematological toxicity included grade 2–3 nausea or vomiting (34%), grade 3 fatigue (25%),and grade 2 alopecia (24%). Eighteen (37%) patients experienced response. Median progression-free (PF) and overall survivals (OS) were 4.6 and 11.4 months, respectively. The OXA–GE combination has high activity and acceptable toxicity in AOCEP patients. A comparison of the doublet OXA–GE with single-agent treatment is warranted.