nils-herrmann/clean_scirepeval huggingface dataset:
Patterns of alcohol consumption and ischaemic heart disease in culturally divergent countries: the Prospective Epidemiological Study of Myocardial Infarction (PRIME)

To investigate the effect of alcohol intake patterns on ischaemic heart disease in two countries with contrasting lifestyles, Northern Ireland and France.



Cohort data from the Prospective Epidemiological Study of Myocardial Infarction (PRIME) were analysed. Weekly alcohol consumption, incidence of binge drinking (alcohol >50 g on at least one day a week), incidence of regular drinking (at least one day a week, and alcohol <50 g if on only one occasion), volume of alcohol intake, frequency of consumption, and types of beverage consumed were assessed once at inclusion. All coronary events that occurred during the 10 year follow-up were prospectively registered. The relation between baseline characteristics and incidence of hard coronary events and angina events was assessed by Cox's proportional hazards regression analysis.



One centre in Northern Ireland (Belfast) and three centres in France (Lille, Strasbourg, and Toulouse).



9778 men aged 50-59 free of ischaemic heart disease at baseline, who were recruited between 1991 and 1994.



Incident myocardial infarction and coronary death ("hard" coronary events), and incident angina pectoris.



A total of 2405 men from Belfast and 7373 men from the French centres were included in the analyses, 1456 (60.5%) and 6679 (90.6%) of whom reported drinking alcohol at least once a week, respectively. Among drinkers, 12% (173/1456) of men in Belfast drank alcohol every day compared with 75% (5008/6679) of men in France. Mean alcohol consumption was 22.1 g/day in Belfast and 32.8 g/day in France. Binge drinkers comprised 9.4% (227/2405) and 0.5% (33/7373) of the Belfast and France samples, respectively. A total of 683 (7.0%) of the 9778 participants experienced ischaemic heart disease events during the 10 year follow-up: 322 (3.3%) hard coronary events and 361 (3.7%) angina events. Annual incidence of hard coronary events per 1000 person years was 5.63 (95% confidence interval 4.69 to 6.69) in Belfast and 2.78 (95% CI 2.41 to 3.20) in France. After multivariate adjustment for classic cardiovascular risk factors and centre, the hazard ratio for hard coronary events compared with regular drinkers was 1.97 (95% CI 1.21 to 3.22) for binge drinkers, 2.03 (95% CI 1.41 to 2.94) for never drinkers, and 1.57 (95% CI 1.11 to 2.21) for former drinkers for the entire cohort. The hazard ratio for hard coronary events in Belfast compared with in France was 1.76 (95% CI 1.37 to 2.67) before adjustment, and 1.09 (95% CI 0.79 to 1.50) after adjustment for alcohol patterns and wine drinking. Only wine drinking was associated with a lower risk of hard coronary events, irrespective of the country.



Regular and moderate alcohol intake throughout the week, the typical pattern in middle aged men in France, is associated with a low risk of ischaemic heart disease, whereas the binge drinking pattern more prevalent in Belfast confers a higher risk.
Phase I–II study of high-dose etoposide in patients with refractory breast cancer

At conventional doses of 200-400 mg/m 2 every 3 weeks, etoposide has shown marginal activity in pretreated breast cancer patients , but it may have additive activity in combination with cisplatin  or cyclophosphamide , In other malignancies, its activity appears dose-dependent and doses of 1200 to 1500 mg/m ~ have been given without bone marrow support with severe, yet transient, myelosuppression . Based on these considerations, high-dose etoposide has been incorporated in autologous bone marrow transplant regimens for breast cancer patients , although there are no data to substantiate its increased activity or additive effect at higher than standard doses in combination chemotherapy programs. In this study we attempted to define the nonhematologic maximum tolerated dose (MTD) and dose-limiting toxic effects of etoposide administered to breast cancer patients without autologous bone marrow support, and to assess its efficacy at higher-than-conventional doses.
Unmet needs in cancer patients: development of a supportive needs screening tool (SNST)

A diagnosis of cancer can have a profound impact on the physical, emotional, psychological, social and spiritual areas of a person’s life. Supportive care services are directed towards this full range of issues associated with cancer. Identification of need is the first step in meeting supportive care concerns, but there is a lack of tools and processes regularly used in clinical practice. This article reports the first steps in the development of a supportive needs screening tool appropriate for use in an oncology outpatient setting. A review of the literature was undertaken, and a draft tool developed using a process of item reduction. A small pre-test followed by a pilot test with 87 patients attending Peter MacCallum Cancer Centre, Melbourne Australia was undertaken. Evaluation to identify usability and acceptability in clinical practice included descriptive statistics to profile patient needs and referrals generated by the supportive needs screening tool (SNST), interviews with a small sample of participants and surveys completed by staff. The SNST was developed with 41 questions, the majority requiring a yes/no response. From the tool, a total of 1,085 needs were identified (mean = 12 needs/patient). A total of 264 referrals were generated, with 72% of patients receiving at least one referral. Patients and staff reported high acceptability. The SNST has face validity and demonstrated usability in an ambulatory care oncology stetting, as first steps in instrument development. Further testing of reliability and validity are being undertaken.
Applying theory to practice

We discuss the art of applying theory to practice. In particular, we discuss in detail our interactions with two research projects at IBM Almaden: the Garlic project, which built a multimedia database system on top of various existing systems, and the Clio project, which developed tools for converting data from one format to another. We discuss the problems we resolved, and the impact this had both on the Garlic or Clio systems and on the broader scientific community. We draw morals from these interactions, including why theoreticians do better theory by working with system builders, and why system builders build better systems by working with theoreticians. We present the remarkably simple Threshold Algorithm, which is optimal in an extremely strong sense: optimal not just in the worst case, or in the average case, but in every case! The Threshold Algorithm and its variants have applications to numerous areas, including information retrieval, fuzzy and uncertain databases, group recommendation systems, and the semantic web .
Effect of kinetic therapy on pulmonary complications.

Optimal turning of critically ill patients is not well established. Kinetic therapy (systematic mechanical rotation of patients with 40 degree turns) may improve pulmonary function more than the improvement in function achieved via the standard of care (turning patients every 2 hours).



To determine (1) if patients receiving mechanical ventilation who tolerate kinetic therapy have better pulmonary function than do patients treated with standard turning and (2) the cost-effectiveness of kinetic therapy.



A prospective, randomized, multicenter study including 234 medical, surgical, and trauma patients (137 control patients, 97 patients receiving kinetic therapy).



Kinetic therapy significantly decreased the occurrence of ventilator-associated pneumonia and lobar atelectasis. The risk of pneumonia developing was lower (P = .002) in patients receiving kinetic therapy than in the control patients. The risk of lobar atelectasis developing was decreased (P = .02) for the patients receiving kinetic therapy. Lengths of stay in the intensive care unit and in the hospital did not differ between the groups. Charges for intensive care were less in the kinetic therapy group (81,700 dollars) than in the control group (84,958 dollars), but not significantly less. Twenty-one patients did not tolerate kinetic therapy and were not included in the analysis.



Kinetic therapy helps prevent ventilator-associated pneumonia and lobar atelectasis in critically ill patients. Costs to rent the bed may be offset by the potential cost reduction associated with kinetic therapy.
Severe weight loss in 3 months after allogeneic hematopoietic SCT was associated with an increased risk of subsequent non-relapse mortality

Patients after allogeneic hematopoietic SCT (HSCT) are at risk of malnutrition. To assess the impact of malnutrition after allogeneic HSCT on transplant outcomes, we conducted a retrospective study. Adult patients who received allogeneic HSCT from 2000 to 2009 for standard-risk leukemia and achieved disease-free survival up to 3 months after allogeneic HSCT were included. From participating centers, 145 patients were enrolled. Median age was 46 years (19–68). Patients were classified based on weight loss during 3 months after allogeneic HSCT as follows: normal group (weight loss <5%, n=53), mild malnutrition group (5%⩽weight loss<10%, n=47), severe malnutrition group (10% ⩽weight loss, n=45). The cumulative incidences of 2-year nonrelapse mortality (NRM) were 3.8% in the normal group, 8.5% in the mild malnutrition group and 27.3% in the severe malnutrition group. The probabilities of a 2-year OS were 73.2% in the normal group, 74.5% in the mild malnutrition group and 55.3% in the severe malnutrition group. In multivariate analysis, severe malnutrition was associated with an increased risk of NRM and a worse OS. In conclusion, weight loss ⩾10% was associated with a worse clinical outcome. Prospective studies that identify patients at risk of malnutrition and intervention by a nutritional support team are warranted.
Three months of moderate-intensity exercise reduced plasma 3-nitrotyrosine in rheumatoid arthritis patients

Rheumatoid arthritis (RA) patients display high levels of oxidative stress. Transient exercise-induced increases in oxidative stress are thought to be adaptive in healthy populations. This study investigated the effect of exercise on markers of oxidative stress in RA, following acute exercise and a period of exercise training.  RA patients (N = 12, age: 56 ± 11) undertook a bout of exercise (30–40 min, 70 % VO2MAX), and blood samples were taken before and after exercise to assess markers of oxidative stress.  RA patients (N = 19, age: 56 ± 10) were randomised into either a control or exercise group, who undertook 3 exercise sessions per week (30–40 min @70 % VO2MAX) for 3 months. Plasma markers of oxidative stress (protein carbonyls (PC), lipid hydroperoxides (LOOH), 3-nitrotyrosine (3-NT), total antioxidant capacity (TAC) and catalase (CAT) activity), inflammation (interleukin-8 (IL-8) and C-reactive protein (CRP)) and nitric oxide metabolites (NOx) were assessed before and after training.  Protein carbonyls (PC) (+18 %) and NOx (+27 %) were significantly increased following exercise.  3-nitrotyrosine (3-NT) decreased (2.18 ± 1.78 to 1.10 ± 0.93 μM) in the exercise group only, alongside increases in aerobic fitness (24.45 ± 4.98 to 27.10 ± 4.51 ml/kg/min−1) and reductions in disease activity score (DAS: 3.47 ± 1.17 to 2.88 ± 0.76). PC, LOOH, TAC, IL-8, CRP and NOx concentrations, and CAT activity were unchanged in both groups. Aerobic exercise training did not increase markers of oxidative stress in RA patients. 3-Nitrotyrosine and disease activity were decreased following exercise training.
Adverse events associated with acupuncture: three multicentre randomized controlled trials of 1968 cases in China

In order to evaluate the safety of acupuncture in China objectively, we investigated the adverse events associated with acupuncture based on three multicentre randomized controlled trials (RCTs) to assess the safety of acupuncture, identifying the common types of acupuncture adverse events, and analysing the related risk factors for their occurrence.



This observational study included patients who received acupuncture from three multicentre RCTs respectively for migraine, functional dyspepsia and Bell's palsy. The 1968 patients and their acupuncturists documented adverse events associated with acupuncture after treatment. We collected data about adverse events due to acupuncture treatment from their case report forms. We analysed the incidence and details of the adverse effects, and studied the risk factors for acupuncture adverse events with non-conditional logistic regression analysis.



Among the 1968 patients, 74 patients (3.76%) suffered at least one adverse event throughout the treatment period. We did not observe the occurrence of serious adverse events. 73 patients with adverse events recovered within 2 weeks through effective treatment such as physiotherapy or self-treatment. A total of 3 patients withdrew because of adverse events. There were 9 types of adverse events related to acupuncture, including subcutaneous haematoma, bleeding, skin bruising and needle site pain. Subcutaneous haematoma and haemorrhage in the needling points were the most common adverse events. Age and gender were related to the occurrence of acupuncture adverse events. The older the patients were, the higher the risk of adverse events was. In addition, male patients had slightly higher risk of an adverse event than female patients.



Acupuncture is a safe therapy with low risk of adverse events in clinical practice. The risk factors for adverse events (AEs) were related to the patients' gender and age and the local anatomical structure of the acupoints. AEs could be reduced and mitigated by improving the medical environment, ensuring a high technical level of the acupuncture practitioners and establishing a good relationship of mutual trust between doctor and patient.
Effect of carotid artery stenting on cerebral blood flow: evaluation of hemodynamic changes using arterial spin labeling

The purpose of this work was to quantitatively evaluate the hemodynamic changes after carotid artery stenting (CAS) by measuring cerebral blood flow (CBF) using arterial spin labeling (ASL). Twenty sets of pre- and postprocedural CBF maps were acquired using ASL in patients who underwent CAS. Vascular territory- and anatomical structure-based regions of interest were applied to the CBF maps. Relative CBF (rCBF) was calculated by adjusting ipsilateral CBF with contralateral CBF. To assess the changes in rCBF after CAS (ΔrCBF), we calculated the following difference: $$ \Delta\mathrm{rCBF}=\mathrm{rCB}{{\mathrm{F}}_{\mathrm{postprocedural}}}-\mathrm{rCB}{{\mathrm{F}}_{\mathrm{preprocedural}}} $$ . Postprocedural CBFs were significantly higher than preprocedural CBFs for internal carotid artery and middle cerebral artery territories (P < 0.05 in both). Postprocedural rCBFs were also significantly higher than preprocedural rCBFs for internal carotid artery and middle cerebral artery territories (P < 0.05 in both). Significant correlations were observed between preprocedural rCBF and ΔrCBF for the internal carotid artery and middle cerebral artery territories (r = −0.7211, P = 0.0003 and r = −0.6427, P = 0.0022, respectively). Areas in which the ΔrCBF values were >5.00 ml 100 g−1 min−1 were the precentral, postcentral, middle frontal, middle temporal (caudal), superior parietal, and angular gyri. ASL has potential as a noninvasive imaging tool for the quantitative evaluation of hemodynamic changes after CAS. CAS improves cerebral perfusion in patients with carotid artery stenosis, and patients with greater perfusion deficits prior to CAS have greater improvement in perfusion after CAS. In addition, eloquent areas show the greatest improvement in perfusion.
Reliability of the 36-item version of the Token Test in patients with poststroke aphasia.

The purpose of this study was to investigate the intra- and inter-rater reliability of the 36-item version of the Token Test.



Twenty-four people following stroke with mild disorder of language comprehension were assessed by two speech therapists at a distance of 2  days apart.



The test showed excellent and good inter-rater reliability, while some parts had lower coefficients.



This version of the Token Test can be used to assess mild disorder of oral language comprehension. However, further clearer instructions for administration and scoring may improve the test reliability.
Gemcitabine at fixed dose-rate in patients with advanced soft tissue sarcomas: a mono-institutional phase II study

To explore the clinical activity and toxicity of gemcitabine infused at the fixed dose of 10 mg/m2/min over 100 min in patients with soft tissue sarcomas (STSs). Fourteen patients with advanced locally unresectable and/or metastatic, pretreated STSs (seven leiomyosarcoma, three malignant schwannoma, one synovialsarcoma, one malignant fibrous histiocytoma, one endometrial stromal cell sarcoma, one undifferentiated) were treated with gemcitabine 10 mg/m2/min/week over 100 min given for 3 weeks out of 4. The median age was 52 years (range 27–77), male/female ratio was 3/11, and the median WHO performance status was 0 (range 0–1). The median number of previous medical treatments for advanced disease was 1 (range 1–2). A median number of three cycles (range 1–10 cycles) and a total of 151 weekly administrations (median 9, range 3–27) of gemcitabine were administered. Treatment was well tolerated and the main causes of dose-reduction or omission/delay were hematological and liver toxicities. One patient (7%; 95% confidence interval: 0.2–33.9%) with a metastatic uterine leiomyosarcoma obtained a partial response that lasted for 6.5 months. Three patients (two leiomyosarcoma and one schwannoma) (21%) obtained a stabilization of disease. The median time to progression was 3.1 months (range 1.0–9.5). The median overall survival was 11.8 months (range 1.0–54.5+). Gemcitabine infused at the fixed dose of 10 mg/m2/min over 100 min shows a good tolerability but an overall modest activity in unselected STSs histotypes. Nevertheless, an interesting tumor growth control rate was observed in specific histological variants (i.e., leiomyosarcoma), thus confirming data from recent controlled clinical trials.
How valid is the clinical diagnosis of Parkinson's disease in the community?

Many patients diagnosed with Parkinson's disease are later found to have an erroneous diagnosis, often only when they come to necropsy; conversely, many patients with Parkinson's disease in the community remain undiagnosed.



To assess the validity of a clinical diagnosis of parkinsonism in the general population according to strict published criteria.



As part of a population based study on the prevalence of Parkinson's disease in London, all patients were identified with a diagnosis of parkinsonism, tremor with onset over age 50 years, or who had ever received antiparkinsonian drugs. All patients who agreed to participate were diagnosed according to strict clinical diagnostic criteria, after a detailed neurological interview and examination and discussion of the findings with examination of their video recordings. Follow up information was obtained over a period of at least one year, and atypical cases were reviewed at the end of the study.



A diagnosis of probable Parkinson's disease was confirmed in 83% of patients with this diagnosis, including three (2%) in whom atypical features were found that were insufficient to discard a diagnosis of Parkinson's disease. Two additional patients (2%) were found to have possible Parkinson's disease. However, in 15% of patients the diagnosis was unequivocally rejected. Conversely, 13 patients who had previously not been diagnosed with Parkinson's disease (19%) were found to have this disorder.



At least 15% of patients with a diagnosis of Parkinson's disease in the population do not fulfil strict clinical criteria for the disease, and approximately 20% of patients with Parkinson's disease who have already come to medical attention have not been diagnosed as such.
Pharmacokinetics and clinical activity of very low-dose alemtuzumab in transplantation for acute leukemia

The optimal dose of in vivo-administrated alemtuzumab in the allogeneic transplantation setting has not been defined. We report our experience on 37 patients with high-risk diseases, mainly acute leukemia (AML 23, ALL 10 patients), who underwent sibling (49%) or unrelated (51%) PBSCT (35 patients), and received a total dose of only 10–20 mg Campath-1H as part of the conditioning, and post-transplant CYA without MTX. The neutrophil and especially the platelet engraftment were rapid. There were only two grade III–IV acute GvHD cases, which occurred in unrelated transplants in the Campath-10 cohort. Chronic GvHD developed in six cases (17%) and was limited to skin in five of them. After a median follow-up of 371 days (59–1191), 70% patients are alive and in CR (Karnofsky 100%), and 11 died (TRM n=6, relapse n=5). From the five patients relapsed, three were at advanced stage at transplant and four underwent sibling HCT with the higher (20 mg) alemtuzumab dose. With the 10 mg alemtuzumab schedule (5 mg/day at days −2 and −1) we achieve at day of transplantation low but still lymphotoxic alemtuzumab serum concentrations (176 ng/mL), whereas levels declined fast thereafter, and at engraftment nearly no Campath antibody remained in the patient's serum.
Early Childhood Investments Substantially Boost Adult Health

High-quality early childhood programs have been shown to have substantial benefits in reducing crime, raising earnings, and promoting education. Much less is known about their benefits for adult health. We report on the long-term health effects of one of the oldest and most heavily cited early childhood interventions with long-term follow-up evaluated by the method of randomization: the Carolina Abecedarian Project (ABC). Using recently collected biomedical data, we find that disadvantaged children randomly assigned to treatment have significantly lower prevalence of risk factors for cardiovascular and metabolic diseases in their mid-30s. The evidence is especially strong for males. The mean systolic blood pressure among the control males is 143 millimeters of mercury (mm Hg), whereas it is only 126 mm Hg among the treated. One in four males in the control group is affected by metabolic syndrome, whereas none in the treatment group are affected. To reach these conclusions, we address several statistical challenges. We use exact permutation tests to account for small sample sizes and conduct a parallel bootstrap confidence interval analysis to confirm the permutation analysis. We adjust inference to account for the multiple hypotheses tested and for nonrandom attrition. Our evidence shows the potential of early life interventions for preventing disease and promoting health.