nils-herrmann/clean_scirepeval huggingface dataset:
Early Expression of FcγRI (CD64) on Monocytes  of Cardiac Surgical Patients and 
Higher Density of  Monocyte Anti-Inflammatory Scavenger CD163  Receptor in “On-Pump” Patients

Activation of innate immunity cells is inseparably linked to cardiac surgical operation. The aim of this study was to assess the kinetics in the expression of receptor for Fc part of IgG, FcgammaRI (CD64), and scavenger receptor CD163 on peripheral blood cells of cardiac surgical patients and to examine the effect of cardiac bypass as a separable influence on the systemic acute inflammatory response.



Forty patients, twenty in each group, were randomly assigned to CABG surgery performed either with "on-pump" or without "off-pump" cardiopulmonary bypass. Standardized quantitative flow cytometry method was used to determine the expression of surface markers.



The density of CD64 molecule on monocytes reached maximum on the 1st postoperative day (P<.001) whereas the peak for CD64 molecule expression on granulocytes was postponed to the 3rd postoperative day (P<.001). The expression of CD163 scavenger molecule on monocytes reached maximum on the 1st postoperative day (P<.001). The density of CD163 molecule on monocytes on the 1st postoperative day is significantly higher in "on-pump" patients in comparison with "off-pump" patients (P<.001).



In cardiac surgical patients the expression of activation marker FcgammaR1 (CD64) on monocytes is increased earlier in comparison with granulocytes in both "on-pump" and "off-pump" patients. The expression of scavenger molecule CD163 on monocytes is significantly higher in "on-pump" patients.
Mechanism Design with Strategic Mediators

We consider the problem of designing mechanisms that interact with strategic agents through strategic intermediaries (or mediators), and investigate the cost to society due to the mediators’ strategic behavior. Selfish agents with private information are each associated with exactly one strategic mediator, and can interact with the mechanism exclusively through that mediator. Each mediator aims to optimize the combined utility of his agents, while the mechanism aims to optimize the combined utility of all agents. We focus on the problem of facility location on a metric induced by a publicly known tree. With nonstrategic mediators, there is a dominant strategy mechanism that is optimal. We show that when both agents and mediators act strategically, there is no dominant strategy mechanism that achieves any approximation. We, thus, slightly relax the incentive constraints, and define the notion of a two-sided incentive compatible mechanism. We show that the 3-competitive deterministic mechanism suggested by Procaccia and Tennenholtz [2013] and Dekel et al. [2010] for lines extends naturally to trees, and is still 3-competitive as well as two-sided incentive compatible. This is essentially the best possible (follows from Dekel et al. [2010] and Procaccia and Tennenholtz [2013]). We then show that by allowing randomization one can construct a 2-competitive randomized mechanism that is two-sided incentive compatible, and this is also essentially tight. This result also reduces a gap left in the work of Procaccia and Tennenholtz [2013] and Lu et al. [2009] for the problem of designing strategy-proof mechanisms for weighted agents with no mediators on a line. We also investigate a generalization of the preceding setting where there are multiple levels of mediators.
Bone Turnover and Insulin-like Growth Factor I Levels Increase After Improved Glycemic Control in Noninsulin-dependent Diabetes Mellitus

It is unclear whether both bone resorption and formation are affected by glycemic control, and contribute to diabetic osteopenia. In this study, 20 patients with noninsulin-dependent diabetes mellitus (12 men and 8 postmenopausal women) and 20 healthy control subjects (10 men and 10 postmenopausal women) were examined at baseline and 2 months. The diabetic patients showed an improvement of glycemic control (decreased HbA1c) at the second measurement. Analysis of variance showed that there was no effect of gender on the variables that increased with improved glycemic control, and therefore results are presented for both male and female subjects. Baseline values of serum osteocalcin, a marker of formation, were significantly lower in diabetic patients compared with healthy subjects (2.5 ± 1.3 versus 4.4 ± 1.4 ng/ml; P= 0.0006), but markers of bone resorption [urinary pyridinoline (PYD), deoxypyridinoline (DPD)] did not differ. Improved glycemic control in diabetic patients resulted in increased values of PYD (P= 0.012), DPD (P= 0.049), serum osteocalcin (P= 0.001), and serum insulin-like growth factor I (IGF-I, P= 0.003), but no change in serum parathyroid hormone or 25-hydroxyvitamin D. In diabetic patients there were inverse correlations for the percent change from baseline to improved glycemic control for osteocalcin and HbA1c (r =−0.53; P= 0.016) and glucose (r =−0.46; P= 0.050). These data suggest that improved glycemic control is accompanied by an increase in bone turnover for male and female diabetic patients, possibly mediated by increased levels of circulating IGF-I.
A randomized, controlled trial of oral and intramuscular dexamethasone in the prevention of neonatal respiratory distress syndrome.

The study's objective was to compare the efficacies of oral and intramuscular antenatal administration of dexamethasone in reducing neonatal respiratory distress syndrome.



Subjects at high risk for preterm delivery between 24 and 33 weeks' gestation were prospectively randomly assigned to receive either 6 mg intramuscular dexamethasone or 8 mg oral dexamethasone every 12 hours for 4 doses. The regimen was repeated weekly until 34 weeks' gestation if delivery had not yet occurred. A blinded data review was performed. The primary outcome of the trial was respiratory distress syndrome. Data were analyzed in an intent to treat fashion. Comparisons were made with an unpaired t test, chi2 or Fisher exact test, and survival analysis. P <.05 was considered significant.



The study was discontinued at 39% enrollment after a blinded review of available outcomes. A total of 170 women with 188 fetuses were randomly assigned. The oral and intramuscular groups had similar mean gestational ages at enrollment (29.9 weeks vs 29.2 weeks) and similar median latencies (9.5 vs 10 days). No difference in the frequency of respiratory distress syndrome was found between the oral and intramuscular groups, (34.3% vs 29.8%). Neonatal sepsis (10.1% vs 1.2%, P =.01) and intraventricular hemorrhage (10.1% vs 2. 4%, P =.04) were significantly higher in the oral group. There were no statistical differences in the frequencies of necrotizing enterocolitis or neonatal death. A subgroup analysis of 112 patients who were delivered at <34 weeks' gestation revealed no statistical difference in respiratory distress syndrome between the groups; however, oral dexamethasone was associated with a significant increase in sepsis (15.9% vs 1.6%, P =.009) and intraventricular hemorrhage (15.9% vs 3.3%, P =.03).



Oral administration increases neonatal morbidity without demonstrable benefit and should not at this time be used clinically for induction of fetal pulmonary maturation.
Stent-assisted endovascular thrombolysis versus intravenous thrombolysis in internal carotid artery dissection with tandem internal carotid and middle cerebral artery occlusion.

Thrombolysis Versus Intravenous Thrombolysis in Internal Carotid Artery Dissection With Tandem Internal Carotid and Middle Cerebral Artery Occlusion  We have read the exciting article entitled “Stent-assisted endovascular thrombolysis versus intravenous thrombolysis in internal carotid artery dissection with tandem internal carotid and middle cerebral artery occlusion.”1 The authors compared 4 patients who underwent intravenous thrombolysis (IVT) with recombinant tissue plasminogen activator administered according to National Institute of Neurological Disorders and Stroke (NINDS) guidelines with 6 patients who were treated with an IV bolus of the glycoprotein (GP) IIb/IIIa antagonist abciximab (0.25 mg/kg body weight) and carotid stenting followed by mechanical thrombectomy in 5 cases and intra-arterial thrombolysis with 40 mg recombinant tissue plasminogen activator in the remaining case.1 Three-month outcome was worse in the IVT group although the presenting neurological deficit was comparable in the 2 groups and the mean time from stroke to treatment onset was 90 minutes longer in patients treated with endovascular techniques. These results differ from our findings observed in 18 consecutive patients with internal carotid artery dissection causing carotid occlusion and a symptomatic middle cerebral artery occlusion defined by a hyperdense middle cerebral artery sign in native brain CT in all cases, and in addition by catheter angiography in 4 and CT angiography in 6 cases (Table). Four patients were treated with carotid stenting followed by intra-arterial thrombolysis with urokinase (mean dose 625 000 227 000 IE; 3 patients have already been reported2), and 14 with IVT using recombinant tissue plasminogen activator according to the NINDS criteria. Severity of the baseline deficit was similar in both groups, and mean time from the onset of stroke to thrombolytic treatment was similar in both treatment
Omega-3 fatty acid treatment and T(2) whole brain relaxation times in bipolar disorder.

The authors hypothesized that changes in brain membrane composition resulting from omega-3 fatty acid administration in patients with bipolar disorder would result in greater membrane fluidity, as detected by reductions in T(2) values.



Women with bipolar disorder (N=12) received omega-3 fatty acids for 4 weeks. A cohort of bipolar subjects (N=9) and a group without bipolar disorder (N=12) did not receive omega-3 fatty acids. T(2) values were acquired at baseline and after 4 weeks.



Bipolar subjects who received omega-3 fatty acids had significant decreases in T(2). There was a dose-dependent effect when the bipolar omega-3 fatty acid group was subdivided into high- and low-dose cohorts.



Omega-3 fatty acids lowered T(2) values, consistent with the hypothesis that the fluidity of cell membranes was altered. Further studies are needed to clarify the significance of alterations in brain physiology induced by omega-3 fatty acids, as reflected in T(2) values.
Osteoid osteomas in common and in technically challenging locations treated with computed tomography-guided percutaneous radiofrequency ablation

To evaluate the efficacy of computed tomography (CT)-guided radiofrequency (RF) ablation for the treatment of osteoid osteomas in common and in technically challenging locations. Twenty-three patients with osteoid osteomas in common (nine cases) and technically challenging [14 cases: intra-articular (n = 7), spinal (n = 5), metaphyseal (n = 2)] positions were treated with CT-guided RF ablation. Therapy was performed under conscious sedation with a seven-array expandable RF electrode for 8–10 min at 80–110°C and power of 90–110 W. The patients went home under instruction. A brief pain inventory (BPI) score was calculated before and after (1 day, 4 weeks, 6 months and 1 year) treatment. All procedures were technically successful. Primary clinical success was 91.3% (21 of total 23 patients), despite the lesions’ locations. BPI score was dramatically reduced after the procedure, and the decrease in BPI score was significant (P < 0.001, paired t-test; n − 1 = 22) for all periods during follow up. Two patients had persistent pain after 1 month and were treated successfully with a second procedure (secondary success rate 100%). No immediate or delayed complications were observed. CT-guided RF ablation is safe and highly effective for treatment of osteoid osteomas, even in technically difficult positions.
A game-theoretic model for dynamic load balancing in distributed systems

Process of improving the performance of a parallel and distributed system through a redistribution of load among the processors is called load balancing. If it is being done at run time then it treats as dynamic load balancing. In this paper we present the framework for obtaining a user optimal load balancing scheme in distributed system. We formulate the Dynamic load balancing problem in distributed systems as a noncooperative game among users. The system model considers various parameters and accordingly the load balancing algorithm is defined. For the proposed noncooperative load balancing game, we consider the structure of the Nash equilibrium. Based on this structure we derive a new distributed load balancing algorithm. Our focus is to define the load balancing problem and the scheme to overcome it, by using new area called game theory.
Pulmonary cytolytic thrombi: a newly recognized complication of stem cell transplantation

Over the past 5 years we have recognized a new pulmonary complication of hematopoietic stem cell transplantation (HSCT) associated with fever and pulmonary nodules termed ‘pulmonary cytolytic thrombi’ (PCT). Retrospective analysis of medical and radiographic records and pathologic material from 13 HSCT recipients with PCT and a review of the Blood and Marrow Transplant Database for all patients with radiographic evidence of pulmonary nodules or who underwent open-lung biopsy from 1 January 1993 to 31 December 1998 (n = 1228) were performed. The median age of patients with PCT was 11.9 years (range, 1.3–29.7 years). All patients developed fever at a median of 72 days (range, 8–343 days) post transplant, followed by pulmonary nodules on chest CT. Eleven patients were receiving therapy for active GVHD (acute, grades I–IV (n = 10); extensive chronic (n = 1)). Biopsy of the pulmonary nodules revealed a unique pattern of necrotic, basophilic thromboemboli with amorphous material suggestive of cellular breakdown products. This was descriptively labeled ‘pulmonary cytolytic thrombi’. Immunohistochemical staining revealed entrapped leukocytes and disrupted endothelium, but was negative for histiocytes. Cultures and immunohistochemical stains were negative for infectious agents. Empiric therapy included systemic corticosteroids (n = 9) and amphotericin (n = 7). Nine patients survive with resolution of PCT at a median follow-up of 1.5 years. Bone Marrow Transplantation (2000) 25, 293–300.
MR colonography with limited bowel preparation compared with optical colonoscopy in patients at increased risk for colorectal cancer.

To prospectively evaluate the diagnostic performance of magnetic resonance (MR) colonography by using limited bowel preparation in patients with polyps of 10 mm or larger in diameter in a population at increased risk for colorectal cancer, with optical colonoscopy as the reference standard.



The institutional review boards of all three hospitals approved the study. All patients provided written informed consent. In this multicenter study, patients undergoing colonoscopy because of a personal or family history of colorectal cancer or adenomatous polyps were included. Two blinded observers independently evaluated T1- and T2-weighted MR colonographic images obtained with limited bowel preparation (bright-lumen fecal tagging) for the presence of polyps. The limited bowel preparation consisted of a low-fiber diet, with ingestion of lactulose and an oral gadolinium-based contrast agent (with all three major meals) starting 48 hours prior to imaging. Results were verified with colonoscopic outcomes. Patient sensitivity, patient specificity, polyp sensitivity, and interobserver agreement for lesions of 10 mm or larger were calculated for both observers individually and combined.



Two hundred patients (mean age, 58 years; 128 male patients) were included; 41 patients had coexistent symptoms. At colonoscopy, 12 patients had 22 polyps of 10 mm or larger. Per-patient sensitivity was 58% (seven of 12) for observer 1, 67% (eight of 12) for observer 2, and 75% (nine of 12) for both observers combined for polyps of 10 mm or larger. Per-patient specificity was 95% (178 of 188) for observer 1, 97% (183 of 188) for observer 2, and 93% (175 of 188) for both observers combined. Per-polyp sensitivity was 55% (12 of 22) for observer 1, 50% (11 of 22) for observer 2, and 77% (17 of 22) for both observers combined. Interobserver agreement was 93% for identification of patients with lesions of 10 mm or larger.



In patients at increased risk for colorectal cancer, specificity of MR colonography by using limited bowel preparation was high, but sensitivity was modest.
The efficacy of a perceptive rehabilitation on postural control in patients with chronic nonspecific low back pain.

Patients with chronic low back pain have a worse posture, probably related to poor control of the back muscles and altered perception of the trunk midline. The aim of this study was to evaluate the efficacy of a perceptive rehabilitation in terms of stability and pain relief in patients with chronic nonspecific low back pain. Thirty patients were enrolled and randomized into two groups: 15 patients received rehabilitation, on the basis of a specific tool to perform perceptive exercises [perceptive group (PG)], and 15 patients received a back school programme [back school group (BG)]. Both groups were assessed using stabilometry and the McGill Pain Questionnaire before and at the end of treatment. For the reference values of stabilometric parameters, 15 healthy individuals were enrolled. Significant reductions in sway length (P=0.019) and laterolateral sway velocity (P=0.038) were observed in the PG. The anteroposterior sway velocity was reduced in both the groups, but significantly only for BG (P=0.048). The percentage of sway length reduction was inversely and significantly correlated with the initial sway length value for PG (R=-0.708, P=0.003), but not for BG (R=-0.321, P=0.243). In the PG, the sagittal arrows and bi-acromial and bi-spinoiliac lines' angles were all significantly reduced. General pain relief was reported after treatment, without a significant difference (P=0.436). Our results suggest that a perceptive rehabilitation can improve the postural stability for the realignment of the trunk, controlling the back pain. The use of cognitive exercises may strengthen the usual rehabilitation of low back pain, avoiding the recurrence of symptoms.
Single-ring posterior left atrial (box) isolation results in a different mode of recurrence compared with wide antral pulmonary vein isolation on long-term follow-up: longer atrial fibrillation-free survival time but similar survival time free of any atrial arrhythmia.

Electric isolation of the pulmonary veins and posterior left atrium with a single ring of radiofrequency lesions (single-ring isolation [SRI]) may result in fewer atrial fibrillation (AF) recurrences than wide antral pulmonary vein isolation (wide antral isolation [WAI]) by abolishing extravenous AF triggers. The effect of mitral isthmus line (MIL) ablation on outcomes after SRI has not previously been assessed.



We randomly assigned 220 consecutive patients (58 ± 10 years old; 82% men) with highly symptomatic AF (61% paroxysmal, 39% persistent/longstanding persistent) to undergo either SRI or WAI. Half of each cohort was also randomly allocated to have left lateral MIL ablation (2 ×2 factorial study design). Patients were followed clinically and with 7-day Holter studies for arrhythmia recurrences. The primary end points were recurrence of AF and organized atrial tachyarrhythmias. AF-free survival at 2 years was better after SRI (74% [95% CI, 65%-82%]) than WAI (61% [51%-70%]; P=0.031). Organized atrial tachyarrhythmia-free survival was similar after SRI and WAI (67% [57%-75%] ersus 64% [54%-72%], respectively, at 2 years; P=0.988). MIL ablation resulted in better 2-year organized atrial tachyarrhythmia-free survival (71% [62%-79%] versus 60% [50%-69%]; P=0.07), which approached statistical significance. Survival free of any atrial arrhythmia after one procedure was not significantly affected by isolation technique or MIL ablation. Conclusions- SRI resulted in fewer AF recurrences compared with WAI on long-term follow-up but did not reduce the recurrence of all atrial arrhythmias. MIL ablation may reduce organized atrial tachyarrhythmia recurrences.
Performance of a hybrid central venous catheter utilized for both peripheral blood stem cell harvest and transplant support of patients undergoing autologous peripheral blood stem cell transplantation

Patients undergoing autologous peripheral blood stem cell transplantation (PBSC) frequently require the sequential insertion of two central venous catheters, one for leukapheresis and one for transplant support. Hybrid catheters suitable for leukapheresis and long-term use have been increasingly used, but there is limited information regarding their performance and complication rate. The purpose of this study was to determine the performance of the Pheres-Flow hybrid catheter when utilized for both leukapheresis and transplant support, with particular emphasis on the incidence of infectious and occlusive complications. We prospectively analyzed the performance of 92 catheters in 82 consecutive patients who underwent autologous peripheral blood stem cell (PBSC) transplantation. Occlusion was the most frequent complication of this catheter with 29% of the patients experiencing difficulty drawing blood or infusing fluids. Infection was another frequent complication. Twenty-two percent of patients developed catheter-related bloodstream infections and 15 catheters had to be removed because of proven or suspected infection that did not respond to antibiotic therapy. Nevertheless, 77% of patients were able to complete leukapheresis and transplant support with only one catheter. We conclude that the utilization of the Pheres-Flow catheter for both leukapheresis and transplant support is feasible, but that new strategies need to be developed to decrease the incidence of occlusive and infectious complications of hybrid catheters.
Predicting Heart Failure With Preserved and Reduced Ejection Fraction: The International Collaboration on Heart Failure Subtypes.

Heart failure (HF) is a prevalent and deadly disease, and preventive strategies focused on at-risk individuals are needed. Current HF prediction models have not examined HF subtypes. We sought to develop and validate risk prediction models for HF with preserved and reduced ejection fraction (HFpEF, HFrEF).



Of 28,820 participants from 4 community-based cohorts, 982 developed incident HFpEF and 909 HFrEF during a median follow-up of 12 years. Three cohorts were combined, and a 2:1 random split was used for derivation and internal validation, with the fourth cohort as external validation. Models accounted for multiple competing risks (death, other HF subtype, and unclassified HF). The HFpEF-specific model included age, sex, systolic blood pressure, body mass index, antihypertensive treatment, and previous myocardial infarction; it had good discrimination in derivation (c-statistic 0.80; 95% confidence interval [CI], 0.78-0.82) and validation samples (internal: 0.79; 95% CI, 0.77-0.82 and external: 0.76; 95% CI: 0.71-0.80). The HFrEF-specific model additionally included smoking, left ventricular hypertrophy, left bundle branch block, and diabetes mellitus; it had good discrimination in derivation (c-statistic 0.82; 95% CI, 0.80-0.84) and validation samples (internal: 0.80; 95% CI, 0.78-0.83 and external: 0.76; 95% CI, 0.71-0.80). Age was more strongly associated with HFpEF, and male sex, left ventricular hypertrophy, bundle branch block, previous myocardial infarction, and smoking with HFrEF (P value for each comparison ≤0.02).



We describe and validate risk prediction models for HF subtypes and show good discrimination in a large sample. Some risk factors differed between HFpEF and HFrEF, supporting the notion of pathogenetic differences among HF subtypes.