nils-herrmann/clean_scirepeval huggingface dataset:
Development and validation of the stroke action test.

Accurately assessing the public's readiness to respond to stroke is important. Most published measures are based on recall or recognition of stroke symptoms, or knowledge of the best action for stroke when the diagnosis is provided. The purpose of this study was to develop and evaluate a new written instrument whose items require the respondent to associate individual symptoms with the most appropriate action.



The Stroke Action Test (STAT) contains 21 items that name or describe stroke symptoms from all 5 groups of warning signs and 7 items that are nonstroke symptoms. For each item, the respondent selects 1 of 4 options: call 911, call doctor, wait 1 hour, or wait 1 day. The instrument validation sample included 249 subjects from community-based organizations. Score reliability and validity were analyzed using multiple data and information sources.



The mean overall STAT score (all 28 items) for the lay people was 36.8%. On average, they chose call 911 for 34.1% of the stroke symptoms. They chose call doctor for 39.4% of the stroke symptoms, wait 1 hour for 20.1%, and wait 1 day for 6.0%. Score reliability is good (alpha=0.83). Evidence confirming score validity is presented based on analysis of item content and response patterns, and examination of the relationships between test scores and key variables related to stroke knowledge.



STAT directly assesses a critical aspect of practical stroke knowledge that has been largely overlooked and provides scores with good reliability and validity.
Influence of nurses on compliance with breast screening recommendations in an organized breast screening program.

Evidence from breast screening trials has shown that a significant reduction in breast cancer mortality from screening can be achieved by regular attendance. Few studies have evaluated the influence of nurses on compliance with breast screening recommendations.



The cohort included 157,788 women ages 50 to 69 years who were screened at 1 of 9 regional cancer centers or 57 affiliated centers with nurses or 26 affiliated centers without nurses between January 1, 2002, and December 31, 2002, within the Ontario Breast Screening Program. These women were followed up prospectively for at least 30 months to compare compliance for annual and biennial screening recommendations among women who attended centers with and without nurses. The associations between type of screening center and the odds of compliance were modeled using mixed-effect logistic regression models. All P values are two-sided.



Women attending a regional cancer center [odds ratios (OR), 1.96; 95% confidence interval (95% CI), 1.07-3.58] or affiliated center with nurses (OR, 1.75; 95% CI, 1.38-2.22) were significantly more likely to return within 18 months of their annual screening recommendation than women attending affiliated centers without nurses. In addition, women attending regional cancer centers (OR, 2.28; 95% CI, 1.34-3.89) or affiliated centers with nurses (OR, 2.30; 95% CI, 1.86-2.83) were significantly more likely to make a timely return within the recommended biennial screening interval of between 18 and 30 months.



Breast screening programs should consider methods of integrating educational activities as provided by the nurses to improve compliance with screening.
Draft Report of the SIGCSE Committee on Computing Education in the Liberal Arts

The SIGCSE Committee on Computing Education in the Liberal Arts seeks to identify distinctive needs of liberal arts computing educators, and to suggest ways of addressing those needs. This session will be the initial presentation of the Committee's findings and recommendations, and a chance for the community to comment on the results prior to our final written report. The Committee found considerable variety among liberal arts computing programs, but enough common features to consider "liberal arts computing program" to be a distinct category with needs that arise from its shared features. The liberal arts computing community expressed a very strong desire for a permanent organization to support its members and represent its interests to the rest of the world. Conversely, we see evidence that the computing education community as a whole values liberal arts computing perspectives and would benefit from a well-defined source for those perspectives. The Committee's main recommendation is therefore to establish a permanent liberal arts computing organization that can serve both to support computing education in the liberal arts and to represent that community in larger conversations.
Serum sex steroids in premenopausal women and breast cancer risk within the European Prospective Investigation into Cancer and Nutrition (EPIC).

Contrasting etiologic hypotheses about the role of endogenous sex steroids in breast cancer development among premenopausal women implicate ovarian androgen excess and progesterone deficiency, estrogen excess, estrogen and progesterone excess, and both an excess or lack of adrenal androgens (dehydroepiandrosterone [DHEA] or its sulfate [DHEAS]) as risk factors. We conducted a case-control study nested within the European Prospective Investigation into Cancer and Nutrition cohort to examine associations among premenopausal serum concentrations of sex steroids and subsequent breast cancer risk.



Levels of DHEAS, (Delta4-)androstenedione, testosterone, and sex hormone binding globulin (SHBG) were measured in single prediagnostic serum samples from 370 premenopausal women who subsequently developed breast cancer (case patients) and from 726 matched cancer-free control subjects. Levels of progesterone, estrone, and estradiol were also measured for the 285 case patients and 555 matched control subjects who had provided information about the day of menstrual cycle at blood donation. Conditional logistic regression models were used to estimate relative risks of breast cancer by quartiles of hormone concentrations. All statistical tests were two-sided.



Increased risks of breast cancer were associated with elevated serum concentrations of testosterone (odds ratio [OR] for highest versus lowest quartile = 1.73, 95% confidence interval [CI] = 1.16 to 2.57; P(trend) = .01), androstenedione (OR for highest versus lowest quartile = 1.56, 95% CI = 1.05 to 2.32; P(trend) = .01), and DHEAS (OR for highest versus lowest quartile = 1.48, 95% CI = 1.02 to 2.14; P(trend) = .10) but not SHBG. Elevated serum progesterone concentrations were associated with a statistically significant reduction in breast cancer risk (OR for highest versus lowest quartile = 0.61, 95% CI = 0.38 to 0.98; P(trend) = .06). The absolute risk of breast cancer for women younger than 40 followed up for 10 years was estimated at 2.6% for those in the highest quartile of serum testosterone versus 1.5% for those in the lowest quartile; for the highest and lowest quartiles of progesterone, these estimates were 1.7% and 2.6%, respectively. Breast cancer risk was not statistically significantly associated with serum levels of the other hormones.



Our results support the hypothesis that elevated blood concentrations of androgens are associated with an increased risk of breast cancer in premenopausal women.
Multi-Resolution Level Sets with Shape Priors: A Validation Report for 2D Segmentation of Prostate Gland in T2W MR Images

The level set approach to segmentation of medical images has received considerable attention in recent years. Evolving an initial contour to converge to anatomical boundaries of an organ or tumor is a very appealing method, especially when it is based on a well-defined mathematical foundation. However, one drawback of such evolving method is its high computation time. It is desirable to design and implement algorithms that are not only accurate and robust but also fast in execution. Bresson et al. have proposed a variational model using both boundary and region information as well as shape priors. The latter can be a significant factor in medical image analysis. In this work, we combine the variational model of level set with a multi-resolution approach to accelerate the processing. The question is whether a multi-resolution context can make the segmentation faster without affecting the accuracy. As well, we investigate the question whether a premature convergence, which happens in a much shorter time, would reduce accuracy. We examine multiple semiautomated configurations to segment the prostate gland in T2W MR images. Comprehensive experimentation is conducted using a data set of a 100 patients (1,235 images) to verify the effectiveness of the multi-resolution level set with shape priors. The results show that the convergence speed can be increased by a factor of ≈ 2.5 without affecting the segmentation accuracy. Furthermore, a premature convergence approach drastically increases the segmentation speed by a factor of ≈ 17.9.
Testing Messages to Encourage Discussion of Clinical Trials Among Cancer Survivors and Their Physicians: Examining Monitoring Style and Message Detail

Encouraging cancer survivors to discuss clinical trials with their physicians may increase enrollment in clinical trials. Health messages offer one method for encouraging such discussions. We hypothesized that matching messages to an individual’s preference for detailed or non-detailed information (i.e., monitoring style) would result in more discussions. Participants (N = 538) were cancer survivors, who phoned the National Cancer Institute’s Cancer Information Service (CIS). Participants were classified as higher or lower monitors and then randomized to receive detailed or non-detailed messages in the mail 1 and 4 weeks following their baseline CIS call. At 12 weeks, there was a significant interaction between monitoring style and message detail. Follow-up analyses were nonsignificant but suggested a theoretically consistent pattern in which non-detailed messages were more effective among lower monitors. These findings imply that providing extremely detailed information may be excessive, even to individuals engaged in information seeking behavior.
Penthrox alone versus Penthrox plus periprostatic infiltration of local analgesia for analgesia in transrectal ultrasound-guided prostate biopsy.

The objective of this study was to compare pain intensity in patients undergoing transrectal ultrasound (TRUS)-guided biopsy of the prostate with Penthrox alone compared with Penthrox plus periprostatic infiltration of local analgesia (PILA).



Seventy-two subjects participated in this study after receiving appropriate education. Forty-two patients self-administered inhaled Penthrox (3 mL methoxyflurane) alone for analgesia (Group A), followed by 30 patients who self-administered Penthrox and received PILA with 5 mL of 2% lignocaine. All subjects had TRUS biopsy performed. Immediately after the procedure, patients were asked to rate their pain intensity using a numerical verbal rating scale from 0 to 10.



Baseline characteristics of the two groups were similar. Patients in Group B reported significantly lower post TRUS biopsy median pain intensity of 2 (1-3) compared with Group A subjects who reported a median post TRUS biopsy pain intensity of 3 (2-5) (P = 0.014). A total of 72 men underwent TRUS-guided biopsy. All patients indicated they would be happy to have another TRUS-guided prostate biopsy in the future.



Our study shows that Penthrox plus PILA shows promise as an efficacious and easily tolerated analgesic technique for outpatient TRUS biopsy, keeping resource use to a minimum. Planning for a multi-centre, double-blind randomized control trial comparing Penthrox plus PILA with PILA alone is presently underway.
A dose-escalation and pharmacokinetic study of gemcitabine and oxaliplatin in patients with advanced solid tumors.

Gemcitabine and oxaliplatin have broad antineoplastic activity and favorable toxicity. We conducted a phase I study to determine the maximum tolerated doses (MTDs) and dose-limiting toxicities (DLTs) of the combination in patients with advanced solid tumors.



Sixty-eight patients with advanced stage solid tumors were enrolled. Treatment was first-line for 35% of patients, second-line for 27%, and third-line for 38%. Gemcitabine was administered at escalating doses of 1000-2000 mg/m(2) as a 30-min intravenous (i.v.) infusion on days 1 and 8 and oxaliplatin at 60-130 mg/m(2) as a 4-h i.v. infusion on day 8 every 21 days without growth factor support.



The MTD was defined at gemcitabine 1800 mg/m(2) on days 1 and 8 and oxaliplatin 130 mg/m(2) on day 8. Twelve dose levels were evaluated and DLTs occurring during the first cycle consisted of grade 4 neutropenia, grade 3 asthenia or mucositis and grade 1-3 neutropenia or thrombocytopenia resulting in treatment delays. A total of 266 cycles were administered with only one episode of febrile neutropenia and no toxic deaths. Seven (3%) and 26 (10%) cycles were complicated by grade 4 and 3 neutropenia, respectively, three (1%) and 13 (5%) by grade 4 and 3 thrombocytopenia, and eight (3%) by grade 3 anemia. The most common non-hematological toxicity was grade 2/3 asthenia observed in 23% of cycles. Responses were observed in patients with a variety of epithelial neoplasms. The pharmacokinetic study revealed no significant interaction between the two drugs.



The combination of gemcitabine and oxaliplatin has excellent tolerability and promising activity in patients with advanced solid tumors. As the MTD exceeds the recommended single-agent dose for gemcitabine, and a dose-response effect has not been established, we recommend using both drugs at full doses, e.g. gemcitabine 1200-1400 mg/m(2) on days 1 and 8 and oxaliplatin 130 mg/m(2) on day 8 for further phase II studies.
Practical animation of liquids

We present a general method for modeling and animating liquids. The system is specifically designed for computer animation and handles viscous liquids as they move in a 3D environment and interact with graphics primitives such as parametric curves and moving polygons. We combine an appropriately modified semi-Lagrangian method with a new approach to calculating fluid flow around objects. This allows us to efficiently solve the equations of motion for a liquid while retaining enough detail to obtain realistic looking behavior. The object interaction mechanism is extended to provide control over the liquid s 3D motion. A high quality surface is obtained from the resulting velocity field using a novel adaptive technique for evolving an implicit surface.
Illness Identity in Adolescents and Emerging Adults With Type 1 Diabetes: Introducing the Illness Identity Questionnaire.

The current study examined the utility of a new self-report questionnaire, the Illness Identity Questionnaire (IIQ), which assesses the concept of illness identity, or the degree to which type 1 diabetes is integrated into one's identity. Four illness identity dimensions (engulfment, rejection, acceptance, and enrichment) were validated in adolescents and emerging adults with type 1 diabetes. Associations with psychological and diabetes-specific functioning were assessed.



A sample of 575 adolescents and emerging adults (14-25 years of age) with type 1 diabetes completed questionnaires on illness identity, psychological functioning, diabetes-related problems, and treatment adherence. Physicians were contacted to collect HbA1c values from patients' medical records. Confirmatory factor analysis (CFA) was conducted to validate the IIQ. Path analysis with structural equation modeling was used to examine associations between illness identity and psychological and diabetes-specific functioning.



CFA indicated that the IIQ has a clear factor structure, meaningfully differentiating four illness identity dimensions. Rejection was related to worse treatment adherence and higher HbA1c values. Engulfment was related to less adaptive psychological functioning and more diabetes-related problems. Acceptance was related to more adaptive psychological functioning, fewer diabetes-related problems, and better treatment adherence. Enrichment was related to more adaptive psychological functioning.



The present findings underscore the importance of the concept of illness identity. A valid and reliable measure, the IIQ, is introduced to measure four illness identity dimensions in individuals with type 1 diabetes. These four illness identity dimensions were uniquely related to psychological and diabetes-specific functioning.
Do acute elevations of serum creatinine in primary care engender an increased mortality risk?

The significant impact Acute Kidney Injury (AKI) has on patient morbidity and mortality emphasizes the need for early recognition and effective treatment. AKI presenting to or occurring during hospitalisation has been widely studied but little is known about the incidence and outcomes of patients experiencing acute elevations in serum creatinine in the primary care setting where people are not subsequently admitted to hospital. The aim of this study was to define this incidence and explore its impact on mortality.



The study cohort was identified by using hospital data bases over a six month period.



People with a serum creatinine request during the study period, 18 or over and not on renal replacement therapy.The patients were stratified by a rise in serum creatinine corresponding to the Acute Kidney Injury Network (AKIN) criteria for comparison purposes. Descriptive and survival data were then analysed.Ethical approval was granted from National Research Ethics Service (NRES) Committee South East Coast and from the National Information Governance Board.



The total study population was 61,432. 57,300 subjects with 'no AKI', mean age 64.The number (mean age) of acute serum creatinine rises overall were, 'AKI 1' 3,798 (72), 'AKI 2' 232 (73), and 'AKI 3' 102 (68) which equates to an overall incidence of 14,192 pmp/year (adult). Unadjusted 30 day survival was 99.9% in subjects with 'no AKI', compared to 98.6%, 90.1% and 82.3% in those with 'AKI 1', 'AKI 2' and 'AKI 3' respectively. After multivariable analysis adjusting for age, gender, baseline kidney function and co-morbidity the odds ratio of 30 day mortality was 5.3 (95% CI 3.6, 7.7), 36.8 (95% CI 21.6, 62.7) and 123 (95% CI 64.8, 235) respectively, compared to those without acute serum creatinine rises as defined.



People who develop acute elevations of serum creatinine in primary care without being admitted to hospital have significantly worse outcomes than those with stable kidney function.
Decreasing adrenergic or sympathetic hyperactivity after severe traumatic brain injury using propranolol and clonidine (DASH After TBI Study): study protocol for a randomized controlled trial

Severe TBI, defined as a Glasgow Coma Scale ≤ 8, increases intracranial pressure and activates the sympathetic nervous system. Sympathetic hyperactivity after TBI manifests as catecholamine excess, hypertension, abnormal heart rate variability, and agitation, and is associated with poor neuropsychological outcome. Propranolol and clonidine are centrally acting drugs that may decrease sympathetic outflow, brain edema, and agitation. However, there is no prospective randomized evidence available demonstrating the feasibility, outcome benefits, and safety for adrenergic blockade after TBI.



The DASH after TBI study is an actively accruing, single-center, randomized, double-blinded, placebo-controlled, two-arm trial, where one group receives centrally acting sympatholytic drugs, propranolol (1 mg intravenously every 6 h for 7 days) and clonidine (0.1 mg per tube every 12 h for 7 days), and the other group, double placebo, within 48 h of severe TBI. The study uses a weighted adaptive minimization randomization with categories of age and Marshall head CT classification. Feasibility will be assessed by ability to provide a neuroradiology read for randomization, by treatment contamination, and by treatment compliance. The primary endpoint is reduction in plasma norepinephrine level as measured on day 8. Secondary endpoints include comprehensive plasma and urine catecholamine levels, heart rate variability, arrhythmia occurrence, infections, agitation measures using the Richmond Agitation-Sedation Scale and Agitated Behavior scale, medication use (anti-hypertensive, sedative, analgesic, and antipsychotic), coma-free days, ventilator-free days, length of stay, and mortality. Neuropsychological outcomes will be measured at hospital discharge and at 3 and 12 months. The domains tested will include global executive function, memory, processing speed, visual-spatial, and behavior. Other assessments include the Extended Glasgow Outcome Scale and Quality of Life after Brain Injury scale. Safety parameters evaluated will include cardiac complications.



The DASH After TBI Study is the first randomized, double-blinded, placebo-controlled trial powered to determine feasibility and investigate safety and outcomes associated with adrenergic blockade in patients with severe TBI. If the study results in positive trends, this could provide pilot evidence for a larger multicenter randomized clinical trial. If there is no effect of therapy, this trial would still provide a robust prospective description of sympathetic hyperactivity after TBI.
Arthroscopic pancapsular plication for multidirectional shoulder instability in overhead athletes.

Treating shoulder multidirectional instability with an open stabilization procedure has been reported to have good results. However, few studies exist of arthroscopic plication, especially in overhead athletes. The purpose of this study was to evaluate the clinical outcomes of arthroscopic pancapsular plication for multidirectional instability in overhead athletes.Twenty-three athletes with symptomatic multidirectional instability were treated with arthroscopic pancapsular plication and evaluated at a mean follow-up of 36.3 months (range, 24-61 months). Mean patient age was 23.3 years (range, 19-33 years). Functional outcomes were evaluated with the American Shoulder and Elbow Surgeons (ASES) score, Constant shoulder score, and Rowe instability score. The degree of pain and range of motion were also recorded. All postoperative functional scores were rated good to excellent, with an average ASES score of 88.4 (range, 82-95), average Constant shoulder score of 88.1 (range, 81-100), and average Rowe instability score of 86.7 (range, 80-100). Five patients returned to the same level of competitive sports, and 18 returned to a limited level. All patients were satisfied with the stability postoperatively. No significant change was observed in postoperative range of motion, but patients who returned to a limited level of sports had lower functional scores and more pain than did those who fully returned to sports.Arthroscopic pancapsular plication for treating multidirectional instability in overhead athletes can provide good stability. However, the low rate of return to a full level of overhead sports is a problem. Further evaluation of the benefits of this procedure for overhead athletes with symptomatic multidirectional instability is needed.
Effects of fluconazole and clarithromycin on rifabutin and 25-O-desacetylrifabutin pharmacokinetics.

Ten human immunodeficiency virus-infected patients were given rifabutin in addition to fluconazole and clarithromycin. There was a 76% increase in the area under the concentration-time curve of rifabutin when either fluconazole or clarithromycin was given alone and a 152% increase when both drugs were given together with rifabutin. Patients should be monitored for adverse effects of rifabutin administered concomitantly with clarithromycin and/or fluconazole.