nils-herrmann/clean_scirepeval huggingface dataset:
Dual protection therapy with staged coronary artery bypass surgery and stenting in patients with left main coronary artery stenosis: long-term results from a single center.

We evaluated the efficacy and safety of dual protection therapy with staged coronary artery bypass grafting (CABG) and bare-metal stenting (BMS) in patients with left main coronary artery (LMCA) disease.



CABG is currently the preferred therapy for complex LMCA disease; however, the long-term patency rates of these grafts are unsatisfactory, and stenting alone for LMCA may be associated with the potentially fatal consequences of stent thrombosis or restenosis.



Between January 1997 and October 2005, 42 patients underwent staged bypass surgery and BMS, with the latter procedure performed 2 weeks after the initial CABG. Of these patients, 40 received left internal mammary artery (LIMA) grafts, 34 saphenous vein grafts, 6 radial artery grafts, and 3 right IMA (RIMA) grafts. Minimally invasive bypass surgery was performed in 10 patients.



There were no operative complications. Forty-two stents were implanted in 42 lesions without complications. During the follow-up period of 135 ± 55 months, 1 patient died of cancer, 2 of cardiac causes, and 5 patients (12%) experienced target lesion revascularization. The target vessel failure rate was 24%. Forty patients (95%) underwent a 6-month angiographic follow-up. Restenosis was noted in 7 patients (18%). Reocclusion was also noted in 5 LIMA grafts, 5 saphenous vein grafts, 1 radial artery graft, and 1 RIMA graft. Only 1 patient experienced both restenosis of LM stenting and total occlusion of the 2 bypass grafts.



Dual protection therapy with staged CABG and stenting is not an appropriate therapeutic strategy because of unacceptable graft patency rate. A higher occlusive rate of the bypass grafts may result from decreased blood flow because of competing blood flow between the bypass graft and the native coronary vessel.
Genetic association and brain morphology studies and the chromosome 8p22 pericentriolar material 1 (PCM1) gene in susceptibility to schizophrenia.

There is evidence of linkage to a schizophrenia susceptibility locus on chromosome 8p21-22 found by several family linkage studies.



To fine map and identify a susceptibility gene for schizophrenia on chromosome 8p22 and to investigate the effect of this genetic susceptibility on an endophenotype of abnormal brain structure using magnetic resonance imaging.



Fine mapping and identification of a chromosome 8p22 susceptibility gene was carried out by finding linkage disequilibrium between genetic markers and schizophrenia in multiply affected families, a case-control sample, and a trio sample. Variation in brain morphology associated with pericentriolar material 1 (PCM1) alleles was examined using voxel-based morphometry and statistical parametric mapping with magnetic resonance imaging.  A family sample of 13 large families multiply affected with schizophrenia, 2 schizophrenia case-control samples from the United Kingdom and Scotland, and a sample of schizophrenic trios from the United States containing parents and 1 affected child with schizophrenia.



Tests of transmission disequilibrium between PCM1 locus polymorphisms and schizophrenia using a family sample and tests of allelic association in case-control and trio samples. Voxel-based morphometry using statistical parametric mapping.



The family and trio samples both showed significant transmission disequilibrium between marker D85261 in the PCM1 gene locus and schizophrenia. The case-control sample from the United Kingdom also found significant allelic association between PCM1 gene markers and schizophrenia. Voxel-based morphometry of cases who had inherited a PCM1 genetic susceptibility showed a significant relative reduction in the volume of orbitofrontal cortex gray matter in comparison with patients with non-PCM1-associated schizophrenia, who, by contrast, showed gray matter volume reduction in the temporal pole, hippocampus, and inferior temporal cortex.



The PCM1 gene is implicated in susceptibility to schizophrenia and is associated with orbitofrontal gray matter volumetric deficits.
The effects of interval- vs. continuous exercise on excess post-exercise oxygen consumption and substrate oxidation rates in subjects with type 2 diabetes.

For unknown reasons, interval training often reduces body weight more than energy-expenditure matched continuous training. We compared the acute effects of time-duration and oxygen-consumption matched interval- vs. continuous exercise on excess post-exercise oxygen consumption (EPOC), substrate oxidation rates and lipid metabolism in the hours following exercise in subjects with type 2 diabetes (T2D).



Following an overnight fast, ten T2D subjects (M/F: 7/3; age=60.3±2.3years; body mass index (BMI)=28.3±1.1kg/m(2)) completed three 60-min interventions in a counterbalanced, randomized order: 1) control (CON), 2) continuous walking (CW), 3) interval-walking (IW - repeated cycles of 3min of fast and 3min of slow walking). Indirect calorimetry was applied during each intervention and repeatedly for 30min per hour during the following 5h. A liquid mixed meal tolerance test (MMTT, 450kcal) was consumed by the subjects 45min after completion of the intervention with blood samples taken regularly.



Exercise interventions were successfully matched for total oxygen consumption (CW=1641±133mL/min; IW=1634±126mL/min, P>0.05). EPOC was higher after IW (8.4±1.3l) compared to CW (3.7±1.4l, P<0.05). Lipid oxidation rates were increased during the MMTT in IW (1.03±0.12mg/kg per min) and CW (0.87±0.04mg/kg per min) compared with CON (0.73±0.04mg/kg per min, P<0.01 and P<0.05, respectively), with no difference between IW and CW. Moreover, free fatty acids and glycerol concentrations, and glycerol kinetics were increased comparably during and after IW and CW compared to CON.



Interval exercise results in greater EPOC than oxygen-consumption matched continuous exercise during a post-exercise MMTT in subjects with T2D, whereas effects on substrate oxidation and lipid metabolism are comparable.
Cost-effectiveness of preventing depression in primary care patients: randomised trial.

Little is known about the cost-effectiveness of preventing mental disorders.



To study the cost-effectiveness of care as usual plus minimal contact psychotherapy relative to usual care alone in preventing depressive disorder.



An economic evaluation was conducted alongside a randomised clinical trial. Primary care patients with sub-threshold depression were assigned to minimal contact psychotherapy plus usual care (n=107) or to usual care alone (n=109).



Primary care patients with sub-threshold depression benefited from minimal contact psychotherapy as it reduced the risk of developing a full-blown depressive disorder from 18% to 12%. In addition, this intervention had a 70% probability of being more cost-effective than usual care alone. A sensitivity analysis indicated the robustness of these results.



Over 1 year adjunctive minimal contact psychotherapy improved outcomes and generated lower costs. This intervention is therefore superior to usual care alone in terms of cost-effectiveness.
Treatment of diabetic nephropathy with Tripterygium wilfordii Hook F extract: a prospective, randomized, controlled clinical trial

Diabetic nephropathy (DN) is the most common cause of end-stage renal failure. Although angiotensin II receptor blockers (ARBs) can be used to attenuate proteinuria in DN patients, their efficacy remains limited. This clinical trial aimed to evaluate the efficacy of Tripterygium wilfordii Hook F (TwHF) extract in the treatment of type 2 diabetes mellitus (DM)-induced nephropathy. A total of 65 DN patients with proteinuria levels ≥ 2.5 g/24 h and serum creatinine levels < 3 mg/dl were enrolled in this six-month, prospective, randomized, controlled study. The patients were randomized into treatment groups that received either 120 mg of TwHF extract per day for three months, followed by 60 mg per day for three more months, or 160 mg of valsartan daily for six months. The urinary protein and estimated glomerular filtration (eGFR) level were measured at one, three, and six months after the commencement of treatment. The primary measure of treatment efficacy was a reduction in the 24-h urine protein level between baseline and the end of the study, and the secondary measure of treatment efficacy was a reduction in the eGFR value. At the end of the treatment period, the mean urine protein level in the TwHF group was dramatically decreased (4.99 ± 2.25 g/24 h vs 2.99 ± 1.81 g/24 h, p < 0.01), with decreases at one, three, and six months of 32.9%, 38.8%, and 34.3%, respectively. In contrast, the proteinuria in the valsartan group was not significantly attenuated, and the decreases in urine protein levels at treatment months one, three, and six were 1.05%, 10.1%, and -11.7%, respectively. The mean decrease in eGFR in the valsartan group was greater than that in the TwHF group (26.4% vs. 13.7%, respectively; p =0.067). TwHF extract can reduce the urine protein level of DN patients and represents a novel, potentially effective, and safe drug for the treatment of DN patients with proteinuria.
Menopausal status strongly influences the utility of predictive models in differential diagnosis of ovarian tumors: an external validation of selected diagnostic tools.

The aim of this study was to externally validate the diagnostic performance of the International Ovarian Tumor Analysis logistic regression models (LR1 and LR2, 2005) and other popular prognostic models including the Timmerman logistic regression model (1999), the Alcazar model (2003), the risk of malignancy index (RMI, 1990), and the risk of malignancy algorithm (ROMA, 2009). We compared these models to subjective ultrasonographic assessment performed by an experienced ultrasonography specialist, and with our previously developed scales: the sonomorphologic index and the vascularization index. Furthermore, we evaluated diagnostic tests with regard to the menopausal status of patients.



This study included 268 patients with adnexal masses; 167 patients with benign ovarian tumors and 101 patients with malignant ovarian tumors were enrolled. All tumors were evaluated by using trans- vaginal ultrasonography according to the diagnostic criteria of the analyzed models.



This study included 268 patients with adnexal masses; 167 patients with benign ovarian tumors and 101 patients with malignant ovarian tumors were enrolled. All tumors were evaluated by using trans- vaginal ultrasonography according to the diagnostic criteria of the analyzed models.



The subjective ultrasonographic assessment and all of the studied predictive models achieved similar diagnostic performance in the whole study population. However significant differences were observed when pre- and postmenopausal patients were analyzed separately In the subgroup of premenopausal patients, the highest area under the curve (AUC) was achieved by subjective ultrasonographic assessment (0.931), the Alcazar model (0.912), and LR1 (0.909). Alternatively in the group of postmenopausal patients, the highest AUC was noted for the Timmerman model (0.973), ROMA (0.951), and RMI (0.938).



Menopausal status is a key factor that affects the utility of prognostic models for differential diagno sis of ovarian tumors. Diagnostic models of ovarian tumors are reasonable tools for predicting tumor malignancy
The GADD45A (1506T>C) Polymorphism Is Associated with Ovarian Cancer Susceptibility and Prognosis

GADD45A (growth arrest and DNA damage 45 A) is the first stress-inducible gene identified to be a target of p53. However, no studies to date have assessed variants of the GADD45 gene and their potential relationship to tumor susceptibility. We investigated the association of the GADD45A (1506T>C) polymorphism with ovarian cancer development in 258 ovarian cancer patients and 332 age-matched healthy women as controls using sequence analysis. We found a statistically significant difference in the GADD45A (1506T>C) genotype distributions between the case and control groups (TT vs. TC vs. CC, P = 0.0021) and found that variant 1506T>C was significantly associated with an increased risk of ovarian cancer (P<0.001, OR = 1.71, 95% CI [1.28-2.29]). We observed a statistically significant effect between tumor histology (P = 0.032) and CA125 status (P = 0.021). Carrying the C allele (TC+CC) was associated with an increased risk of positive CA125 (OR = 3.20, 95% CI [1.15-8.71). Carrying the T allele (TT+TC) showed a significant correlation with both higher GADD45A mRNA expression and longer ovarian cancer RFS (relapse-free survival) and OS (overall survival). We are the first group to demonstrate that the GADD45A (1506T>C) polymorphism is associated with ovarian cancer susceptibility and prognosis. These data suggest that GADD45A (1506T>C) is a new tumor susceptibility gene and could be a useful molecular marker for assessing ovarian cancer risk and for predicting ovarian cancer patient prognosis.
Fixed-Dose Combinations of Renin–Angiotensin System Inhibitors and Calcium Channel Blockers in the Treatment of Hypertension

Fixed-dose combinations (FDCs) of different regimens are recommended in guidelines for the treatment of hypertension. However, clinical studies comparing FDCs of angiotensin receptor blocker (ARB)/calcium channel blocker (CCB) and angiotensin-converting enzyme inhibitor (ACE inhibitor)/CCB in hypertensive patients are lacking.Using a propensity score matching of 4:1 ratio, this retrospective claims database study compared 2 FDC regimens, ARB/CCB and ACE inhibitor/CCB, in treating hypertensive patients with no known atherosclerotic cardiovascular disease. All patients were followed for at least 3 years or until the development of major adverse cardiovascular events (MACEs) during the study period. In addition, the effect of medication adherence on clinical outcomes was evaluated in subgroup analysis based on different portions of days covered.There was no significant difference in MACE-free survival (hazard ratio [HR]: 1.21; 95% confidence interval [CI]: 0.98-1.50; P = 0.08) and survival free from hospitalization for heart failure (HR: 1.15; 95% CI: 082-1.61; P = 0.431), new diagnosis of chronic kidney disease (HR: 0.98; 95% CI: 071-1.36; P = 0.906), and initiation of dialysis (HR: 0.99; 95% CI: 050-1.92; P = 0.965) between the 2 study groups. The results remained the same within each subgroup of patients with different adherence statuses.ARBs in FDC regimens with CCBs in the present study were shown to be as effective as ACE inhibitors at reducing the risks of MACEs, hospitalization for heart failure, new diagnosis of chronic kidney disease, and new initiation of dialysis in hypertensive patients, regardless of the medication adherence status.
Validation of the Screening Tool for the Assessment of Malnutrition in Paediatrics (STAMP) in patients with spinal cord injuries (SCIs)

To validate the Screening Tool for the Assessment of Malnutrition in Paediatrics (STAMP) in paediatric spinal cord injuries (SCIs) patients admitted to the tertiary SCI centre.children’s baseline clinical data, anthropometric measurements and STAMP score were assessed on admission. The validity of STAMP was assessed by (i) comparison with a full dietetic assessment (criterion validity); (ii) comparison with generic paediatric screening tools: the Paediatric Yorkhill Malnutrition Score (PYMS; concurrent validity); and (iii) completion of an additional STAMP to assess inter- and intra-rater reliability. The agreement was assessed using Cohen’s κ-statistics.Fifty-one children were screened by STAMP. The prevalence of undernutrition risk was 58.8%. STAMP had moderate agreement with dietitian assessment (κ: 0.507) and a fair agreement with PYMS (κ: 0.314). The STAMP had substantial reliability (inter-rater reliability: κ: 0.752; intra-rater reliability: κ: 0.635). When compared with dietetic assessment as a reference standard, STAMP had a sensitivity of 83.3%, specificity of 66.7% and an overall agreement of 76.5%.Conclusion:The present study shows that undernutrition is common in children with SCI. The STAMP is an acceptable (valid and reliable) tool to identify paediatric SCI patients at risk of undernutrition.
Antecedents of chronic lung disease following three patterns of early respiratory disease in preterm infants.

The incidence of chronic lung disease (CLD) varies among groups defined by their early pattern of respiratory disease.



The study examined data collected prospectively on 1204 of the 1506 infants born in 2002-2004 at 23-27 weeks gestation who survived to 36 weeks post-menstrual age. Based on their initial respiratory presentation and need for supplemental oxygen during the first 2 weeks, infants were classified as having early and persistent pulmonary dysfunction (EPPD), early recovery of pulmonary function followed by deterioration (PD) or consistently good pulmonary function characterised by low FiO(2) (Low FiO(2)).



CLD was diagnosed in 69% of infants with EPPD, 52% with PD, and 17% in the Low FiO(2) group. Birth weight z score <-1 conveyed information about CLD risk in all three groups and was the major risk factor for infants in the Low FiO(2) group (OR 27; 95% CI 7 to 95). Mechanical ventilation at 7 days was associated with increased risk in the PD (OR 4.2, 95% CI 2.5 to 6.9) and EPPD groups (OR 2.7, 95% CI 1.5 to 4.7), but not the Low FiO(2) group (OR 1.5, 95% CI 0.5 to 3.9).



The likelihood of a very preterm infant developing CLD and the profile of risk factors linked with CLD are related to the infant's pattern of respiratory disease during the first 2 postnatal weeks. Among infants with little exposure to oxygen during this period, fetal growth restriction, not mechanical ventilation, is the factor with the strongest association with CLD.
Cytosine methylation in the HPV16 3’ L1/ 5’LCR region characterized from anal epithelia of HPV-HIV coinfected men

Anal specimens derived from 83 HIV-HPV16 co-infected men were analyzed for cytosine methylation using bisulfite modification, PCR amplification, cloning, and sequencing. Data were processed using the ClustalW alignment algorithm within BiQ Analyzer Software and input into SAS 9.2 to generate heat maps and histograms(Figure 1). Approximately 10 clones were characterized for each specimen across 81 CpA, CpT, CpC (denovo methylation) and 10 CpG sites within the 3′-L1 and 5′LCR region of HPV16 genomes. Analyses were confined to 64 denovo cytosine residues and 10 CpGs outside the primer annealing regions. Clinical outcome evaluation by a single examiner showed seven men with no anal intraepithelial neoplasias (AIN), 26 with AIN-1, and 50 with AIN-2. Data showed the average prevalence (standard deviation) of methylcytosines was 11% (0.3) across 7,553 bases/residues and did not vary across maintained or denovo cytosine groups, i.e., 6,723 denovo sites and 830 CpGs. Evaluation by a single examiner using cytology and histology showed 7 with no anal intraepithelial neoplasias (AIN), 26 showed AIN-1, and 50 showed AIN-2. Mean and median prevalence of denovo and CpG methylation were closely approximated across AIN groups. Maxima were observed in two regions: 7111 to 7119, and 7505 to 7514 that showed a methylcytocine prevalence of 24% (0.4), and 18% (0.4), respectively. Logistic regression suggests that with each year of age, risk for moderate-severe methylation ≥30% at each site decreases; however, among smokers risk for ≥30% methylation increases. Specifically, moderate cytosine-methylation decreased by 5% (OR=0.95, 95% CI,
Antiviral effect, safety, and pharmacokinetics of five-day oral administration of Deleobuvir (BI 207127), an investigational hepatitis C virus RNA polymerase inhibitor, in patients with chronic hepatitis C.

Deleobuvir (BI 207127) is an investigational oral nonnucleoside inhibitor of hepatitis C virus (HCV) NS5B RNA polymerase. Antiviral activity, virology, pharmacokinetics, and safety were assessed in HCV genotype 1-infected patients receiving 5 days' deleobuvir monotherapy. In this double-blind phase 1b study, treatment-naive (TN; n = 15) and treatment-experienced (TE; n = 45) patients without cirrhosis received placebo or deleobuvir at 100, 200, 400, 800, or 1,200 mg every 8 h (q8h) for 5 days. Patients with cirrhosis (n = 13) received deleobuvir at 400 or 600 mg q8h for 5 days. Virologic analyses included NS5B genotyping and phenotyping of individual isolates. At day 5, patients without cirrhosis had dose-dependent median HCV RNA reductions of up to 3.8 log10 (with no placebo response); patients with cirrhosis had median HCV RNA reductions of approximately 3.0 log10. Three patients discontinued due to adverse events (AEs). The most common AEs were gastrointestinal, nervous system, and skin/cutaneous tissue disorders. Plasma exposure of deleobuvir was supraproportional at doses ≥ 400 mg q8h and approximately 2-fold higher in patients with cirrhosis than in patients without cirrhosis. No virologic breakthrough was observed. NS5B substitutions associated with deleobuvir resistance in vitro were detected in 9/59 patients; seven encoded P495 substitutions, including P495L, which conferred 120- to 310-fold-decreased sensitivity to deleobuvir. P495 variants did not persist in follow-up without selective drug pressure. Deleobuvir monotherapy was generally well tolerated and demonstrated dose-dependent antiviral activity against HCV genotype 1 over 5 days.
Long-term follow-up of a randomized trial comparing laparoscopic and mini-incision open live donor nephrectomy.

Long-term physical and psychosocial effects of laparoscopic and open kidney donation are ill defined. We performed long-term follow-up of 100 live kidney donors, who had been randomly assigned to mini-incision open donor nephrectomy (MIDN) or laparoscopic donor nephrectomy (LDN). Data included blood pressure, glomerular filtration rate, quality of life (SF-36), fatigue (MFI-20) and graft survival. After median follow-up of 6 years clinical and laboratory data were available for 47 donors (94%) in both groups; quality of life data for 35 donors (70%) in the MIDN group, and 37 donors (74%) in the LDN group. After 6 years, mean estimated glomerular filtration rates did not significantly differ between MIDN (75 mL/min) and LDN (76 mL/min, p = 0.39). Most dimensions of the SF-36 and MFI-20 did not significantly differ between groups at long-term follow-up, and most scores had returned to baseline. Twelve percent of the donors reported persistent complaints, but no major complications requiring surgical intervention. Five-year death-censored graft survival was 90% for LDN, and 85% for MIDN (p = 0.50). Long-term outcome of live kidney donation is excellent from the perspective of both the donor and the recipient.