tbuckley/cabot-search huggingface dataset:
World Health Report 2000: how it removes equity from the agenda for public health monitoring and policy Commentary: comprehensive approaches are needed for full understanding
Authors: P. Braveman, B. Starfield, H J. Geiger, C. J L Murray
Journal: BMJ (2001)

# World Health Report 2000: how it removes equity from the agenda for public health monitoring and policy {#article-title-2}

The World Health Report 2000 recommends that national health systems be assessed not only by the average health status of a country's population but also by the extent to which health varies within the population.1 Although we applaud this recommendation, we are concerned that the report's approach to measuring health inequalities undermines efforts to achieve greater equity in health within nations. We argue that the report's measure of health inequalities is not useful for guiding national policy because it provides no information to guide resource allocation or to target policies. In addition, it does not measure socioeconomic or other social disparities in health within countries. When used as a substitute for monitoring social inequalities in health, as its authors implicitly1 and explicitly2 recommend, it removes equity and human rights considerations from the routine measurement and reporting of health disparities within nations.

#### Summary points

The World Health Report 2000 measure of health inequality is not useful for guiding national policies

It does not measure socioeconomic or other social inequalities in health within countries

It removes equity and human rights considerations from the routine measurement and reporting of health disparities within countries

The report's measure correlates poorly with other well established indices of social inequality in health

Without studying the report's technical references,2–4 most readers will assume that health inequalities refer to social inequalities in health. Social inequalities in health are health disparities between population groups defined by social characteristics such as wealth, education, occupation, racial or ethnic group, sex, rural or urban residence, and social conditions of the places where people live and work. These social characteristics are selected for defining population groups and comparing how health and health care vary across the different groups because of their strong and ubiquitous associations with both underlying social advantage …
Contribution of β-cell dysfunction and insulin resistance to cirrhosis-associated diabetes: Role of severity of liver disease
Authors: Valeria Grancini, Maddalena Trombetta, Maria Elena Lunati, Dario Zimbalatti, Maria Linda Boselli, Stefano Gatti, Maria Francesca Donato, Veronica Resi, Roberta D’Ambrosio, Alessio Aghemo, Giuseppe Pugliese, Riccardo C. Bonadonna, Emanuela Orsi
Journal: Journal of Hepatology (2015)
Suicide attempts in children and adolescents
Authors: Barry D. Garfinkel, Art Froese, Jane Hood
Journal: American Journal of Psychiatry (1982)

In a review of pediatric hospital emergency room admissions over 7 years, the authors found 505 children and adolescents who had attempted suicide. There were three times as many girls as boys, and the boys were significantly younger. Features that distinguished them from matched controls were religion, living situation, substance abuse, current psychiatric illness, prior psychotherapy, and current medical illness. Their families had more psychiatric illness (primarily drug or alcohol abuse), suicide, paternal unemployment, and paternal and maternal absence than the controls' families. The suicide attempts usually occurred in the winter, after school or in the evening, at home with someone nearby, and by drug overdose.
All-Ireland health conference discusses cross border cooperation
Authors: Doug Payne
Journal: BMJ (2000)

The first ever all-Ireland health conference—an initiative of the BMA and the Irish Medical Organisation—has heard details of how hospitals on both sides of the border could share ambulance services and emergency beds in future.

More than 400 representatives of the health professions, research bodies, and government departments from both sides of the border and from the United Kingdom and the United States …
Modelling and simulation in successful drug development programmes: Characterisation of exacerbation reduction with roflumilast to corroborate the importance of defining patient subsets in COPD
Authors: Gezim Lahu, Axel Facius, Laurent Claret, Rene Bruno, Dirk Bredenbröker
Journal: European Respiratory Journal (2011)

Background/Rationale: Roflumilast (ROF), an oral, selective PDE4 inhibitor, reduces the rate of exacerbations and improves lung function in severe COPD. During clinical development, modelling and simulation techniques were used to identify and confirm a paradigm to explore patient, disease and treatment covariates. This approach identified patient populations that will benefit most from ROF, and was used to help design confirmatory clinical trials.

Methods: Data from two 1-year, randomised, double-blind, placebo-controlled, parallel-group trials [Rennard S, et al . Respir Res 2011;12(1):18] in 2686 patients were used to build exacerbation and lung function models to identify patient characteristics that significantly impacted the clinical endpoints.

Results: Patients with chronic bronchitis, higher cough/sputum scores, concomitant ICS use and low predicted FEV1 at baseline were identified as having a higher rate of exacerbations and treatment effect. Patient characteristics as defined by the models were used, in addition to a history of exacerbations, to simulate the design of two other 1-year clinical trials [Calverley PMA, et al . Lancet 2009;374:685–94], with the inclusion criteria described in the trial protocols. The models predicted that the two trials would show a 17% reduction in exacerbation rate and a 47mL gain in FEV1 with ROF; observed results were 17% reduction and a 48mL gain.

Conclusions: This modelling and simulation approach showed the importance of defining COPD subsets for drug development, and helped support phase III studies confirming exacerbation reduction with ROF.
Pioglitazone attenuates angiotensin II-induced atherosclerosis via a smooth muscle cell-specific ppargamma mechanism but has no effect on abdominal aortic aneurysms
Authors: Venkateswaran Subramanian, Dennis Bruemmer, Jonathan Golledge, Alan Daugherty
Journal: Circulation (2009)

Objective: Chronic infusion of angiotensin II (AngII) augments development of atherosclerosis and induces abdominal aortic aneurysms (AAAs) in hypercholesterolemic mice. Smooth muscle cells (SMCs) play a pivotal role in the development of these two pathologies. Peroxisome proliferator-activated receptor gamma (PPARgamma) agonists have previously been shown to attenuate atherosclerosis in male mice. The purpose of the study was to determine the role of SMC-specific PPARgamma in ligand-mediated attenuation of AngII-induced atherosclerosis and AAAs.

Methods and Results: Pairs of LDL receptor –/– mice with homozygous floxed PPARgamma alleles (PPARgammaf/f) were bred. Cre was expressed under the control of the SMC-specific promoter, SM22. Littermates were generated that did not express Cre (Cre0/0, n = 33) or were hemizygous for Cre (Cre1/0, n = 24). Male mice were fed a fat-enriched diet (21% wt/wt milk fat; 0.15% wt/wt cholesterol) with or without the PPARgamma agonist, pioglitazone (Pio - 20 mg/kg/day) for 5 weeks. After 1 week of feeding, mice were infused with AngII (1,000 ng/kg/min) by osmotic minipumps for 4 weeks. Pio administration attenuated AngII increased systolic blood pressure equivalently in both Cre0/0 and Cre1/0 groups. SMC-specific deficiency of PPARgamma or Pio administration had no effect on serum cholesterol concentrations and lipoprotein-cholesterol distributions. SMC-specific PPARgamma deficiency increased atherosclerosis (Cre1/0 = 11.6±1.5% versus Cre0/0 = 6.7±0.9% P<0.05). Pio administration reduced atherosclerosis in Cre0/0 mice (Pio-Cre0/0 = 2.9±0.4% versus Control-Cre0/0 = 6.7±0.9%, P<0.05, n=7–12 ), but failed to reduce atherosclerosis in mice with SMC-specific PPARgamma deficiency (Control-Cre1/0 = 11.6±1.5% versus Pio-Cre1/0 = 9.9±2.5%, P=NS). SMC-specific PPARgamma deficiency or Pio administration had no effect on AngII-induced AAAs as measured by ex vivo external diameter (Control-Cre0/0 = 2.0±0.2, Control-Cre1/0 = 2.4±0.4 versus Pio-Cre0/0 = 2.2±0.2, Pio-Cre1/0 = 1.9±0.2 mm, P=NS).

Conclusion: Administration of Pio attenuates AngII-induced atherosclerosis via the activation of SMC-specific PPARgamma but did not influence formation of AAAs in male hypercholesterolemic mice.
Mammary and Peritoneal Tumors Induced by Intraperitoneal Administration of 7,12-Dimethylbenz[a]anthracene in Newborn and Adult Rats
Authors: Charles Huggins, Ryo Fukunishi
Journal: Cancer Research (1963)

Summary  A lipide emulsion of 7,12-dimethylbenz[ a ]anthracene (7,12-DMBA) was prepared which has the advantages of a high concentration of the hydrocarbon, ease of preparation, sterility, and stability. The vehicle was not toxic.  A single intraperitoneal injection of the emulsion of 7,12-DMBA induced mammary cancer preferentially in all Sprague-Dawley female rats, age 50 days, within 2 months. In the induction of mammary tumors, the emulsion was quantitatively as effective by the intraperitoneal as by the intravenous route.  No tumors of peritoneum were evoked by a single injection of the emulsified 7,12-DMBA, but peritoneal sarcomas arose in a high incidence following deposition of a compressed pellet of 7,12-DMBA in the peritoneal cavity.  A single, intraperitoneal injection of the emulsion of 7,12-DMBA in new born female rats of Sprague-Dawley or Long-Evans strains evoked mammary tumors in high incidence. Benign mammary tumors developed in high and equal incidence in both strains following the injection of 7,12-DMBA, but the incidence of mammary cancer was rather high in Sprague-Dawley rats and very low in their Long-Evans companions. Runt disease was induced in some of the injected newborn rats.
Abstract 9904: Endothelial Function is Impaired in Subjects With Decreased Frequency of Tooth Brushing
Authors: Masato Kajikawa, Yukihito Higashi, Tatsuya Maruhashi, Yumiko Iwamoto, Akimichi Iwamoto, Nozomu Oda, Takeshi Matsumoto, Takayuki Hidaka, Ayumu Nakashima, Kensuke Noma, Akira Taguchi, Yasuki Kihara
Journal: Circulation (2014)

Introduction:  Clinical studies have shown a link between oral health, especially periodontitis, and cardiovascular disease. Poor oral health behavior is associated with increasing risk of cardiovascular disease. Several investigators, including us, have shown that periodontitis is associated with endothelial dysfunction and that treatment of periodontitis improves endothelial function in patients with atherosclerosis as well as in healthy subjects. However, there is no information on the association between oral health behavior and endothelial function. The purpose of this study was to determine the relationships between oral health behavior and endothelial function.   Methods and Results:  We had a questionnaire about oral health behavior, frequency of tooth brushing, and measured vascular function, flow-mediated vasodilation (FMD) and nitroglycerine-induced vasodilation in 190 subjects who underwent health examinations (mean age, 57±18 years), including patients with cardiovascular diseases. We divided the subjects into two groups according to frequency of tooth brushing (twice a day or more and less than once a day). FMD were significantly lower in the less than once a day of tooth brushing group as compared to the twice a day or more of tooth brushing group (3.3±2.2% vs. 5.0±3.0%, P   Conclusion:  These findings suggest that poor oral health behavior, decreased frequency of tooth brushing, is associated with endothelial dysfunction. Tooth brushing is a simple approach for improving a poor oral condition, and it is expected that appropriate oral health care will improve endothelial function.
A Phase I Study Of Azacitidine After Donor Lymphocyte Infusion For Relapsed Acute Myeloid Leukemia Post Allogeneic Stem Cell Transplantation
Authors: Armin Ghobadi, Mark A. Fiala, Camille N. Abboud, Amanda F Cashen, Linda Eissenberg, Timothy Graubert, Meagan A Jacoby, Iskra Pusic, Mark A. Schroeder, Keith E. Stockerl-Goldstein, Michael H. Tomasson, Geoffrey L. Uy, Ravi Vij, Matthew J. Walter, John F. DiPersio, Peter Westervelt
Journal: Blood (2013)
The predictive value of adjustment disorders: a follow-up study
Authors: Nancy C. Andreasen, Paul R. Hoenk
Journal: American Journal of Psychiatry (1982)

A previous investigation explored the diagnosis of adjustment disorder and found it to have descriptive and face validity. This study of the status at 5-year follow-up of 100 patients given this diagnosis strongly supports the validity of the category among adults but only partially among adolescents. Seventy-nine percent of the adults were well at follow-up, with 8% having had an intervening problem. Comparable figures for the adolescents were 57% and 13%. Most adults who were ill developed either major depression or alcoholism. The adolescents' illnesses included schizophrenia, schizoaffective disorder, major depression, bipolar disorder, antisocial personality, alcoholism, and drug use disorder. Chronicity and behavioral symptoms were the strongest predictors of poor outcome.
Validation of a short Orientation-Memory-Concentration Test of cognitive impairment
Authors: Robert Katzman, Theodore Brown, Paula Fuld, Arthur Peck, Ruben Schechter, Herbert Schimmel
Journal: American Journal of Psychiatry (1983)

A 6-item Orientation-Memory-Concentration Test has been validated as a measure of cognitive impairment. This test predicted the scores on a validated 26-item mental status questionnaire of two patient groups in a skilled nursing home, patients in a health-related facility, and in a senior citizens' center. There was a positive correlation between scores on the 6-item test and plaque counts obtained from the cerebral cortex of 38 subjects at autopsy. This test, which is easily administered by a nonphysician, has been shown to discriminate among mild, moderate, and severe cognitive deficits.
Abstract 16019: MRI Venous Volume Measurements are Associated With Ankle Brachial Index in Peripheral Artery Disease Patients: Results From the Effect of Lipid Modification on Peripheral Arterial Disease After Endovascular Intervention Trial (ELIMIT)
Authors: Hassan Kamran, Vijay Nambi, Smita Negi, Eric Y Yang, Changyi Chen, Salim S Virani, Panagiotis Kougias, Alan B Lumsden, Joel D Morrisett, Christie M Ballantyne, Gerd Brunner
Journal: Circulation (2014)

Introduction: The relationship between peripheral artery disease (PAD) and the venous system remains poorly understood. The objective of this secondary analysis of ELIMIT was to assess the association between magnetic resonance imaging (MRI) based superficial femoral vein (SFV) volumes and measures of PAD in patients randomized to triple lipid modification therapy (simvastatin, ezetimibe, niacin) versus mono therapy (simvastatin). Hypothesis: We hypothesized that SFV volume measurements are associated with PAD due to the relationship between arterial and venous flow. Methods: SFV wall, lumen, and total volumes were quantified by MRI in all available ELIMIT scans (79 patients) and analyzed by drug groups and changes over 2-years. Pooled linear regression analyses were performed to assess the associations of SFV measures with ABI, measures of the superficial femoral artery (SFA), and maximum walking time (MWT). Results: There were no significant differences at baseline or for the 24-month changes in SFV vol...
Abstract 19448: Heterozygous Knock-out of Ryanodine Receptor 2 in Rabbits Produces Haploinsufficiency in the Absence of Compensatory Remodeling of the Heart
Authors: Francisco J Alvarado, Jonathan J Hernandez, Dongshan Wang, Jie Xu, Jifeng Zhang, Y E Chen, Hector H Valdivia
Journal: Circulation (2014)

The Ryanodine Receptor type 2 (RyR2) is the major Ca2+ release channel in the heart. It is involved in excitation-contraction coupling (e-c coupling), the process that turns electrical activity into mechanical contraction in the cardiac muscle. During an action potential, RyR2 releases Ca2+ from the sarcoplasmic reticulum (SR), after being activated by a small Ca2+ influx (ICa) through L-type Ca2+ channels. RyR2 has prompted extensive research over the last two decades, because mutations in this channel are the culprits of severe arrhythmogenic syndromes, and because the details of its regulation is not fully understood. Using RNA-guided endonuclease genome editing, we generated a novel RyR2 knockout rabbit model to determine the cardiac effects of RyR2 deficiency. After breeding heterozygous knockout rabbits (RyR2+/-) we have not observed homozygotes, suggesting that, as previously reported for mice, complete ablation of RyR2 is embryonic lethal. Using Western blots, we found that RyR2 expression is decreased in the left ventricle (LV) of RyR2+/- rabbits (32.98±2.90% of RyR2+/+, n=3 per genotype, p 0.05). Interestingly, we did not observe any functional or structural abnormalities in RyR2+/- animals subjected to echocardiography (n=7 per genotype, p>0.05). Histological analysis of LV biopsies revealed no difference in the general microstructure of the tissue (n=3 per genotype). Finally, basic electrocardiogram parameters were not different between RyR2+/- and RyR2+/+ rabbits (heart rate, QTc interval, PR interval, n=7 per genotype, p>0.05). These data suggest that RyR2 haplo-deficiency is compensated in the absence of a whole organ phenotype. We will perform Ca2+-imaging and electrophysiologic studies in LV myocytes, to determine whether the cellular e-c coupling mechanism undergoes functional changes to adjust for RyR2 deficiency. These studies will contribute to better understand the regulation of Ca2+ handling in normal cardiac function. Furthermore, they will give valuable insights into the role of RyR2 in heart disease.
Initial surveillance of 2009 influenza A(H1N1) pandemic in the European Union and European Economic Area, April – September 2009
Authors: I Devaux, P Kreidl, P Penttinen, M Salminen, P Zucs, A Ammon, Collective on behalf of the ECDC influenza surveillance group, Collective and the national coordinators for influenza surveillance
Journal: Eurosurveillance (2010)

European Union (EU) and European Economic Area (EEA) countries reported surveillance data on 2009 pandemic influenza A(H1N1) cases to the European Centre for Disease Prevention and Control (ECDC) through the Early Warning and Response System (EWRS) during the early phase of the 2009 pandemic. We describe the main epidemiological findings and their implications in respect to the second wave of the 2009 influenza pandemic. Two reporting systems were in place (aggregate and case-based) from June to September 2009 to monitor the evolution of the pandemic. The notification rate was assessed through aggregate reports. Individual data were analysed retrospectively to describe the population affected. The reporting peak of the first wave of the 2009 pandemic influenza was reached in the first week of August. Transmission was travel-related in the early stage and community transmission within EU/EEA countries was reported from June 2009. Seventy eight per cent of affected individuals were less than 30 years old. The proportions of cases with complications and underlying conditions were 3% and 7%, respectively. The most frequent underlying medical conditions were chronic lung (37%) and cardio-vascular diseases (15%). Complication and hospitalisation were both associated with underlying conditions regardless of age. The information from the first wave of the pandemic produced a basis to determine risk groups and vaccination strategies before the start of the winter wave. Public health recommendations should be guided by early capture of profiles of affected populations through monitoring of infectious diseases.
Abstract 17486: Circulating Oxidized Low-Density Lipoprotein Levels are Associated with Coronary Lesion Complexity in Patients with Acute Coronary Syndrome: An Optical Coherence Tomography Study
Authors: Yoshiki Matsuo, Takashi Kubo, Tetsuya Iwaguro, Teruaki Wada, Satoshi Ueno, Yasushi Okumoto, Hideharu Akagi, Atsushi Tanaka, Takashi Akasaka
Journal: Circulation (2011)

Background: It has been shown that elevated oxidized low-density lipoprotein (ox-LDL) levels are associated with plaque vulnerability. The aim of this study was to investigate whether circulating ox-LDL levels are correlated with coronary lesion complexity assessed by optical coherence tomography (OCT) in patients with acute coronary syndrome (ACS). Methods and Results: OCT was used to determine plaque morphology in 80 patients with ACS. Blood samples were collected before coronary angiography and circulating levels of malondialdehyde (MDA)-modified LDL, one of ox-LDL, were measured by using enzyme-linked immunosorbent assay. Patients were divided into a high MDA-modified LDL group (high MDA, ≥155 U/L) and low MDA-modified LDL group (low MDA, &lt; 155 U/L) according to median MDA-modified LDL levels. Plaque ruptures and thin cap fibroatheromas (TCFAs) were more frequently observed in high MDA patients compared to low MDA patients (87% vs. 56%, P&lt;0.01; 65% vs. 43%, P&lt;0.05, respectively). The frequency of thrombi was not different between two groups. The MDA-modified LDL levels in patients with complicated lesions (defined as lesions with plaque rupture or rupture with thrombi) were significantly higher compared to non-complicated lesion (P&lt;0.05). A multivariate logistic regression model revealed that the presence of complicated lesion correlated with MDA-modified LDL levels ( P =0.03; odds ratio, 3.13; 95% CI, 1.09 to 8.93). Conclusion: Circulating MDA-modified LDL levels were associated with coronary plaque complexity assessed by OCT. MDA-modified LDL might be a useful biomarker for plaque vulnerability in ACS patients.
Abstract 2466: Increased Plasma Concentrations of N-Terminal Pro Brain Natriuretic Peptide is a More Sensitive Marker of Subclinical Diastolic Dysfunction and Arterial Remodeling in Hypertension: Analytical Performance Comparison with BNP
Authors: Tomoo Furumoto, Satoshi Fujii, Hiroyuki Tsutsui
Journal: Circulation (2008)

Concentrations of plasma N-terminal pro brain natriuretic peptide (NT-proBNP) is inversely related to metabolic cardiovascular risk factors and is a valuable prognostic marker of cardiovascular events in arterial hypertension. Whether NT-proBNP levels are connected with diastolic function and arterial function was determined in hypertension. NT-proBNP was measured in 40 untreated patients with hypertension (mean BP 166/96 mmHg) without heart failure and 20 age and gender matched healthy, controls. Hypertensive patients were studied by pulsed Doppler and color M-mode Doppler echocardiography to evaluate LV diastolic function. Plasma NT-proBNP was significantly elevated in patients with hypertension (75.1 ± 75.2 [SD] pg/ml compared with 37.9 ± 38.5 in controls p &lt; 0.05). In hypertensive patients, NT-proBNP values were negatively correlated with the ratio of color M-mode flow propagation velocity to transmitral E velocity (r=−0.33, p&lt;0.05) while those of BNP had no correlation, suggesting that higher plasma NT-proBNP is indicative of subclinical diastolic dysfunction. Moreover, hypertensive patients with higher NT-proBNP values above the mean value in the control group (NT-proBNP &gt; 38 pg/ml) had significantly increased brachial intimal-medial thickness (0.36 ± 0.08 mm vs. 0.32 ± 0.05, p &lt; 0.05) and reduced wall stress (112.4 ± 29.5 kPa vs. 142.2 ± 30.8, p &lt; 0.05) compared with those with lower NT-proBNP, suggesting that the reference value of NT-proBNP plasma concentrations in uncomplicated hypertensives is 38pg/ml and higher NT-proBNP levels were associated with favorable remodeling of the peripheral arteries. Elevation of plasma NT-proBNP can be useful to identify subclinical LV diastolic dysfunction and peripheral arterial remodeling in asymptomatic patients with hypertension.