tbuckley/cabot-search huggingface dataset:
A molecular classifier for predicting future graft loss in late kidney transplant biopsies
Authors: Gunilla Einecke, Jeff Reeve, Banu Sis, Michael Mengel, Luis Hidalgo, Konrad S. Famulski, Arthur Matas, Bert Kasiske, Bruce Kaplan, Philip F. Halloran
Journal: Journal of Clinical Investigation (2010)

Kidney transplant recipients that develop signs of renal dysfunction or proteinuria one or more years after transplantation are at considerable risk for progression to renal failure. To assess the kidney at this time, a "for-cause" biopsy is performed, but this provides little indication as to which recipients will go on to organ failure. In an attempt to identify molecules that could provide this information, we used microarrays to analyze gene expression in 105 for-cause biopsies taken between 1 and 31 years after transplantation. Using supervised principal components analysis, we derived a molecular classifier to predict graft loss. The genes associated with graft failure were related to tissue injury, epithelial dedifferentiation, matrix remodeling, and TGF-beta effects and showed little overlap with rejection-associated genes. We assigned a prognostic molecular risk score to each patient, identifying those at high or low risk for graft loss. The molecular risk score was correlated with interstitial fibrosis, tubular atrophy, tubulitis, interstitial inflammation, proteinuria, and glomerular filtration rate. In multivariate analysis, molecular risk score, peritubular capillary basement membrane multilayering, arteriolar hyalinosis, and proteinuria were independent predictors of graft loss. In an independent validation set, the molecular risk score was the only predictor of graft loss. Thus, the molecular risk score reflects active injury and is superior to either scarring or function in predicting graft failure.
Stabilization of enzyme-susceptible glucoside bonds of phloridzin through conjugation with poly(γ-glutamic acid)
Authors: Shinji Sakuma, Tomokazu Sagawa, Yoshie Masaoka, Makoto Kataoka, Shinji Yamashita, Yoshiyuki Shirasaka, Ikumi Tamai, Yusuke Ikumi, Toshiyuki Kida, Mitsuru Akashi
Journal: Journal of Controlled Release (2008)
Differing circadian patterns of symptom onset in subgroups of patients with acute myocardial infarction.
Authors: A Hjalmarson, E A Gilpin, P Nicod, H Dittrich, H Henning, R Engler, A R Blacky, S C Smith, F Ricou, J Ross
Journal: Circulation (1989)

Circadian variation of the onset of acute myocardial infarction has been noted in many studies and may carry important pathophysiologic implications. However, only a few previous studies have attempted subgroup analyses. In 4,796 patients with documented acute myocardial infarction, the time of symptom onset was recorded. As in other studies, the peak of onset occurred in the morning from 6:01 AM to 12:00 noon, and 28% of the population (1.16 times the average percentage for the other time periods) experienced symptom onset in that period (p less than 0.001). There was a second, lower peak (25%) in the evening between 6:01 PM and 12:00 midnight, which was also observed in some previous studies. We sought to determine whether or not the presence of subgroups with specific clinical characteristics would exhibit different patterns and thereby contribute to these peaks in the overall population. In patients with a history of congestive heart failure (n = 606) or with non-Q wave infarction (n = 832), a pronounced peak (29%) occurred only in the evening. Two nearly equal peaks were observed in patients older than 70 years of age (n = 1,422), smokers (n = 2,057), diabetics (n = 767), women (n = 1,213), and patients taking beta-blocking drugs (n = 847). Finally, in patients with a previous myocardial infarction (n = 1,104), no peaks were observed.(ABSTRACT TRUNCATED AT 250 WORDS)
Referral to intensive care units should not be limited to consultants
Authors: C M Danbury
Journal: BMJ (1999)

EDITOR—In their article in the ABC of Intensive Care on criteria for admission, Smith and Nielsen state that early referral improves the chances of recovery.1 They later state that patients should be referred by the most senior member of staff responsible for the patient (that is, the consultant) and that this job should be delegated to more junior medical staff only if clear guidelines …
BACILLUS PYOCYANEUS AND ITS PIGMENTS
Authors: Edwin O. Jordan
Journal: The Journal of Experimental Medicine (1899)

The principal conclusions that seem to me justified are as follows: 1. The fluorescent pigment formed by some varieties of B. pyocyaneus is produced under conditions identical with those governing the production of the pigment by other "fluorescent bacteria." 2. The production of pyocyanin is not dependent upon the presence of either phosphate or sulfate in the culture medium. It is formed in non-proteid as well as in proteid media, but is not a necessary accompaniment of the metabolic activities of the organism (e. g. tartrate solution). 3. The power of producing pyocyanin under conditions of artificial cultivation is lost sooner than the fluorescigenic power. 4. There are greater natural and acquired differences in pyocyanigenic power than in fluorescigenic. 5. The fluorescent pigment may be oxidized slowly by the action of light and air as well as by reagents into a yellow pigment, and pyocyanin may be similarly oxidized into a black pigment. 6. A convenient separation of B. pyocyaneus into four varieties would be the following: var. α, pyocyanigenic and fluorescigenic (most common); var. ß, pyocyanigenic only (rare); var. γ, fluorescigenic only (not uncommon, closely related to "B. fluorescens liquefaciens"); var. δ, non-chromogenic. 7. Except for the occasional loss of one or another function the different varieties are not so plastic as sometimes assumed, and cannot be readily converted into one another by subjection to varying conditions of life. 8. The signification and correlation of the almost countless physiological variations among the members of this group in respect to growth in gelatin, behavior to temperature, indol production, etc., remain to be determined. It is not yet clear that the variations in chromogenic power can be in any way correlated with the presence or absence of other physiological functions.
Pragmatics, prosody, and evolution: Language is more than a symbolic system
Authors: Boris Kotchoubey
Journal: Behavioral and Brain Sciences (2005)

The model presented in the target article is biased towards a cognitive-symbolic understanding of language, thus ignoring its other important aspects. Possible relationships of this cognitive-symbolic subsystem to pragmatics and prosody of language are discussed in the first part of the commentary. In the second part, the issue of a purely social versus biological mechanisms for transition from protolanguage to properly language is considered.
Durable power of attorney and informed consent with Alzheimer's disease patients: a clinical study
Authors: R Dukoff, T Sunderland
Journal: American Journal of Psychiatry (1997)

Experience with a new surrogate consent system for patients with Alzheimer's disease is reviewed. It was hypothesized that as patients' cognitive status deteriorated, surrogate consent through a durable power of attorney would become necessary to facilitate continued involvement in clinical research.The authors retrospectively reviewed the charts of inpatients with Alzheimer's disease who participated in research between January 1989 and December 1994 at the Geriatric Psychiatry Unit of the National Institute of Mental Health. Seventy-nine patients were included. The main outcome measures were the Clinical Dementia Rating, Global Deterioration Scale for primary degenerative dementia, and Mini-Mental State.Most patients were in the mild-to-moderate stage of the illness when they chose to participate in research and assign a durable power of attorney (96% scored 2 or less on the Clinical Dementia Rating, and 92% scored 5 or less on the Global Deterioration Scale). On average, the subjects participated in 3.8 (SD = 2.6) studies. For 35 patients with multiple admissions over this period (average = 3.1 years), scores on the Clinical Dementia Rating and Global Deterioration Scale declined by 1.0 and 1.5 points, respectively.The durable power of attorney allows research participation for subjects with Alzheimer's disease at all stages. The linchpin is assignment of a durable power of attorney in the early-to-moderate stage of Alzheimer's disease, before subjects lose the capacity to give informed consent. This approach could also be adapted to patients with cognitive decline due to other debilitating diseases.
Femoral Shaft Fracture II
Authors: Otto E. Aufranc
Journal: JAMA (1963)

<h3>Presentation</h3> Dr. William Harris: Last month a case was presented which brought out the factors involved in the decision whether or not to use intramedullary fixation in treatment of a transverse fracture of the mid-diaphysis of the femur. This month we would like to present a case of the use of intramedullary fixation in which treatment was followed by a severe complication. Dr. R. G. Eaton: A 32-yr-old roofer arrived in shock at the emergency ward of the Massachusetts General Hospital shortly after having been struck by a truck. His blood pressure was 88/42 mm Hg, and his pulse rate was 116 beats per minute. He was responsive but uncooperative and his skin was cold and moist. The major findings included a deep perineal laceration involving the rectal sphincter that extended into the ischiorectal fossa, and was prolonged anteriorly to the scrotum where the left testis was exposed. There were
Operative Neurosurgery: vol 1, Cranial, Cerebral, and Intracranial Vascular Disease
Authors: Oscar Sugar
Journal: JAMA (1969)

The detailed operative techniques, described briefly in the text and profusely illustrated, are those of the chief of neurosurgery at the Walter Reed Army Medical Center. After the topography of the normal anatomy is shown, distortions due to the lesion are pictured, and step-by-step details make the procedures clear. Would that the living structures were as well delineated! The arrangement is by anatomical location and approach, not primarily by disease. Thus, frontotemporal craniotomy is used as the example of how to open the head, and through this basic approach Kempe deals with aneurysms of the anterior portion of the circle of Willis, tumors of or near the hypophysis, basifrontal tumors, and cerebrospinal rhinorrhea. Variations in the operative approach depict attack on sphenoid wing meningioma, and frontal lobectomy. In describing falx and parasagittal meningiomas, the author emphasizes the necessity for crossing the midline with the bone flap, to permit dural sinus
Effect of Triglyceride Levels on Methyl and Methylene Envelope Line Widths in Proton Nuclear Magnetic Resonance Spectroscopy of Human Plasma
Authors: Martha P. Mims, Joel D. Morrisett, Carlos A. Mattioli, Antonio M. Gotto
Journal: New England Journal of Medicine (1989)

Recent studies have described a relation between the line widths of the methyl and methylene resonance envelopes in the proton nuclear magnetic resonance spectrum of human plasma and the occurrence of cancer. An average line width of less than 33 Hz has been reported to correlate with the presence of cancer, whereas greater line widths have not. In 26 normal volunteers, we found a significant inverse correlation between fasting triglyceride level and plasma spectral line width. We also observed that dietary lipids have measurable effects on spectral line widths. In another sample of seven normal persons (three of whom had elevated plasma triglyceride levels), the line widths of whole plasma varied widely (mean, 35.6 +/- 8.8 Hz); however, the mean line widths of the lipoprotein fractions isolated from those samples differed greatly, but the variance within each fraction was small (very-low-density lipoprotein, 22.0 +/- 1.9 Hz; low-density lipoprotein, 35.0 +/- 2.8; high-density lipoprotein, 28.8 +/- 1.9). The results of this study indicate that the plasma triglyceride level has a profound effect on the average spectral line width of plasma. This effect can be explained by the relative amounts of lipoprotein fractions in whole plasma. Plasma triglyceride concentrations of more than 1.24 mmol per liter (greater than 110 mg per deciliter), whatever the source, produce average plasma methyl and methylene line widths of less than 33 Hz.
Comparison of the Structure of the Aortic Valve and Ascending Aorta in Adults Having Aortic Valve Replacement for Aortic Stenosis Versus for Pure Aortic Regurgitation and Resection of the Ascending Aorta for Aneurysm
Authors: William Clifford Roberts, Travis James Vowels, Jong Mi Ko, Giovanni Filardo, Robert Frederick Hebeler, Albert Carl Henry, Gregory John Matter, Baron Lloyd Hamman
Journal: Circulation (2011)

Background— There is debate concerning whether an aneurysmal ascending aorta should be replaced when associated with a dysfunctioning aortic valve that is to be replaced. To examine this issue, we divided the patients by type of aortic valve dysfunction—either aortic stenosis (AS) or pure aortic regurgitation (AR)—something not previously undertaken. Methods and Results— Of 122 patients with ascending aortic aneurysm (unassociated with aortitis or acute dissection), the aortic valve was congenitally malformed (unicuspid or bicuspid) in 58 (98%) of the 59 AS patients, and in 38 (60%) of the 63 pure AR patients. Ascending aortic medial elastic fiber loss (EFL) (graded 0 to 4+) was zero or 1+ in 53 (90%) of the AS patients, in 20 (53%) of the 38 AR patients with bicuspid valves, and in all 12 AR patients with tricuspid valves unassociated with the Marfan syndrome. An unadjusted analysis showed that, among the 96 patients with congenitally malformed valves, the 38 AR patients had a significantly higher likelihood of 2+ to 4+ EFL than the 58 AS patients (crude odds ratio: 8.78; 95% confidence interval: 2.95, 28.13). Conclusions— These data strongly suggest that the type of aortic valve dysfunction—AS versus pure AR—is very helpful in predicting loss of aortic medial elastic fibers in patients with ascending aortic aneurysms and aortic valve disease.
Myocardial <sup>99m</sup> Tc-Tetrofosmin Uptake During Adenosine-Induced Vasodilatation With Either a Critical or Mild Coronary Stenosis
Authors: David K. Glover, Mirta Ruiz, Joo Y. Yang, William H. Smith, Denny D. Watson, George A. Beller
Journal: Circulation (1997)

Background Clinical studies have shown a comparable coronary stenosis detection rate between 99m Tc-tetrofosmin and 201 Tl but with smaller defect magnitudes for 99m Tc-tetrofosmin. The goals of this study were to measure the first-pass extraction fraction (EF) of 99m Tc-tetrofosmin in canine myocardium and to compare 99m Tc-tetrofosmin with 201 Tl uptake during adenosine-induced vasodilatation in dogs with various degrees of coronary stenosis. Methods and Results EF was calculated in 4 anesthetized, open-chest dogs after intracoronary administration of 125 I-labeled albumin and 99m Tc-tetrofosmin. In another 16 dogs with either critical (n=6) or mild (n=10) left anterior descending coronary artery (LAD) stenoses, 201 Tl and 99m Tc-tetrofosmin were administered during adenosine infusion (250 μg · kg −1 · min −1 ). Dogs were killed 5 minutes later, and tracer activities were determined by ex vivo imaging of heart slices and by well counting. Mean 99m Tc-tetrofosmin EF was 54.0±3.7%. In the 6 critical-stenosis dogs, the LAD-to-left circumflex artery (LCx) microsphere flow ratio was 0.22±0.02 with adenosine. The LAD-to-LCx activity ratios were 0.37±0.04 for 201 Tl and 0.67±0.05 for 99m Tc-tetrofosmin ( P &lt;.01). For the 10 mild-stenosis dogs, the LAD-to-LCx flow ratio was 0.44±0.05. The 201 Tl activity ratio was 0.58±0.04, compared with 0.81±0.04 for 99m Tc-tetrofosmin ( P &lt;.01). Thus, in both groups, 99m Tc-tetrofosmin uptake underestimated the flow disparity more than 201 Tl. Similarly, magnitudes of ex vivo image defects were significantly greater for 201 Tl than for 99m Tc-tetrofosmin in both groups. Conclusions In this canine model, relative underperfusion with adenosine stress is better resolved with 201 Tl than with 99m Tc-tetrofosmin and may be explained by the lower EF for 99m Tc tetrofosmin. With clinical imaging, greater 201 Tl attenuation and redistribution may lessen this advantage.
A National Health Insurance Tax on Tobacco and Alcohol: The Puritan HIT
Authors: Rudolph J. Mueller
Journal: JAMA (1991)

<h3>To the Editor.—</h3> I enjoyed the September 26, 1990, issue of<i>JAMA</i>and congratulate the multiple authors. However, I believe more can be done to discourage smoking and other unhealthy behaviors while providing financial support for those with little or no insurance.<sup>1</sup> Adults may legally smoke tobacco and drink alcohol; however, these behaviors account for significant health care costs and mortality rates. Estimated smoking-related health care and insurance costs and lost productivity are $53.7 billion annually (1984) with direct medical care costs at $23 billion (43%).<sup>2</sup>Sixteen percent of all deaths are tobacco related. In 1988, alcohol-related direct costs were $17.4 billion and deaths accounted for 4.5% of costs.<sup>3</sup>Obviously, these "self-induced" illnesses are expensive and fatal. To offset these medically related costs and reduce consumption while providing the financial backing of the underinsured, I propose the development of a national health insurance tax (HIT). The HIT
Diagnostic accuracy and appropriateness of general practitioner referrals to a dermatology out-patient clinic
Authors: T. BASARAB, S.E. MUNN, R. RUSSELL JONES
Journal: British Journal of Dermatology (1996)

A study was undertaken of new referrals by GPs to a dermatology clinic in a district general hospital over a 6-month period. Six hundred and eighty-six consecutive referrals to one consultant were analysed for diagnostic accuracy and requirement for referral. Only 47% of referral letters contained the correct diagnosis. Viral warts and psoriasis were best diagnosed (82 and 78%, respectively), but seborrhoeic warts and dermatofibromas caused difficulty (22 and 19%, respectively). Cutaneous malignancy was correctly diagnosed in 45% of referrals, and eczema, the commonest condition referred, in 54% of cases. Sixty-eight percent of referrals required hospital-based facilities for diagnosis (31%) or treatment/management (37%). Twenty-one per cent of patients referred attended for once-only visits, requiring no specialized diagnostic or therapeutic procedures. Such referrals should decrease with improved GP education. Eleven percent of referrals were for minor surgical procedures such as curettage, shave biopsy, or cryotherapy and would become unnecessary if such facilities were available in the community. Our data demonstrate the potential for management of up to one-third of current dermatological referrals within the community by improving education of GPs and providing appropriate facilities within the community. However, over two-thirds of patients required hospital facilities, a finding of considerable relevance to the future location of dermatological services.
P. aeruginosa lipopolysaccharide (PsLPS) and A. fumigatus (Asp) stimulated TNF-α, RANTES and nitric oxide (NO) from peripheral blood mononuclear cells (PBMCs) from cystic fibrosis (CF) patients with bronchial epithelial cells (BECs): Modulation by rhDNase
Authors: A.R. Narayan, Y.C. Huang, X.P. Wang, L. Goodwin, L. Guida, M. Frieri
Journal: Journal of Allergy and Clinical Immunology (2005)
The Technique and Complications of Pulmonary Valvotomy with Special Reference to the Transarterial Approach
Authors: F. Therkelsen
Journal: Thorax (1955)

Valvotomy for pulmonary stenosis has been used in our departments since August, 1950.Cases operated on by Brock's method and cer- tain cases operated on by the transarterial route through a special clamp first described by S0ndergaard ( 1953) have been dealt with in a previous communication (Therkelsen, 1952).The present paper describes our latest observations with special reference to our experience with a method of valvotomy performed directly through the pulmonary artery. DIAGNOSISPre-operatively the diagnosis was assessed in the majority of cases by cardiac catheterization, and in some angiocardiography was also performed.FIG.1.-The " direct" pulmonary valvotomy performed with the modified Potts-Rikers valvotome.
Understanding and addressing religion among people with mental illness
Authors: Kenneth I. Pargament, James W. Lomax
Journal: World Psychiatry (2013)

This article reviews recent advances in the domain of psychiatry and religion that highlight the double-edged capacity of religion to enhance or damage health and well-being, particularly among psychiatric patients. A large body of research challenges stereotyped views of religion as merely a defense or passive way of coping, and indicates that many people look to religion as a vital resource which serves a variety of adaptive functions, such as self-regulation, attachment, emotional comfort, meaning, and spirituality. There is, however, a darker side to religious life. Researchers and theorists have identified and begun to study problematic aspects of religiousness, including religiously-based violence and religious struggles within oneself, with others, and with the divine. Religious problems can be understood as a by-product of psychiatric illness (secondary), a source of psychiatric illness (primary), or both (complex). This growing body of knowledge underscores the need to attend more fully to the potentially constructive and destructive roles of religion in psychiatric diagnosis, assessment, and treatment. In fact, initial evaluative studies of the impact of spiritually integrated treatments among a range of psychiatric populations have shown promising results. The article concludes with a set of recommendations to advance future research and practice, including the need for additional psychiatric studies of people from diverse cultures and religious traditions.
Edmonton Symptom Assessment System Screening and Depression at the End of Life
Authors: Camilla Zimmermann, Winson Y. Cheung, Christopher Lo, Gary Rodin
Journal: Journal of Clinical Oncology (2011)

data accrued from a randomized trial in which tamoxifen was given for two periods of time.There are three ways that one can examine data from a randomized trial, and in aggregate, we find these data to be less than compelling.First, the total proportion of women who experienced an adverse cardiovascular event was 18.5% in the 2-year tamoxifen arm and 17.5% in the 5-year arm (P ϭ .5).Second, the cumulative incidence curves for cardiovascular events in the 2-year arm and the 5-year arm (Fig A6 in the article by Haskshaw et al) are virtually overlapping.These results are hard to reconcile with the observation that among women age 50 to 59 years, the hazard ratio for cardiovascular events was 0.65 (95% CI, 0.47 to 0.88).The data for the younger women is represented graphically in Figure 4.It is odd that the separationinthetwocurvesseemstobewellunderwayatthe2-yearmark, yet both groups took an identical dose of tamoxifen up until this time.Given the discordant findings in the various analyses of this data, and the post hoc nature of the subgroup analysis, we think it is prudent to wait until all members of the cohort have had at least 10 years of follow-up before we can be confident of the interpretation of the results.