tbuckley/cabot-search huggingface dataset:
Experience-Dependent Development of Spinal Motor Neurons
Authors: Fiona M. Inglis, Katharine E. Zuckerman, Robert G. Kalb
Journal: Neuron (2000)

Locomotor activity in many species undergoes pronounced alterations in early postnatal life, and environmental cues may be responsible for modifying this process. To determine how these events are reflected in the nervous system, we studied rats reared under two different conditions—the presence or absence of gravity—in which the performance of motor operations differed. We found a significant effect of rearing environment on the size and complexity of dendritic architecture of spinal motor neurons, particularly those that are likely to participate in postural control. These results provide evidence that neurons subserving motor function undergo activity-dependent maturation in early postnatal life in a manner analogous to sensory systems.
Evolution in the symbolic dimension: The devil is in the details
Authors: Susan Lappan, Jae Chun Choe
Journal: Behavioral and Brain Sciences (2007)

Abstract Evolution in Four Dimensions argues convincingly that non-genetic inheritance systems have the potential to be agents of evolution and that, in some circumstances, acquired information can be heritable. However, we found the authors' four-dimensional approach to evolution problematic, and doubt that symbolic evolution can be adequately modeled as a distinct dimension of organismal evolution.
Risk factors in acquired faecal incontinence
Authors: P. J Lunniss, M. A Gladman, F. H Hetzer, N. S Williams, S M. Scott
Journal: Journal of the Royal Society of Medicine (2004)

Acquired faecal incontinence arising in the non-elderly population is a common and often devastating condition. We conducted a retrospective cohort analysis in 629 patients (475 female) referred to a tertiary centre, to determine the relative importance of individual risk factors in the development of faecal incontinence, as demonstrated by abnormal results on physiological testing. Potential risk factors were identified in all but 6% of patients (7 female, 32 male). In women, the principal risk factor was childbirth (91%), and in most cases at least one vaginal delivery had met with complications such as perineal injury or the need for forceps delivery. Of the males, half had undergone anal surgery and this was the only identified risk factor in 59%. In many instances, assignment of cause was hampered by a long interval between the supposed precipitating event and the development of symptoms. Abnormalities of anorectal physiology were identified in 76% of males and 96% of females (in whom they were more commonly multiple). These findings add to evidence that occult damage to the continence mechanism, especially through vaginal delivery and anal surgery, can result in subsequent faecal incontinence, sometimes after an interval of many years.
Paying for Cancer Care Under the Diagnosis-Related Group Reimbursement
Authors: Stanley J. Altman
Journal: JAMA (1985)

To the Editor.—  I am writing in regard to the COMMENTARY entitled,  Need for Diagnosis-Related Group  which appeared in the Feb 1, 1985, issue of JAMA . 1 I, too, would like to see the patient care costs of clinical research paid for by Medicare. However, I believe the solution to this problem (creation of DRG [diagnosis-related group] 471) suggested by Yarbro and Mortenson is not properly focused.  The prospective payment system using DRGs is a mechanism to pay for Medicare-covered services. Medicare was not meant to pay for clinical research, and Congress specifically excludes research from coverage. Before the Health Care Financing Administration can reimburse for a DRG 471, Congress must be convinced of the need to change the law.
Cytomegalovirus Retinitis — Evolving Therapies in a New Era
Authors: Richard J. Whitley, Gary N. Holland
Journal: New England Journal of Medicine (1999)

In this issue of the Journal, Martin and colleagues report the success of oral ganciclovir in reducing the risk of cytomegalovirus disease in the initially unaffected eye and other organs of patients with AIDS who have cytomegalovirus retinitis and who are treated with an intraocular ganciclovir implant.1 These findings confirm a long-held assumption about the value of such adjunctive therapy with oral ganciclovir. The study also hints at new directions for the management of cytomegalovirus retinitis in the era of potent antiretroviral therapy.The ganciclovir implant offers superior control of the activity of virus within the eye,2 but cytomegalovirus retinitis . . .
Assisted conception. II--In vitro fertilisation and intracytoplasmic sperm injection
Authors: P. Braude
Journal: BMJ (2003)

In vitro fertilisation (IVF) and intracytoplasmic sperm injection (ICSI) are two of the main types of assisted conception that take place in the laboratory. This article covers these two techniques in detail and looks at their safety and success.



Fertilisation: (left) each egg is surrounded by a complex of cumulus cells (purple) that the sperm need to disperse to reach the zona pellucida, the protective outer coating of the egg; (middle) capacitated sperm first bind to the zona pellucida (1) and release enzymes from the acrosome (2), which digest a pathway through the zona pellucida (3); (right) the sperm is able to fuse with the plasma membrane of the egg and becomes incorporated within the egg



In IVF, oocytes (obtained surgically from ovarian follicles in superovulated cycles) and prepared sperm are brought together in a dish in the laboratory. Fertilisation takes place outside the body (in vitro = in glass). Cleavage stage embryos derived from these fertilised oocytes are placed in the uterus (embryo transfer) for pregnancy to occur.

View this table:

Indications for IVF



### The process

#### Superovulation

Patients receive superovulation treatment with gonadotrophins, usually preceded by pituitary suppression with gonadotrophin releasing hormone analogues (see last week's article). A careful balance is needed to maximise safely the number of oocytes retrieved. Ideally, there should be a choice of embryos for transfer, and some embryos should be available for cryopreservation. However, the risk of ovarian hyperstimulation syndrome also needs to be minimised. Ultrasonography of the ovaries and in some cases monitoring the rise in plasma estradiol concentration are used to check the effect of superovulation. Administration of human chorionic gonadotrophin is scheduled when the leading follicles are≥18 mm in diameter, and given 34-38 hours before planned egg retrieval. About 10% of cycles are cancelled before the planned egg collection because the response to superovulation is excessive and …
Increased Activation of the Supragenual Anterior Cingulate Cortex during Visual Emotional Processing in Male Subjects with High Degrees of Alexithymia: An Event-Related fMRI Study
Authors: Alexander Heinzel, Ralf Schäfer, Hans-Wilhelm Müller, Andre Schieffer, Ariane Ingenhag, Simon B. Eickhoff, Georg Northoff, Matthias Franz, Hubertus Hautzel
Journal: Psychotherapy and Psychosomatics (2010)

&lt;i&gt;Background:&lt;/i&gt; One of the most prominent neurobiological models of alexithymia assumes an altered function of the anterior cingulate cortex (ACC) as the crucial neural correlate of alexithymia. So far functional imaging studies have yielded inconclusive results. Therefore, we tested this hypothesis in healthy alexithymics and nonalexithymics in an event-related fMRI study. &lt;i&gt;Methods:&lt;/i&gt;Thirty high- and 30 low-alexithymic right-handed male subjects (selected by the 20-item Toronto Alexithymia Scale, TAS-20) were investigated with event-related fMRI using a picture viewing paradigm. The stimuli consisted of happy, fearful and neutral facial expressions (Ekman-Friesen) as well as positive, negative and neutral pictures from the International Affective Picture System. &lt;i&gt;Results:&lt;/i&gt; Contrasting the high-alexithymic with the low-alexithymic group we observed increased activation of the supragenual ACC for different emotional valences as well as for different emotional stimuli. Moreover, there was a positive correlation of the ACC with the individual TAS-20 scores but no correlations with the individual Beck Depression Inventory scores. Additionally, there was no difference in activity of the amygdala. &lt;i&gt;Conclusions:&lt;/i&gt; We demonstrated that the supragenual ACC is constantly activated more strongly in alexithymic subjects and that this activation is related to the symptoms of alexithymia and not to associated symptoms such as depression. Therefore, our findings support the hypothesis of an altered function of the ACC in alexithymia.
Cancer and patients with end-stage renal failure.
Authors: J R Curtis
Journal: BMJ (1982)

Cancer and patients with end-stage renal failure Recipients of renal transplants may acquire cancer by the accidental transplantation of cancer cells with a kidney taken from donors with cancer, by the growth of residual or metastatic tumour in patients with pre-existing malignancy, or by the de-novo formation of neoplasms some time after transplantation.'An increased incidence of de-novo neoplasms has been reported1 2 in patients after renal transplantation, and the main factor responsible is thought to be the prolonged use of immunosuppressive drugs given to prevent rejection.Penn and Starzll reported 75 long-term survivors of organ transplanta- tion who had developed de-novo neoplasms, including 16 of their own patients.The incidence of neoplasia was 80 times greater than in the average population in a comparable age range.Forty-four of the patients had epithelial tumours, including squamous-cell or basal-cell skin carcinoma (11 cases), in-situ carcinoma of the cervix uteri (eight cases), carcinoma
Endothelial Fate Mapping in Mice With Pulmonary Hypertension
Authors: Lina Qiao, Toshihiko Nishimura, Lingfang Shi, Dane Sessions, Ama Thrasher, James R. Trudell, Gerald J. Berry, Ronald G. Pearl, Peter N. Kao
Journal: Circulation (2013)

Pulmonary endothelial injury triggers a reparative program, which in susceptible individuals is characterized by neointima formation, vascular narrowing, and the development of pulmonary arterial hypertension. The neointimal cells in human pathological plexiform lesions frequently coexpress smooth muscle α-actin and the endothelial von Willebrand antigen, creating a question about their cellular lineage of origin.Experimental pulmonary hypertension with neointima formation develops in C57Bl/6 mice subjected to left pneumonectomy followed 1 week later by jugular vein injection of monocrotaline pyrrole (20 μg/μL and 1 μL/g; group P/MCTP). Compared with the group vehicle, by day 35, group P/MCTP developed higher right ventricular systolic pressure (54±5 versus 25±2 mm Hg; P<0.01) and right ventricular hypertrophy (0.58±0.16 versus 0.26±0.05; P<0.01). Transgenic vascular endothelial-cadherin Cre recombinase or Tie-2 Cre mice were intercrossed with mTomato/mGreen fluorescent protein double-fluorescent Cre reporter mice to achieve endothelial genetic lineage marking with membrane-targeted green fluorescent protein. In control mice, few endothelial lineage-marked cells lining the lumen of small pulmonary arteries demonstrate expression of smooth muscle α-actin. Concurrent with the development of pulmonary hypertension, endothelial lineage-marked cells are prominent in the neointima and exhibit expression of smooth muscle α-actin and smooth muscle myosin heavy chain. Human pulmonary arterial hypertension neointimal lesions contain cells that coexpress endothelial CD31 or von Willebrand antigen and smooth muscle α-actin.Neointimal cells in pulmonary hypertension include contributions from the endothelial genetic lineage with induced expression of smooth muscle α-actin and smooth muscle myosin heavy chain.
Guselkumab (an IL-23–specific mAb) demonstrates clinical and molecular response in patients with moderate-to-severe psoriasis
Authors: Howard Sofen, Stacy Smith, Robert T. Matheson, Craig L. Leonardi, Cesar Calderon, Carrie Brodmerkel, Katherine Li, Kim Campbell, Stanley J. Marciniak, Yasmine Wasfi, Yuhua Wang, Philippe Szapary, James G. Krueger
Journal: Journal of Allergy and Clinical Immunology (2014)

IL-23 expression is increased in psoriatic lesions and might regulate TH17 T-cell counts in patients with psoriasis.We sought to test a novel IL-23-specific therapeutic agent for the treatment of psoriasis.In this randomized, double-blind, placebo-controlled study the safety, tolerability, and clinical response of guselkumab, an anti-IL-23-specific mAb, were evaluated in patients with moderate-to-severe plaque psoriasis. A total of 24 patients were randomized to receive a single dose of placebo or 10, 30, 100, or 300 mg of guselkumab. Clinical response was assessed by using the Psoriasis Area and Severity Index (PASI). Additionally, histologic analysis and gene expression in skin biopsy specimens from guselkumab-treated patients were compared with those from placebo-treated patients.At week 12, 50% (10 mg), 60% (30 and 100 mg), and 100% (300 mg) of guselkumab-treated patients, respectively, achieved a 75% improvement in PASI scores from baseline compared with 0% of placebo-treated patients. Improvements in PASI scores were generally maintained through week 24 in all guselkumab-treated patients. The proportion of patients experiencing an adverse event was comparable between the combined guselkumab (13/20 [65.0%]) and placebo (2/4 [50.0%]) groups through week 24. Analysis of lesional and nonlesional skin biopsy specimens demonstrated decreases in epidermal thickness and T-cell and dendritic cell expression in guselkumab-treated patients compared with values seen in placebo-treated patients. At week 12, significant reductions in psoriasis gene expression and serum IL-17A levels were observed in guselkumab-treated patients.IL-23 inhibition with a single dose of guselkumab results in clinical responses in patients with moderate-to-severe psoriasis, suggesting that neutralization of IL-23 alone is a promising therapy for psoriasis.
Possible causal role of lisinopril in a case of Kaposi's sarcoma
Authors: N. Bilen, D. Bayramgurler, B. Aydeniz, R. Apaydign, S.K. Ozkara
Journal: British Journal of Dermatology (2002)

Sir, Patients receiving immunosuppressive therapy are at increased risk for Kaposi's sarcoma (KS).1 In addition to immunosuppressive agents and corticosteroids, there were two case reports of KS in whom lesions had begun after captopril [angiotensin‐converting enzyme (ACE) inhibitor] treatment and disappeared after it was stopped.2, 3 Here we present a case of KS possibly caused by lisinopril therapy, which is another ACE inhibitor. A 78‐year‐old man presented with a 6‐month history of erythematous–violaceus plaques and nodular angiomatous lesions on the right shoulder (Fig. 1), left axilla and presternal region and a few nodules in the thighs. In addition, there were haemorrhagic and peduncular tumoral lesions on his left groin and gluteus. Oral mucosa was normal. He had severe lymphoedema of the lower extremities, and multiple, painless and mobile lymphadenopathies on the submandibular, axillary and inguinal areas. He had had diabetes mellitus for 6 years and hypertension for 28 years and had been taking lisinopril for 12 months. In addition, he had used digoxin, dipyridamole, pentaerythritol tetranitrate, ginkgo glicozids, carbamazepine and NPH‐insulin.
Genetic aberrations and survival in plasma cell leukemia
Authors: R E Tiedemann, N Gonzalez-Paz, R A Kyle, R Santana-Davila, T Price-Troska, S A Van Wier, W J Chng, R P Ketterling, M A Gertz, K Henderson, P R Greipp, A Dispenzieri, M Q Lacy, S V Rajkumar, P L Bergsagel, A K Stewart, R Fonseca
Journal: Leukemia (2008)
Blind and Double-Blind Techniques
Authors: Arthur K. Shapiro
Journal: JAMA (1969)

To the Editor:—  This communication is stimulated by Dr. A. Hoffer's letter to The Journal claiming historic priority for the first double—  study in psychiatry.1  My historic research, not yet completed, indicates that the first double-blind study was done by Rivers (1908) in experimental psychology.2The termdouble-blindwas not used to describe the procedure in the former study or in the second such done by Hollingsworth (1912.)3  Although the first partially double—  study was done by Gold et al in 1937,4the first reference to the term blind test was by Gold (1946) in a discussion of the placebo effect at a Cornell conference on therapy.5  The first complete double-blind study in clinical medicine was published in 1950 by Greiner et al.6  The first published double-blind study in psychiatry was done by Hampson et al in 1957.7  Dr. Hoffer reports
Security duties in Northern Ireland and the mental health of soldiers: prospective study
Authors: Geoff Lawrenson, Jane Ogden
Journal: BMJ (2003)

The psychological effects of conflict in wartime have attracted much interest,1 2 but today's army is more commonly employed to maintain internal security and as international peacekeeping forces. Such duties can result in psychological sequelae, including distress, nightmares, and tension.3 4 However, previous research has not included baseline morbidity and nor has it considered working on security duties in Northern Ireland, in which most of the army is employed. We prospectively explored how service in Northern Ireland affects the mental health of military personnel.

We selected a stratified sample of 200 servicemen from an infantry battalion of 566 according to rank (20 officers, 30 from the senior ranks of sergeant to warrant officer, and 150 from the junior ranks of corporal and below). We excluded six women, …
Functional Differentiation of Glycogenoses of the Liver with Respect to the Use of Glycerol
Authors: Boris Senior, Liliane Loridan
Journal: New England Journal of Medicine (1968)

In seven patients with glycogenoses of the liver the effects of glycerol administered by mouth on levels of glucose and of lactate, together with the response to epinephrine or glucagon, were correlated with the results of assays of glucose-6-phosphatase, amylo-1,6-glucosidase and phosphorylase performed on material obtained through biopsy of the liver. The effects on glucose levels were similar to those previously observed after the intravenous administration of glycerol. Patients deficient in glucose-6-phosphatase activity had elevated levels of lactate and little rise of glucose levels in response to either glycerol or epinephrine. By contrast, patients deficient in either amylo-1,6-glucosidase or phosphorylase had normal levels of lactate and enhanced elevations of glucose following glycerol administration. However, the patient lacking amylo-1,6-glucosidase showed little response to glucagon, whereas the response of the two believed deficient in phosphorylase was normal. In this group of seven patients these functional tests appeared to distinguish the patients more clearly than the in vitro enzyme assays.
Motor racing accidents at Brands Hatch, 1988/9.
Authors: M A Chapman, J Oni
Journal: British Journal of Sports Medicine (1991)

Little is known about the incidence of injury to race track motor-cyclists and car drivers. In a 1-year study at Brands Hatch, 70 of 33,184 competitors required hospital treatment. We found this injury rate to be higher than on the public highway. However, the anatomical distribution of injury caused by motor-bike accidents is similar to that found on the public highway. Motor-cyclists are more likely than car drivers to sustain limb trauma requiring outpatient treatment only. The number of participants requiring admission to hospital is broadly similar for car and bike races, being less than 0.1%.
Book: Oxymorons: The Myth of a US Health Care System
Authors: D. Woods
Journal: BMJ (2002)

Three factors militate against changing America's $1.3 trillion non-system of health care, says economist J D Kleinke. The first is chaos, which he believes is a rule, not an aberration, in the delivery of medicine. The second is behavioural inertia among the dozens of layers of healthcare administration. And the third is what he calls the “twaddle echo” factor, which is what executives, pundits, consultants, and other thought leaders in health care think at any given time will solve the first two problems.

The main problem, says Kleinke, is …
Pancreatic hypofunction in extrahepatic portal venous obstruction.
Authors: L Webb, G Smith-Laing, G Lake-Bakaar, S McKavanagh, S Sherlock
Journal: Gut (1980)

Pancreatic function was studied in 29 patients with extrahepatic portal venous obstruction, and 30 age-matched controls. The aetiology of the portal venous obstruction was known in 20 out of 29 patients. No patient had a history of pancreatitis. Serum trypsin, both fasting and for 120 minutes after a Lundh meal, was significantly lower in the patients than in controls (P less than 0.005). 5/28 (18%) patients had reduced fasting serum trypsin levels and in 5/14 trypsin was abnormal after a Lundh meal. Mean fasting serum glucose (3.8 +/- ).49 mmol/l was significantly higher than in control subjects (mean 3.4 +/- 0.42 mmol/l) (P less than 0.05). After 100 g glucose orally, mean serum glucose at 180 minutes (5.26 +/- 1.58 mmol/l) was higher than the control value (3.96 +/- 1.45 mmol/l) (P less than 0.05), and 30 and 60 minutes serum C-peptide values were significantly lower (P less than 0.005). Pancreatic hypofunction found in these patients probably results from an abnormal portal circulation in association with mild pancreatic damage secondary to chronic venous congestion.
Mutation of the gene encoding cellular retinaldehyde–binding protein in autosomal recessive retinitis pigmentosa
Authors: Marion A. Maw, Breandan Kennedy, Allison Knight, Robyn Bridges, Karen E. Roth, E.J. Mani, J.K. Mukkadan, Derek Nancarrow, John W. Crabb, Michael J. Denton
Journal: Nature Genetics (1997)
Hospitalization Charges, Costs, and Income for Firearm-Related Injuries at a University Trauma Center
Authors: Kenneth W. Kizer
Journal: JAMA (1995)

<h3>Objective.</h3> —To quantify the actual cost of inpatient medical care for firearm-related injuries at a university trauma center. <h3>Design.</h3> —Retrospective case series of all hospital admissions for firearm-related injuries for the 3 years 1990 through 1992. Total inpatient financial data were examined by means of a recently instituted cost-accounting methodology. <h3>Setting.</h3> —Level I trauma center at a university hospital that provides trauma care and tertiary care to 3.7 million residents of 23 counties. <h3>Patients.</h3> —A total of 787 consecutive patients were admitted to the hospital with firearm-related injuries. Information from the trauma registry and hospital finance records were linked for 750 (95%) of these patients. <h3>Main Outcome Measures.</h3> —Total inpatient hospital charges, costs, revenues, and net income according to payer source. <h3>Results.</h3> —Men aged 15 to 44 years accounted for 77% of patients with firearm-related injuries. The overall mean and median hospital charges per admission were $52 271 and $28 033, respectively, whereas the overall mean and median hospital costs per admission were $13 794 and $7964, respectively. The net income per patient ranged from an average loss of $6980 for eacn patient having no insurance to an average profit of $28 557 for each patient with a health maintenance organization contract. The losses sustained on nonsponsored and Medicaid patients were more than offset by net income from patients having private health insurance, Medicare, or other insurance coverage such that there was an average profit of $5809 per admission for a firearm-related injury. <h3>Conclusions.</h3> —Treatment of firearm-related injuries produces net income for this university trauma center by virtue of the cost shifting built into its pricing structure. If data from this institution are extrapolated to the nation, then the actual cost of providing medical care for firearm-related injuries in the United States in 1995 is projected to be $4.0 billion. The majority of this cost will be paid indirectly by private health insurance. (<i>JAMA</i>. 1995;273:1768-1773)