tbuckley/cabot-search huggingface dataset:
The Effect of Unmet Expectations among Adults Presenting with Physical Symptoms
Authors: Jeffrey L. Jackson
Journal: Annals of Internal Medicine (2001)

Background: Unmet patient expectations are common and have been associated with decreased patient satisfaction. Objective: To assess the prevalence and effect of unmet expectations in patients presenting with physical symptoms. Design: Prospective cohort study. Setting: Primary care walk-in clinic. Most patients were seeing a particular provider for the first time. Patients: 750 adults whose principal reason for the clinic visit was a physical symptom. Measurements: Patients completed previsit questionnaires that assessed symptom characteristics, the patient's expectations of the visit, functional status (Medical Outcomes Study Short Form-6), and mental disorders (Primary Care Evaluation of Mental Disorders [PRIME-MD]). Patient questionnaires given immediately after the visit and 2 weeks after the visit assessed patient satisfaction with the visit and unmet expectations; the 2-week questionnaire also assessed symptom outcome and functional status. Postvisit physician questionnaires measured encounter difficulty (Difficult Doctor Patient Relationship Questionnaire) and what the physician did in response to the patient's symptom. Results: Nearly all patients (98%) had at least one previsit expectation, including a diagnosis (81%), an estimate of how long the symptom was likely to last (63%), a prescription (60%), a diagnostic test (54%), and a subspecialty referral (45%). Immediately after the visit, the most common unmet expectations were for prognostic information (51%) or diagnostic information (33%). Only 11% of patients had an unmet expectation of a diagnostic test, subspecialty referral, prescription, or sick slip. Unmet patient expectations were more common after encounters experienced as difficult by the clinician and in patients with underlying mental disorders. Patients with no unmet expectations had less worry about serious illness (54% vs. 27%; P < 0.001) and greater satisfaction (59% vs. 19%; P < 0.001), and patients who reported receiving diagnostic or prognostic information were more likely to have symptom alleviation (relative risk, 1.2 [95% CI, 1.02 to 1.3]) and functional improvement (functional status score, 25 vs. 23; P = 0.01) at 2 weeks. Conclusions: Patients who seek care for physical symptoms and do not leave the encounter with an unmet expectation are more likely to be satisfied with their care and to have less worry about serious illness. Diagnostic and prognostic information are particularly valued by patients and may be associated with greater improvement in symptoms and functional status 2 weeks after the visit.
Professional self respect: rights and responsibilities in the new NHS
Authors: P. Richards
Journal: BMJ (1998)

The NHS faces a widening gap between demands and resources. 1 2 The UK government has promised substantial additional funding over the next three years. In return, it expects doctors to help reshape the delivery of health care. Meanwhile, as a result of the Bristol case 3 4 (in which two surgeons from Bristol were found guilty by the General Medical Council of continuing to operate on children when they knew their death rates were unacceptably high) the public is asking whether doctors can be trusted,5 and government ministers are murmuring that the medical profession is a law unto itself. Certainly, the public and politicians suspect that doctors cover up their failings, although neither perhaps would go as far as George Bernard Shaw in asserting that “every doctor will allow a colleague to decimate the whole countryside sooner than vitiate the bond of professional etiquette by giving him away.”6

#### Summary points

If the process of …
Time course of neointimal proliferation arterial remodeling after directional atherectomy: serial ultrasound observations from adjunctive balloon angioplasty following coronary atherectomy study
Authors: H. Hosokawa, O. Kato, H. Tamai, T. Yamaguchi, T. Aizawa, T. Suzuki
Journal: Journal of the American College of Cardiology (1998)
Dysfunctional Interaction of C/EBPα and the Glucocorticoid Receptor in Asthmatic Bronchial Smooth-Muscle Cells
Authors: Michael Roth, Peter R.A. Johnson, Peter Borger, Michel P. Bihl, Jochen J. Rüdiger, Gregory G. King, Qi Ge, Katrin Hostettler, Janette K. Burgess, Judith L. Black, Michael Tamm
Journal: New England Journal of Medicine (2004)

Increased proliferation of bronchial smooth-muscle cells may lead to increased muscle mass in the airways of patients with asthma. The antiproliferative effect of glucocorticoids in bronchial smooth-muscle cells in subjects without asthma is mediated by a complex of the glucocorticoid receptor and the CCAAT/enhancer binding protein alpha (C/EBPalpha). We examined the signaling pathway controlling the inhibitory effect of glucocorticoids on cell proliferation and interleukin-6 synthesis in bronchial smooth-muscle cells of subjects with asthma and those without asthma.Lines of bronchial smooth-muscle cells were established from cells from 20 subjects with asthma, 8 subjects with emphysema, and 26 control subjects. Cell proliferation was determined by means of cell counts and [3H]thymidine incorporation. Signal transduction was studied by means of an electrophoretic DNA mobility-shift assay, a supershift electrophoretic-mobility assay, immunoblotting, use of C/EBPalpha antisense oligonucleotides, and use of a human C/EBPalpha expression vector. Interleukin-6 release was determined by means of an enzyme-linked immunosorbent assay.Glucocorticoids activated the glucocorticoid receptor and inhibited serum-induced secretion of interleukin-6 in bronchial smooth-muscle cells from both subjects with asthma and those without asthma; however, glucocorticoids inhibited proliferation only in bronchial smooth-muscle cells from subjects without asthma. C/EBPalpha protein was detected by immunoblotting in all bronchial smooth-muscle cells from subjects without asthma but not in those with asthma, whereas the protein was expressed in lymphocytes from both groups of subjects. C/EBPalpha antisense oligonucleotides or the glucocorticoid-receptor inhibitor mifepristone reversed the antiproliferative effect of glucocorticoids in bronchial smooth-muscle cells from subjects without asthma. When bronchial smooth-muscle cells from subjects with asthma were transiently transfected with an expression vector for human C/EBPalpha, two forms of the protein were expressed, and subsequent administration of glucocorticoids inhibited cell proliferation.We hypothesize that a cell-type-specific absence of C/EBPalpha is responsible for the enhanced proliferation of bronchial smooth-muscle cells derived from subjects with asthma and that it explains the failure of glucocorticoids to inhibit proliferation in vitro.
Lifestyle Modification for Obesity
Authors: Thomas A. Wadden, Victoria L. Webb, Caroline H. Moran, Brooke A. Bailer
Journal: Circulation (2012)

panels sponsored by both the World Health Organization and the National Institutes of Health have recommended that obese adults (ie, body mass index Ն30 kg/m 2 ), as well as those who are overweight (body mass index of 25-29.9kg/m 2 ) and have comorbid conditions, lose 10% of their initial weight. 1,2A comprehensive program of lifestyle modification is considered the first option for achieving this goal. 2Lifestyle modification, also referred to as behavioral weight control, includes 3 primary components: diet, exercise, and behavior therapy. 3his narrative review examines weight losses achieved with this approach, as well as new developments with each of the 3 components.
THE EFFECT OF A TISSUE ENZYME UPON PNEUMOCOCCI
Authors: René J. Dubos, C. M. MacLeod
Journal: The Journal of Experimental Medicine (1938)

Polymorphonuclear leucocytes contain an enzyme which destroys the basophilic character of beat-killed pneumococci (R and S variants) and inactivates the type specific polysaccharide antigen of encapsulated cells. The same enzyme, however, fails to cause a disintegration of the bacterial cells, or to decompose the capsular polysaccharide itself. The enzyme has been extracted from a number of animal tissues; it appears identical with a purified enzyme extracted from pancreatin and which decomposes yeast nucleic acid. These facts are considered with regard to the failure of rabbits to produce the type specific carbohydrate antibodies when immunized with heat-killed encapsulated pneumococci by the intradermal route.
Active Lifestyle Concept (ALC): a health and fitness enhancing concept at the workplace
Authors: D Lagerstrøm
Journal: British Journal of Sports Medicine (2010)

The ongoing changes in society and in the workplace setting have lead to a new major challenge: health problems caused by sedentary lifestyle. With our background and experience of more than 30 years in the field of workplace health promotion, and with a focus on health related physical activity and well-being, we were able to achieve excellent results in the area of physical health, not only in small companies, but in large international companies such as Dynamit Nobel, Ruhrkohle and Siemens. Some of the noteworthy results are a reduction of 50% in spinal depression during an 8-h work shift as a result of a change in the daily routine such as standing up when using the phone – which does not conflict with breaks or work-time (Eckey et al , 1987), and an improvement of aerobic capacity of 15–20% within 12 weeks by individuals with sedentary lifestyles as a result of walking 20 floors a day (Lagerstrøm/Froboese 1997). At the same time we also identified a growing challenge, caused by the general lack of physical activity in our society. This has led us to develop new strategies and concepts, with a strong focus on the laws of nature, such as the stimulus and economising principles, and a focus on people whose primary motive of staying physically active is not necessarily sports or fitness-training (Lagerstrøm 2010). This ‘Active Lifestyle Concept’ therefore concentrates on establishing a concept where the company's responsibility is to establish activities and programmes that lead to an individual self-concept and long-term effects concerning a healthy and active lifestyle. The quality management includes structure, process and result management. In order to base the recommendations and programmes on individuality, we use questionnaires, screening and test protocols, which are easy, safe and reproducible. To avoid negative experiences, which is very important to people with sedentary lifestyles, we focus on basic activities, movement and skills, try to avoid overstress in the programme as well as at the workplace, and build up a process and stabilise a good psychosomatic balance in the long term. To achieve this, we also apply the principles of the Norwegian ‘Friluftsliv’ (not sports-related, nature based, outdoor activities and behaviour). Besides the special workplace activities, we also have a great focus on activities of daily living and leisure time activities, which can lead to an active lifestyle without sports and fitness-training (Lagerstrøm 2010).
Scottish parliament urged to ban tobacco advertising
Authors: B. Christie
Journal: BMJ (2001)

The Scottish parliament is being urged to go it alone and ban tobacco advertising after the failure of the Westminster government to bring forward legislation.

A coalition of health professionals and cancer charities has been formed in Scotland to campaign for a ban. They are supporting a private member's bill, which the SNP (Scottish National party) has promised to introduce into the Scottish parliament.

The BMA, the Royal College of Nursing, the Imperial Cancer Research Fund, Macmillan Cancer Relief, the Roy Castle Lung Cancer Foundation, the Royal …
Abstract 5617: Enhancement of antitumor radiation efficacy and the abscopal effect by ECI301 mediated TLR4 dependent innate immunity in mice
Authors: Kenshiro Shiraishi, Shoji Yokochi, Yoshiro Ishiwata, Mariko Ishihara, Keiichi Nakagawa, Kouji Matsushima
Journal: Cancer Research (2010)

Abstract [Background] We have previously demonstrated that ECI301, a variant form of human MIP-1α, induced marked inhibition of tumor growth at the irradiated site, with complete tumor eradication and consistent induction of prevention of tumor growth at a non-irradiated site, designated as an abscopal effect (Clin Cancer Res. 2008;14(4):1159-66). This abscopal effect was tumor type independent. In current study, we further studied the action of ECI301 using C3H/HeN, C3H/HeJ and athymic mice implanted with tumor cells. Using RT-PCR analysis, we had found that high mobility group box 1 (HMGB1) RNA level, an important mediator of local and systemic inflammation was up-regulated by ECI301 in tumor tissue. So we also carried out anti-HMGB1 antibody treatment in tumor-bearing mice with ECI301 and radiation. [Methods] FM3A cells were subcutaneously implanted in the both flanks of C3H/HeN and C3H/HeJ mice. When tumor size reached approximately 10 mm in diameter, local irradiation (6 Gy) was delivered from just above the right tumor and ECI301 was administrated as a single dose intravenously once a day for 5 consecutive days, beginning at day 1 after irradiation. Athymic nude mice bearing subcutaneous colon26 tumor cells were treated with local irradiation and ECI301 was administrated as the same manner. [Results] ECI301 inhibited the tumor growth not only in the right flank but also in the left flank (non-irradiation site) in C3H/HeN mice implanted with FM3A cells. In C3H/HeJ mice, however, ECI301 did not enhance the effect of irradiation on the tumor in both flanks. In C3H/HeN study, HMGB1 RNA level was up-regulated in both sides of tumor. Moreover, anti-HMGB1 antibody treatment eliminated the anti-tumor effect of ECI301 in both sides. Furthermore, ECI301 did not inhibit the tumor growth in athymic mice implanted with colon26 cells. These results suggest that the ECI301-induced abscopal effect may be exerted via TLR4 and depend on the activation of T cells, and indicates that the effect of ECI301 may be promoted via inflammation in irradiated tumor tissue with HMGB1-dependent mechanism. [Conclusion] Ionizing radiation induces inflammation and immune response in irradiated tumor tissue. This immunological mechanism is greatly enhanced by ECI301, resulting in the abscopal effect that is essentially intriguing for clinical setting. Our data will encourage future therapeutic application of ECI301 in the treatment of advanced or metastatic cancer with radiation therapy. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 5617.
Development and evaluation of a system of microencapsulation of primary rat hepatocytes
Authors: Zhuhui Cai, Zhiqing Shi, Morris Sherman, Anthony M. Sun
Journal: Hepatology (1989)

To determine the in vitro function of microencapsulated hepatocytes, viable hepatocytes were isolated from rats and encapsulated within biocompatible alginate-polylysine membranes for in vitro studies. Urea formation, prothrombin and cholinesterase activity, the incorporation of tritiated leucine into intracellular proteins and the immunolocation of synthesized albumin were monitored in culture. Despite a decrease in some of these activities, the cultured hepatocytes continued to function throughout the 5-week observation period, producing and excreting urea, prothrombin and cholinesterase activity into the medium. In addition, albumin could be demonstrated within encapsulated hepatocytes for up to 5 weeks. Scanning and transmission electron microscopy showed the cells to be embedded within the alginate matrix and to retain a globular shape.
Therapy of Hepatitis B — Viral Suppression or Eradication?
Authors: Robert P. Perrillo
Journal: Hepatology (2006)

The practicing clinician is currently faced with a number of treatment options for chronic hepatitis B. Beginning in 1998 with the licensing of lamivudine and subsequently adefovir, the treatment paradigm shifted from 4 to 6 months of conventional alfa interferon to a year of nucleoside analog therapy. However, prolonged treatment with nucleoside analogs is often needed to optimize virological response. Recently, a 48-week regimen of pegylated interferon for hepatitis B e antigen (HBeAg)-positive and HBeAg-negative chronic hepatitis B has been shown to be effective, and long-term nucleoside analog therapy has been demonstrated to maintain viral suppression. These findings have added to the complexity of decision-making and have raised questions about whether a finite course of pegylated interferon or nucleoside analog therapy, with possible long-term maintenance, is better as first-line therapy. Each of these fundamentally different approaches has advantages and limitations, and both have a place in the therapeutic armamentarium against chronic hepatitis B. Long-term therapy with nucleoside analogs, however, raises a number of practical concerns that have not been fully addressed as of yet. I will present evidence in support of the recommendation that antiviral therapy should ideally be directed toward achieving the highest rate of viral clearance with the shortest interval of treatment.
Nicaragua: The Role of USAID
Authors: Janet C. Ballantyne
Journal: JAMA (1994)

<h3>To the Editor.</h3> —The Letter From Nicaragua by Garfield et al<sup>1</sup>states that following the 1990 election, which brought President Violeta Chamorro to power, US Agency for International Development (USAID) assistance to the Nicaraguan health sector was confined to responding to several emergencies. The article goes on to state that the Pan American Health Organization (PAHO) was the only international organization able to respond quickly to the new situation. The facts are quite different. In 1990, during the first 8 months of President Chamorro's government, USAID provided a total of $9.4 million in assistance to Nicaragua's health sector. Of this total, $2.2 million was used to procure emergency medicines after the former Sandinista government had ransacked the state-run medical supply cabinets; $6.5 million was used to fund private voluntary agencies engaged in providing immediate health services to war victims as well as poor women and children; $700 000 went
Protection of an Insulin Pump in the Amazonian Jungle
Authors: Jane Muir
Journal: JAMA (1989)

<h3>To the Editor. —</h3> A 50-year-old physician with diabetes mellitus recently traveled deep into the Ecuadorian Amazon rain forest. This physician had controlled his diabetes with an insulin pump for the past 9 years. Although he was well accustomed to temporarily removing his pump to protect it from water exposure in showers and baths and during swimming, he was concerned about travel to an environment that was oppressively humid, where intense rainfall occurred without warning, and that was approachable only via a narrow canoe navigating the broad, turbulent Rio Napo. Desiring to protect his battery-operated insulin pump at all costs, the physician requested help of an enterostomal therapist. She devised a protective apparatus normally used for collecting colostomy or ileostomy effluents and adapted it for maintaining the pump within a watertight seal. A Hollister Two-Piece Ostomy System with a 10-cm flange was adapted to the job by cutting out a
Performance indicators for primary care groups: an evidence based approach
Authors: A. McColl, P. Roderick, J. Gabbay, H. Smith, M. Moore
Journal: BMJ (1998)

In England primary care groups will have a key role in promoting the health and improving the health care of their local population.1 By April 1999 these groups, involving all primary care professionals, will provide and commission health care for roughly 100 000 people in each locality. Primary care groups will be accountable to health authorities and “will agree targets for improving health, health services and value for money.”1There will be several primary care groups in each district health authority. This new approach offers primary care the opportunity to further integrate health promotion and health care at the individual and population levels.

The present UK government intends to manage the performance of the “new NHS”; the word performance appeared 88 times in its recent white paper.1 It has published a national framework for assessing performance as a consultation document,2and primary care groups within health authorities will be judged to have “performed” well on the basis of the indicators listed in table 1. Most are attributable in part to primary care, but only some are linked to interventions that will necessarily lead to improved health outcomes. The government has also proposed four targets for England in its green paper Our Healthier Nation .3 Approaches taken by health authorities, and presumably by primary care groups, will be “fully monitored by the Regional Offices of the NHS Executive.”3 These targets for reduced death rates from heart disease and stroke, cancer, suicide, and accidents are all outcome indicators but, again, are only partly attributable to primary care.

### Summary points

The NHS Executive and Department of Health have proposed a wide range of performance indicators many of which are applicable to future primary care groups

Some of these indicators reflect access and efficiency, but few of the effectiveness …
Loss of transforming growth factor β adaptor protein β-2 spectrin leads to delayed liver regeneration in mice
Authors: Arun Thenappan, Vivek Shukla, Feras J. Abdul Khalek, Ying Li, Kirti Shetty, Pu Liu, Lu Li, Randy L. Johnson, Lynt Johnson, Lopa Mishra
Journal: Hepatology (2010)

Abstract Liver regeneration, following partial hepatectomy (PHx), occurs through precisely controlled and synchronized cell proliferation, in which quiescent hepatocytes undergo one to two rounds of replication, with restoration of liver mass and function. We previously demonstrated that loss of the Smad3/4 adaptor protein β-2 spectrin (β2SP) is associated with faster entry into S phase, and hepatocellular cancer formation. These observations led us to further pursue the role of β2SP in cell cycle progression in vivo . Liver regeneration studies with PHx in β2SP+/− mice reveal a surprising and significant decrease in liver/body weight ratio at 48 hours after PHx in β2SP+/− mice in comparison to wildtype mice. At 48 hours after PHx we also observe decreased levels of cyclin E (2.4-fold, P &lt; 0.05), Cdk1 (7.2-fold, P &lt; 0.05), cyclin A, pRb (Ser249/Thr252), proliferative cell nuclear antigen (PCNA), cyclin D1 with elevated levels of pCdk1 (Thr14) (3.6-fold, P &lt; 0.05). Strikingly, at 24 hours elevated levels of p53 (4-fold, P &lt; 0.05), phospho-p53 (ser15 and ser20), and p21 (200-fold, P &lt; 0.05) persisting to 48 hours after PHx further correlated with raised expression of the DNA damage markers pChk2 (Thr68) and γH2AX (S139). However, compromised cell cycle progression with loss of β2SP is not rescued by inhibiting p53 function, and that G2/M phase arrest observed is independent and upstream of p53. Conclusion : β2SP deficiency results in dysfunctional hepatocyte cell cycle progression and delayed liver regeneration at 48 hours after PHx, which is p53-independent. β2SP loss may increase susceptibility to DNA damage, impair cell cycle progression, and ultimately lead to hepatocellular cancer. (Hepatology 2011;)
Relating Bayes to cognitive mechanisms
Authors: Mitchell Herschbach, William Bechtel
Journal: Behavioral and Brain Sciences (2011)

Abstract We support Enlightenment Bayesianism's commitment to grounding Bayesian analysis in empirical details of psychological and neural mechanisms. Recent philosophical accounts of mechanistic science illuminate some of the challenges this approach faces. In particular, mechanistic decomposition of mechanisms into their component parts and operations gives rise to a notion of levels distinct from and more challenging to accommodate than Marr's.