tbuckley/cabot-search huggingface dataset:
Comparative Effectiveness of Childhood Obesity Interventions in Pediatric Primary Care
Authors: Elsie M. Taveras, Richard Marshall, Ken P. Kleinman, Matthew W. Gillman, Karen Hacker, Christine M. Horan, Renata L. Smith, Sarah Price, Mona Sharifi, Sheryl L. Rifas-Shiman, Steven R. Simon
Journal: JAMA Pediatrics (2015)

Evidence of effective treatment of childhood obesity in primary care settings is limited.To examine the extent to which computerized clinical decision support (CDS) delivered to pediatric clinicians at the point of care of obese children, with or without individualized family coaching, improved body mass index (BMI; calculated as weight in kilograms divided by height in meters squared) and quality of care.We conducted a cluster-randomized, 3-arm clinical trial. We enrolled 549 children aged 6 to 12 years with a BMI at the 95% percentile or higher from 14 primary care practices in Massachusetts from October 1, 2011, through June 30, 2012. Patients were followed up for 1 year (last follow-up, August 30, 2013). In intent-to-treat analyses, we used linear mixed-effects models to account for clustering by practice and within each person.In 5 practices randomized to CDS, pediatric clinicians received decision support on obesity management, and patients and their families received an intervention for self-guided behavior change. In 5 practices randomized to CDS + coaching, decision support was augmented by individualized family coaching. The remaining 4 practices were randomized to usual care.Smaller age-associated change in BMI and the Healthcare Effectiveness Data and Information Set (HEDIS) performance measures for obesity during the 1-year follow-up.At baseline, mean (SD) patient age and BMI were 9.8 (1.9) years and 25.8 (4.3), respectively. At 1 year, we obtained BMI from 518 children (94.4%) and HEDIS measures from 491 visits (89.4%). The 3 randomization arms had different effects on BMI over time (P = .04). Compared with the usual care arm, BMI increased less in children in the CDS arm during 1 year (-0.51 [95% CI, -0.91 to -0.11]). The CDS + coaching arm had a smaller magnitude of effect (-0.34 [95% CI, -0.75 to 0.07]). We found substantially greater achievement of childhood obesity HEDIS measures in the CDS arm (adjusted odds ratio, 2.28 [95% CI, 1.15-4.53]) and CDS + coaching arm (adjusted odds ratio, 2.60 [95% CI, 1.25-5.41]) and higher use of HEDIS codes for nutrition or physical activity counseling (CDS arm, 45%; CDS + coaching arm, 25%; P < .001 compared with usual care arm).An intervention that included computerized CDS for pediatric clinicians and support for self-guided behavior change for families resulted in improved childhood BMI. Both interventions improved the quality of care for childhood obesity.clinicaltrials.gov Identifier: NCT01537510.
Co-option of Membrane Wounding Enables Virus Penetration into Cells
Authors: Stefania Luisoni, Maarit Suomalainen, Karin Boucke, Lukas B. Tanner, Markus R. Wenk, Xue Li Guan, Michał Grzybek, Ünal Coskun, Urs F. Greber
Journal: Cell Host & Microbe (2015)
T Cell Costimulation through CD28 Depends on Induction of the Bcl-xγ Isoform
Authors: Qunrui Ye, Barry Press, Stephan Kissler, Xiao-Feng Yang, Linrong Lu, Craig H. Bassing, Barry P. Sleckman, Marianne Jansson, Vily Panoutsakopoulou, Linda A. Trimble, Frederick W. Alt, Harvey Cantor
Journal: The Journal of Experimental Medicine (2002)

The molecular basis of CD28-dependent costimulation of T cells is poorly understood. Bcl-xγ is a member of the Bcl-x family whose expression is restricted to activated T cells and requires CD28-dependent ligation for full expression. We report that Bcl-xγ–deficient (Bcl-xγ−/−) T cells display defective proliferative and cytokine responses to CD28-dependent costimulatory signals, impaired memory responses to proteolipid protein peptide (PLP), and do not develop PLP-induced experimental autoimmune encephalomyelitis (EAE). In contrast, enforced expression of Bcl-xγ largely replaces the requirement for B7-dependent ligation of CD28. These findings identify the Bcl-xγ cytosolic protein as an essential downstream link in the CD28-dependent signaling pathway that underlies T cell costimulation.
Imaging features of adenomyosis
Authors: C Reinhold
Journal: Human Reproduction Update (1998)

This review focuses on non-invasive imaging techniques that have proven useful in diagnosing adenomyosis, including hysterosalpingography, transabdominal and endovaginal ultrasound, as well as magnetic resonance imaging. An understanding of the histopathological features of this disease is crucial when attempting to interpret the associated imaging findings. The muscular hyperplasia accompanying the heterotopic endometrial tissue actually produces the typical gross appearance of adenomyosis and corresponds to areas of decreased echogenicity or signal intensity on ultrasound and magnetic resonance imaging respectively. The heterotopic endometrial tissue also contributes to the imaging appearance of adenomyosis, and with the advent of high resolution imaging techniques, these changes are being detected with increasing frequency, including the presence of myometrial nodules, linear striation, poor definition and nodularity of the endo-myometrial cysts or haemorrhagic foci. The purpose of this review is to (i) present the spectrum of imaging findings of adenomyosis, (ii) illustrate potential pitfalls in diagnosis and (iii) review the accuracy and role of currently available noninvasive imaging techniques.
Molecular detection of Ehrlichia canis in cats in Brazil
Authors: L.S. de Oliveira, L.C. Mourão, K.A. Oliveira, M. da Matta Agostini, A.C. de Oliveira, M.R. de Almeida, J.L.R. Fietto, L.G. Conceição, J.D.R. Filho, M.A.M. Galvão, C. Mafra
Journal: Clinical Microbiology and Infection (2009)
United Kingdom back pain exercise and manipulation (UK BEAM) randomised trial: effectiveness of physical treatments for back pain in primary care
Journal: BMJ (2004)

<h3>Abstract</h3> <b>Objective</b> To estimate the effect of adding exercise classes, spinal manipulation delivered in NHS or private premises, or manipulation followed by exercise to “best care” in general practice for patients consulting with back pain. <b>Design</b> Pragmatic randomised trial with factorial design. <b>Setting</b> 181 general practices in Medical Research Council General Practice Research Framework; 63 community settings around 14 centres across the United Kingdom. <b>Participants</b> 1334 patients consulting their general practices about low back pain. <b>Main outcome measures</b> Scores on the Roland Morris disability questionnaire at three and 12 months, adjusted for centre and baseline scores. <b>Results</b> All groups improved over time. Exercise improved mean disability questionnaire scores at three months by 1.4 (95% confidence interval 0.6 to 2.1) more than “best care.” For manipulation the additional improvement was 1.6 (0.8 to 2.3) at three months and 1.0 (0.2 to 1.8) at 12 months. For manipulation followed by exercise the additional improvement was 1.9 (1.2 to 2.6) at three months and 1.3 (0.5 to 2.1) at 12 months. No significant differences in outcome occurred between manipulation in NHS premises and in private premises. No serious adverse events occurred. <b>Conclusions</b> Relative to “best care” in general practice, manipulation followed by exercise achieved a moderate benefit at three months and a small benefit at 12 months; spinal manipulation achieved a small to moderate benefit at three months and a small benefit at 12 months; and exercise achieved a small benefit at three months but not 12 months.
842-3 Blunted erythropoietin production and defective iron supply for erythropoiesis as major causes of anemia in patients with chronic heart failure
Authors: Cristina Opasich, Mario Cazzola, Stefania De Feo, Enzo Bosimini, Rocco La Gioia, Oreste Febo, Roberto Ferrari, Gloria Francolini, Remiglio Moratti, Laura Scelsi, Maurizio Volterrani, Roberto Tramarin, Luigi Tavazzi
Journal: Journal of the American College of Cardiology (2004)
The Effect of Flexible Low Glycemic Index Dietary Advice Versus Measured Carbohydrate Exchange Diets on Glycemic Control in Children With Type 1 Diabetes
Authors: Heather R. Gilbertson, Jennie C. Brand-Miller, Anne W. Thorburn, Sharon Evans, Patty Chondros, George A. Werther
Journal: Diabetes Care (2001)

OBJECTIVE—To determine the long-term effect of low glycemic index dietary advice on metabolic control and quality of life in children with type 1 diabetes. RESEARCH DESIGN AND METHODS—Children with type 1 diabetes (n = 104) were recruited to a prospective, stratified, randomized, parallel study to examine the effects of a measured carbohydrate exchange (CHOx) diet versus a more flexible low–glycemic index (GI) dietary regimen on HbA1c levels, incidence of hypo- and hyperglycemia, insulin dose, dietary intake, and measures of quality of life over 12 months. RESULTS—At 12 months, children in the low-GI group had significantly better HbA1c levels than those in the CHOx group (8.05 ± 0.95 vs. 8.61 ± 1.37%, P = 0.05). Rates of excessive hyperglycemia (&amp;gt;15 episodes per month) were significantly lower in the low-GI group (35 vs. 66%, P = 0.006). There were no differences in insulin dose, hypoglycemic episodes, or dietary composition. The low-GI dietary regimen was associated with better quality of life for both children and parents. CONCLUSIONS—Flexible dietary instruction based on the food pyramid with an emphasis of low-GI foods improves HbA1c levels without increasing the risk of hypoglycemia and enhances the quality of life in children with diabetes.
Regular Smoking and Asthma Incidence in Adolescents
Authors: Frank D. Gilliland, Talat Islam, Kiros Berhane, W. James Gauderman, Rob McConnell, Edward Avol, John M. Peters
Journal: American Journal of Respiratory and Critical Care Medicine (2006)

Rationale: Although involuntary exposure to maternal smoking during the in utero period and to secondhand smoke are associated with occurrence of childhood asthma, few studies have investigated the role of active cigarette smoking on asthma onset during adolescence.Objectives: To determine whether regular smoking is associated with the new onset of asthma during adolescence.Methods: We conducted a prospective cohort study among 2,609 children with no lifetime history of asthma or wheezing who were recruited from fourth- and seventh-grade classrooms and followed annually in schools in 12 southern California communities. Regular smoking was defined as smoking at least seven cigarettes per day on average over the week before and 300 cigarettes in the year before each annual interview. Incident asthma was defined using new cases of physician-diagnosed asthma.Measurements and Main Results: Regular smoking was associated with increased risk of new-onset asthma. Children who reported smoking 300 or more cigarettes per year had a relative risk (RR) of 3.9 (95% confidence interval [95% CI], 1.7–8.5) for new-onset asthma compared with nonsmokers. The increased risk from regular smoking was greater in nonallergic than in allergic children. Regular smokers who were exposed to maternal smoking during gestation had the largest risk from active smoking (RR, 8.8; 95% CI, 3.2–24.0).Conclusions: Regular smoking increased risk for asthma among adolescents, especially for nonallergic adolescents and those exposed to maternal smoking during the in utero period.
Lineages of language and the diagnosis of asthma.
Authors: Gopalakrishnan Netuveli, Brian Hurwitz, Aziz Sheikh
Journal: Journal of the Royal Society of Medicine (2007)

Asthma, wheeze and cough are words with profoundly differing histories, etymologies and meanings. Yet their medical usage today is clustered around the diagnosis and management of a single disease. Hitherto, asthma has been a clinical diagnosis but wheeze, cough and asthma now are key terms in cross-cultural questionnaire surveys which seek information on asthma prevalence. In this essay, we examine differences in the linguistic properties of terms likely to be relevant to interpreting large-scale variations in asthma prevalence uncovered by questionnaires. We show how etymologically distinct each term is: while asthma and cough each share semantic congruencies across six European languages, albeit for different reasons, there is less congruence across these languages for the term wheeze. The medical meanings of all three terms contrast with meanings revealed by the non-medical usage of all three terms, which are highly figurative. Linguistic considerations indicate that interpretation of international questionnaires that phrase questions in terms of cough, asthma and their derivatives are likely to be more reliable for the purposes of comparing prevalence than those which deploy questions phrased in terms of wheeze.
Heritability, theory of mind, and the nature of normality
Authors: Linda Mealey
Journal: Behavioral and Brain Sciences (1997)

It is impossible to discuss the constructs “heritability,” “theory of mind,” and “normality” in a single coherent essay. The following three rejoinders address each of these exceedingly complex constructs individually, as each relates to the two-path model of sociopathy and psychopathy.
Chlamydial Infection in sheep: Immune Control versus Fetal Pathology
Authors: G Entrican, D Buxton, D Longbottom
Journal: Journal of the Royal Society of Medicine (2001)

Chlamydial abortion was first described by Greig1 in 1936 and named enzootic abortion of ewes (EAE). At that time he suggested that it was the result of environmental factors such as dietary deficiency. It was not until 1950 that Stamp and colleagues2 demonstrated that it was an infectious condition caused by an organism of the ‘psittacosis-lymphogranuloma venereum group’. In the mid 1960s specific phenotypic traits of the chlamydial strains were identified (sulphadiazine sensitivity and glycogen accumulation), which together with inclusion morphology became the basis by which the strains were differentiated into the two species Chlamydia trachomatis and C. psittaci3. The C. psittaci group consisted of strains from a wide variety of animal sources, including that responsible for EAE, while the C. trachomatis group consisted of strains from human sources. The development of DNA-based classification methods, particularly DNA—DNA reassociation studies4,5, in the 1980s led to the designation of two additional species, C. pneumoniae6 and C. pecorum7. These studies also supported the classification of chlamydial strains into eight species groups, with a ninth identified in 19938, highlighting the need for a revision of chlamydial taxonomy. In 1999 Everett and colleagues9 proposed a reclassification of the order Chlamydiales and its taxa based mainly on phylogenetic analyses of the 16S and 23S rRNA genes, but also on corroborating genetic and phenotypic information. A summary of this reclassification is shown in Table 1. The family Chlamydiaceae, which previously had only one genus Chlamydia, has been divided into two genera, Chlamydia and Chlamydophila. Within these genera five new species, in addition to the existing four, have been proposed. The organism responsible for ovine abortion, which was previously classified as serotype 1 C. psittaci, has been given species status and named Chlamydophila abortus.



Table 1

Reclassification of the family
Outcome of Relapse of Diffuse Large B-Cell Lymphoma After Autologous Stem Cell Transplantation
Authors: Hiroto Kaneko, Saeko Kuwahara, Muneo Ohshiro, Yasuhiko Tsutsumi, Toshiki Iwai, Junya Kuroda, Shigeo Horiike, Shohei Yokota, Masafumi Taniwaki
Journal: Annals of Oncology (2014)

Abstract   Introduction: Usefulness of autologous stem cell transplantation (ASCT) for diffuse large B-cell lymphoma (DLBCL) has been established. However, relapse after ASCT even at complete remission (CR) remains to be crucial. We evaluated outcome of such patients concerning the intervals from ASCT to relapse.  Patients and methods: Among 77 patients who received ASCT at CR between 1997 and 2013, 26 relapsed. Their age ranged from 39 to 74 with a median of 58. They included 23 at first CR and 3 second CR. We retrospectively analyzed clinical records to investigate survival outcome.  Results: Induction chemotherapy was CHOP-like regimen with or without rituximab (R). 3 patients with second CR had received MECP as re-induction therapy. Stem cells were mobilized by high-dose etoposide and MCVC was used as a conditioning regimen. Most patients had nodal relapse, but 4 patients (15.4%) at central nervous system and one (3.8%) at testis. Patients had received 1 to 4 regimens of salvage therapy, i. e., MECP, CHASE, or DHAP. CR was achieved in 3 patients (11.5%) and PR in 2 (7.7%), resulting in overall response rate of 19.2%. With observation periods of 4 to 198 months (median 22), 1-year overall survival (OS) was 50%. Although OS was significantly poor in patients who relapsed within a year after ASCT, survival from relapse was not different.  Discussion: These results suggest that relapse rate after ASCT should be reduced since highly refractory disease might emerge after myeloablative therapy. Deeper remission is required and prophylaxis of sanctuary region appears to be more widely considerable in first-line therapy.
Human HLA-A0201-restricted cytotoxic T lymphocyte recognition of influenza A is dominated by T cells bearing the V beta 17 gene segment.
Authors: P J Lehner, E C Wang, P A Moss, S Williams, K Platt, S M Friedman, J I Bell, L K Borysiewicz
Journal: The Journal of Experimental Medicine (1995)

The major histocompatibility complex class I-restricted cytotoxic T lymphocyte (CTL) response is important in the clearance of viral infections in humans. After influenza A infection, a peptide from the matrix protein, M58-66, is presented in the context of the MHC allele HLA-A0201 and the resulting CTL response is detectable in most HLA-A0201 subjects. An initial study suggested that M58-66-specific CTL clones show conserved T cell receptor (TCR) alpha and beta gene segments. We have addressed the significance of this observation by determining the expression of V beta 17 during the development of M58-66-specific CTL lines in 21 unrelated HLA-A0201 subjects, and analyzing TCR usage by M58-66-specific CTL clones. TCR V beta 17 was the dominant V beta segment used and CD8 V beta 17 expansion correlated with M58-66-specific lysis. Limiting dilution analysis from five subjects showed the M58-66 CTL precursor frequency to vary between 1/54,000 and less than 1/250,000, and that up to 85% of the matrix peptide (M58-66)-specific CTL used the V beta 17 gene segment. The M58-66 specific CTL response was dependent on previous viral exposure and specific V beta 17 expansion, as it was not found in cord blood, despite a readily expandable V beta 17+ CD8+ T cell subpopulation. Sequence analysis of 38 M58-66-specific V beta 17 transcripts from 13 subjects revealed extensive conservation in the CDR3 region including conservation of an arginine-serine motif. To test the dependence of this CTL response on the V beta 17 gene segment, peripheral blood lymphocytes were depleted of CD8+ TCR V beta 17+ cells, before the generation of M58-66-specific CTL. In most cases such depletion blocked or severely reduced the generation of the M58-66-specific response, and under limiting dilution conditions could abolish M58-66-specific CTL precursors. These studies reveal the dependence of this natural human immune response on a particular TCR gene segment.
A national register for long-term oxygen therapy in chronic hypoxia: preliminary results
Authors: K Strom, J Boe
Journal: European Respiratory Journal (1988)

A national register of patients undergoing long-term oxygen therapy in Sweden was started in 1987. Of the population of 8.4 million, 560 patients (267 males) were registered as undergoing domiciliary oxygen treatment on January 1, 1987. These registered patients, aged between 2-86 yrs (mean age 65 yrs), constituted some 90% of all patients receiving domiciliary oxygen therapy because of chronic hypoxaemia on that date. The chronic respiratory diseases leading to hypoxaemia (more than one diagnosis could be registered for each patient) were: chronic obstructive pulmonary disease (COPD) (393), sequelae from pulmonary tuberculosis (92), thoracic deformity (97), interstitial fibrosis (44), benign pleural disease (22) and others (84). Concentrators were used by 253 patients and high-pressure compressed gas cylinders by 307. Arterial blood gas analyses were registered for 547 patients. The mean arterial oxygen tension (PaO2) when breathing air was 6.5 +/- 1.1 kPa and 9.0 +/- 1.4 kPa when breathing oxygen. The mean arterial carbon dioxide tension (PaCO2) without oxygen was 6.5 +/- 1.5 kPa and 6.8 +/- 1.5 kPa with oxygen. The register forms a data-base which can be used for the evaluation of different home oxygen systems, regional differences in the access to treatment and treatment performance and decisions relating to health care economics.
High prevalence of oncogenic MYD88 and CD79B mutations in diffuse large B-cell lymphomas presenting at immune-privileged sites
Authors: W Kraan, H M Horlings, M van Keimpema, E J M Schilder-Tol, M E C M Oud, C Scheepstra, P M Kluin, M J Kersten, M Spaargaren, S T Pals
Journal: Blood Cancer Journal (2013)

Activating mutations in CD79 and MYD88 have recently been found in a subset of diffuse large B-cell lymphoma (DLBCL), identifying B-cell receptor and MYD88 signalling as potential therapeutic targets for personalized treatment. Here, we report the prevalence of CD79B and MYD88 mutations and their relation to established clinical, phenotypic and molecular parameters in a large panel of DLBCLs. We show that these mutations often coexist and demonstrate that their presence is almost mutually exclusive with translocations of BCL2, BCL6 and cMYC, or Epstein-Bar virus infection. Intriguingly, MYD88 mutations were by far most prevalent in immune-privileged site-associated DLBCL (IP-DLBCL), presenting in central nervous system (75%) or testis (71%) and relatively uncommon in nodal (17%) and gastrointestinal tract lymphomas (11%). Our results suggest that MYD88 and CD79B mutations are important drivers of IP-DLBCLs and endow lymphoma-initiating cells with tissue-specific homing properties or a growth advantage in these barrier-protected tissues.
Predicting sleep apnoea syndrome from heart period: a time-frequency wavelet analysis
Authors: F Roche, V Pichot, E Sforza, I Court-Fortune, D Duverney, F Costes, M Garet, J C Barthélémy
Journal: European Respiratory Journal (2003)

Heart rate fluctuations are a typical finding during obstructive sleep apnoea, characterised by bradycardia during the apnoeic phase and tachycardia at the restoration of ventilation. In this study, a time-frequency domain analysis of the nocturnal heart rate variability (HRV) was evaluated as the single diagnostic marker for obstructive sleep apnoea syndrome (OSAS). The predictive accuracy of time-frequency HRV variables (wavelet (Wv) decomposition parameters from level 2 (Wv2) to level 256 (Wv256)) obtained from nocturnal electrocardiogram Holter monitoring were analysed in 147 consecutive patients aged 53.8+/-11.2 yrs referred for possible OSAS. OSAS was diagnosed in 66 patients (44.9%) according to an apnoea/hypopnoea index > or = 10. Using receiver-operating characteristic curves analysis, the most powerful predictor variable was Wv32 (W 0.758, p<0.0001), followed by Wv16 (W 0.729, p<0.0001) and Wv64 (W 0.700, p<0.0001). Classification and Regression Trees methodology generated a decision tree for OSAS prediction including all levels of Wv coefficients, from Wv2 to Wv256 with a sensitivity reaching 92.4% and a specificity of 90.1% (percentage of agreement 91.2%) with this nonparametric analysis. Time-frequency parameters calculated using wavelet transform and extracted from the nocturnal heart period analysis appeared as powerful tools for obstructive sleep apnoea syndrome diagnosis.