tbuckley/cabot-search huggingface dataset:
Effect of Home Visiting by Nurses on Maternal and Child Mortality
Authors: David L. Olds, Harriet Kitzman, Michael D. Knudtson, Elizabeth Anson, Joyce A. Smith, Robert Cole
Journal: JAMA Pediatrics (2014)

IMPORTANCEMothers and children living in adverse contexts are at risk of premature death.OBJECTIVE To determine the effect of prenatal and infant/toddler nurse home visiting on maternal and child mortality during a 2-decade period (1990-2011). DESIGN, SETTING, AND PARTICIPANTSA randomized clinical trial was designed originally to assess the home visiting program's effect on pregnancy outcomes and maternal and child health through child age 2 years.The study was conducted in a public system of obstetric and pediatric care in Memphis, Tennessee.Participants included primarily African American women and their first live-born children living in highly disadvantaged urban neighborhoods, who were assigned to 1 of 4 treatment groups: treatment 1 (transportation for prenatal care [n = 166]), treatment 2 (transportation plus developmental screening for infants and toddlers [n = 514]), treatment 3 (transportation plus prenatal/postpartum home visiting [n = 230]), and treatment 4 (transportation, screening, and prenatal, postpartum, and infant/toddler home visiting [n = 228]).Treatments 1 and 3 were included originally to increase statistical power for testing pregnancy outcomes.For determining mortality, background information was available for all 1138 mothers assigned to all 4 treatments and all but 2 live-born children in treatments 2 and 4 (n = 704).Inclusion of children in treatments 1 and 3 was not possible because background information was missing on too many children.INTERVENTIONS Nurses sought to improve the outcomes of pregnancy, children's health and development, and mothers' health and life-course with home visits beginning during pregnancy and continuing through child age 2 years. MAIN OUTCOMES AND MEASURESAll-cause mortality in mothers and preventable-cause mortality in children (sudden infant death syndrome, unintentional injury, and homicide) derived from the National Death Index. RESULTSThe mean (SE) 21-year maternal all-cause mortality rate was 3.7% (0.74%) in the combined control group (treatments 1 and 2), 0.4% (0.43%) in treatment 3, and 2.2% (0.97%) in treatment 4. The survival contrast of treatments 1 and 2 combined with treatment 3 was significant (P = .007);the contrast of treatments 1 and 2 combined with treatment 4 was not significant (P = .19),and the contrast of treatments 1 and 2 combined with treatments 3 and 4 combined was significant (post hoc P = .008).At child age 20 years, the preventable-cause child mortality rate was 1.6% (0.57%) in treatment 2 and 0.0% (SE not calculable) in treatment 4; the survival contrast was significant (P = .04).CONCLUSIONS AND RELEVANCE Prenatal and infant/toddler home visitation by nurses is a promising means of reducing all-cause mortality among mothers and preventable-cause mortality in their first-born children living in highly disadvantaged settings.
Mammography in Younger Women: The Dilemma of Diminishing Returns
Authors: N. Calonge
Journal: JNCI Journal of the National Cancer Institute (2010)

JNCI Vol. 102, Issue 10 | May 19, 2010 In this issue of the Journal, researchers from the Breast Cancer Surveillance Consortium (BCSC) present data on the performance of screening and diagnostic mammography in 117 738 women younger than 40 years ( 1 ). This landmark descriptive study should inform women and clinicians and guide research efforts for the early detection of breast cancer in this age group. There are a number of breast cancer screening guidelines for younger women that have been published by prominent health and medical groups including the American Cancer Society ( 2 ) and the American College of Radiology ( 3 ) that advocate screening starting at approximately age 30 years (or 10 years before the premenopausal diagnosis of breast cancer in their relevant relative) for women with BRCA1 and/or BRCA2 mutations or who are otherwise at increased risk for breast cancer. The American Cancer Society recommendation also states that “because the evidence is limited regarding the best age at which to start screening, this decision should be based on shared decision-making between patients and their health care providers, taking into account personal circumstances and preferences.” The BCSC analysis ( 1 ) provides a retrospective insight on the benefi ts and harms that might accompany such screening. It is, however, critical to point out that this article investigates mammography only and not the use of magnetic resonance imaging or ultrasound in combination with mammography in screening younger high-risk women. What would basic epidemiology principles lead us to expect to fi nd in reviewing the BCSC data, in comparison with mammography screening in women aged 40 years or older? One would expect to fi nd that, even with a specifi city similar to that in women older than 40 years, using mammography in this population with a lower prevalence of disease would result in a lower cancer detection rate, a lower positive predictive value, more false-positive results, and more callbacks for additional imaging studies and other associated workup procedures. One might expect that the known differences in breast density at younger ages could translate to differences in the screening Mammography in Younger Women: The Dilemma of Diminishing Returns
Relation of Increase in Muscle Mass to Performance of Hypertrophied Right Ventricle in the Dog
Authors: ALEXANDER S. GEHA, JOHN P. DUFFY, H. J. C. SWAN
Journal: Circulation Research (1966)

Right ventricular hypertrophy was produced by chronic constriction (banding) of the pulmonary artery in the dog. Right ventricular muscle mass increased by 40% in 6 to 12 weeks after banding. Maximal work performance of this ventricle also increased; at 12 weeks the mean was 175% more than that of the normal right ventricle. It was concluded that, per unit of gross myocardial mass, the work performance of the hypertrophied right ventricle of the dog was no less than that of the normal right ventricle.
Identification of four subsets of human CD3-CD16+ natural killer (NK) cells by the expression of clonally distributed functional surface molecules: correlation between subset assignment of NK clones and ability to mediate specific alloantigen recognition.
Authors: A Moretta, C Bottino, D Pende, G Tripodi, G Tambussi, O Viale, A Orengo, M Barbaresi, A Merli, E Ciccone
Journal: The Journal of Experimental Medicine (1990)

In previous studies we identified a surface molecule (termed GL183) capable of mediating cell activation and selectively expressed by a subset of human CD3-CD16+ natural killer (NK) cells. In this study we analyzed whether other subset-specific functional molecules were expressed in GL183- NK cells. To this end, mice were immunized with the PE29 (CD3-CD16+GL183-) NK clone. Monoclonal antibodies (mAbs) were selected by screening the hybridoma supernatants for their ability to trigger the cytolytic activity of clone PE29 against the human myelomonocytic leukemia U937. The EB6 mAb (IgG1) triggered the PE29 clone, but not a GL183+ clone used as a control. EB6+ cells ranged between 1 and 13% of peripheral blood lymphocytes and were largely included in the CD3-CD16+CD56+ cell populations (only less than 2% of EB6+ cells were CD3+). Analysis of resting or activated CD3-CD16+ populations, or clones for the expression of EB6 or GL183 mAbs, allowed us to identify four distinct, phenotypically stable, NK subsets (EB6+GL183-; EB6+GL183+; EB6-GL183+; EB6-GL183-). Similar to GL183 mAb, the EB6 mAb selectively triggered the NK subset expressing the corresponding surface antigen to lyse human tumor cell lines including U937, IGROV-I, M14, and A549. In addition, EB6 mAb sharply inhibited the cytolytic activity of EB6+ clones against P815, M12, and P3U1 murine target cells. In EB6+GL183+ ("double-positive") clones both EB6 and GL183 mAb inhibited the redirected killing of P815 cells induced by anti-CD16, anti-CD2 mAbs and phytohemagglutinin (PHA). Similar to GL183 molecules, molecules precipitated by EB6 mAb were represented by either single 58-kD chain or double chains of 55 and 58 kD (with no detectable differences in EB6+GL183- or EB6+GL183+ clones). In sequential immunoprecipitation experiments using the double-positive clones CEG52 and CA25.50, preclearing of cell lysates with EB6 or GL183 mAb removed only EB6 or GL183 molecules, respectively, thus indicating that the two antigenic determinants are carried by two distinct molecules. Peptide map analysis indicated that EB6 (or GL183) molecules precipitated from double-positive clones were identical to the corresponding molecules isolated from single-positive ones. On the other hand, comparison of the EB6 and GL183 maps revealed peptides that were unique to each molecule, although most of the major peptides migrated to identical positions. We further investigated whether correlation existed between the phenotypic assignment of NK clones and their ability to mediate specific lysis of normal allogeneic cells.(ABSTRACT TRUNCATED AT 400 WORDS)
Ecological variability and religious beliefs
Authors: Adam B. Cohen, Douglas T. Kenrick, Yexin Jessica Li
Journal: Behavioral and Brain Sciences (2006)

Religious beliefs, including those about an afterlife and omniscient spiritual beings, vary across cultures. We theorize that such variations may be predictably linked to ecological variations, just as differences in mating strategies covary with resource distribution. Perhaps beliefs in a soul or afterlife are more common when resources are unpredictable, and life is brutal and short.
Achilles tendinosis is associated with sprouting of substance P positive nerve fibres
Authors: T E O Schubert
Journal: Annals of the Rheumatic Diseases (2005)

<b>Objectives:</b> To identify and characterise nerve fibres and inflammatory alterations in painful Achilles tendinosis and thus gain evidence about the origin of pain in Achilles tendinosis. <b>Methods:</b> The composition of 10 tendon samples from patients with a prior history of painful Achilles tendinosis and 10 samples from patients with spontaneously ruptured tendons but no previous pain was compared by immunohistochemistry and conventional histology. <b>Results:</b> The presence of granulation tissue was shown in 8/10 cases of Achilles tendinosis. Nociceptive substance P (SP) positive nerve fibres were significantly increased, and an inflammatory infiltration comprising B and T lymphocytes was found. Additionally, small foci with iron positive haemosiderophages, indicating prior microtraumatic events, were found in 6/10 samples. None of the spontaneously ruptured tendons contained granulation tissue or haemosiderophages. Inflammatory infiltration in these patients consisted almost exclusively of granulocytes and SP positive nerve fibres were decreased. The density of sympathetic nerve fibres did not differ in the two conditions. <b>Conclusion:</b> Achilles tendinosis is associated with the presence of granulation tissue, haemosiderophages, and SP positive nerve fibres, which may transmit the clinically pertinent pain. Achilles tendinosis may be caused by repeated microtraumata with ensuing organisation that is accompanied by sprouting of nociceptive SP positive nerve fibres.
Magnetic Resonance Imaging of the Axial Skeleton for Detecting Bone Metastases in Patients With High-Risk Prostate Cancer: Diagnostic and Cost-Effectiveness and Comparison With Current Detection Strategies
Authors: Frédéric E. Lecouvet, Daphné Geukens, Annabelle Stainier, François Jamar, Jacques Jamart, Bertrand Janne d'Othée, Patrick Therasse, Bruno Vande Berg, Bertrand Tombal
Journal: Journal of Clinical Oncology (2007)

To evaluate the diagnostic performance, costs, and impact on therapy of one-step magnetic resonance imaging (MRI) of the axial skeleton (MRIas) for detecting bone metastases in patients with high-risk prostate cancer (PCa).Sixty-six consecutive patients with high-risk PCa prospectively underwent MRIas in addition to the standard sequential work-up (SW) of bone metastases (technetium-99m bone scintigraphy [BS] completed with targeted x-rays [TXR] in patients with equivocal BS findings and with MRI obtained on request [MRIor] in patients with inconclusive BS/TXR findings). Panel review of initial and 6-month follow-up MRI findings, BS/TXR, and all available baseline and follow-up clinical and biologic data were used as the best valuable comparator to define metastatic status. Diagnostic effectiveness of MRIas alone was compared with each step of the SW. Impact of MRIas screening on patient management and costs was evaluated.On the basis of the best valuable comparator, 41 patients (62%) had bone metastases. Sensitivities were 46% for BS alone, 63% for BS/TXR, 83% for BS/TXR/MRIor, and 100% for MRIas; the corresponding specificities were 32%, 64%, 100%, and 88%, respectively. MRIas was significantly more sensitive than any other approach (P < .05, McNemar). MRIas identified metastases in seven (30%) of 23 patients considered negative and eight (47%) of 17 patients considered equivocal by other strategies, which altered the initially planned therapy. Economic impact was variable among countries, depending on reimbursement rates.MRIas is more sensitive than the current SW of radiographically identified bone metastases in high-risk PCa patients, which impacts the clinical management of a significant proportion of patients.
Alveolar Macrophage–mediated Killing of <i>Pneumocystis carinii</i> f. sp. <i>muris</i> Involves Molecular Recognition by the Dectin-1 β-Glucan Receptor
Authors: Chad Steele, Luis Marrero, Steve Swain, Allen G. Harmsen, Mingquan Zheng, Gordon D. Brown, Siamon Gordon, Judd E. Shellito, Jay K. Kolls
Journal: The Journal of Experimental Medicine (2003)

Innate immune mechanisms against Pneumocystis carinii, a frequent cause of pneumonia in immunocompromised individuals, are not well understood. Using both real time polymerase chain reaction as a measure of organism viability and fluorescent deconvolution microscopy, we show that nonopsonic phagocytosis of P. carinii by alveolar macrophages is mediated by the Dectin-1 β-glucan receptor and that the subsequent generation of hydrogen peroxide is involved in alveolar macrophage–mediated killing of P. carinii. The macrophage Dectin-1 β-glucan receptor colocalized with the P. carinii cyst wall. However, blockage of Dectin-1 with high concentrations of anti–Dectin-1 antibody inhibited binding and concomitant killing of P. carinii by alveolar macrophages. Furthermore, RAW 264.7 macrophages overexpressing Dectin-1 bound P. carinii at a higher level than control RAW cells. In the presence of Dectin-1 blockage, killing of opsonized P. carinii could be restored through FcγRII/III receptors. Opsonized P. carinii could also be efficiently killed in the presence of FcγRII/III receptor blockage through Dectin-1–mediated phagocytosis. We further show that Dectin-1 is required for P. carinii–induced macrophage inflammatory protein 2 production by alveolar macrophages. Taken together, these results show that nonopsonic phagocytosis and subsequent killing of P. carinii by alveolar macrophages is dependent upon recognition by the Dectin-1 β-glucan receptor.
Inspiratory muscle force in normal subjects and patients with interstitial lung disease.
Authors: A de Troyer, J C Yernault
Journal: Thorax (1980)

Measurements of the lowest mouth pressures developed during maximum static inspiratory efforts are related to the recoil force of the lung and occasionally are influenced by glottic closure. The measurement of minimal pleural pressures (P pl min) over the entire range of inspiratory capacity eliminates both problems and, in addition, provides a good estimate of the subject9s cooperation. Using this technique, we have investigated the inspiratory muscle force in 120 healthy adults (60 men, 60 women) aged 21 to 76 years, and 15 healthy children (eight boys, seven girls) aged 7 to 13 years. Twelve patients with interstitial lung disease were studied for comparison. In the healthy adults, at any fixed (fractional) lung volume, P pl min increased, that is, became less negative with advancing age, both in males and females (all r greater than 0.56, p less than 0.001). This pattern was not modified after correction of the data for the static recoil pressure of the chest wall, indicating that the inspiratory muscle force actually decreases with age. In any age group, and after correction of lung volume for the difference in stature, the P pl min values in women were between 80 and 90% of the values found in men; moreover the children generated pressures that were as low as those developed by the younger adults. This is probably because women and children have a smaller thorax than men and are therefore able to generate low pressures, despite weaker muscles. When the reduction in lung volume was taken into account, the relationship between lung volume and P pl min was normal in the patients with interstitial lung disease. These patients showed a close relationship between the degree of lung volume restriction and the increase of the static recoil pressure of the lung at full inflation, suggesting that their thorax is normally compliant. It appears therefore that these patients have normal inspiratory muscle force, at least when they are not in an advanced stage of the disease.
Phosphodiesterase 4 inhibition decreases MUC5AC expression induced by epidermal growth factor in human airway epithelial cells
Authors: M Mata
Journal: Thorax (2005)

<b>Background:</b> A common pathological feature of chronic inflammatory airway diseases such as asthma and chronic obstructive pulmonary disease (COPD) is mucus hypersecretion. MUC5AC is the predominant mucin gene expressed in healthy airways and is increased in asthmatic and COPD patients. Recent clinical trials indicate that phosphodiesterase type 4 (PDE4) inhibitors may have therapeutic value for COPD and asthma. However, their direct effects on mucin expression have been scarcely investigated. <b>Methods:</b> MUC5AC mRNA and protein expression were examined in cultured human airway epithelial cells (A549) and in human isolated bronchial tissue stimulated with epidermal growth factor (EGF; 25 ng/ml). MUC5AC mRNA was measured by real time RT-PCR and MUC5AC protein by ELISA (cell lysates and tissue homogenates), Western blotting (tissue homogenates) and immunohistochemistry. <b>Results:</b> EGF increased MUC5AC mRNA and protein expression in A549 cells. PDE4 inhibitors produced a concentration dependent inhibition of the EGF induced MUC5AC mRNA and protein expression with potency values (−log IC<sub>50</sub>): roflumilast (∼7.5) &gt; rolipram (∼6.5) &gt; cilomilast (∼5.5). Roflumilast also inhibited the EGF induced expression of phosphotyrosine proteins, EGF receptor, and phospho-p38- and p44/42-MAPK measured by Western blot analysis in A549 cells. In human isolated bronchus, EGF induced MUC5AC mRNA and protein expression was inhibited by roflumilast (1 μM) as well as the MUC5AC positive staining shown by immunohistochemistry. <b>Conclusion:</b> Selective PDE4 inhibition is effective in decreasing EGF induced MUC5AC expression in human airway epithelial cells. This effect may contribute to the clinical efficacy of this new drug category in mucus hypersecretory diseases.
Cdc42 Regulates the Restoration of Endothelial Barrier Function
Authors: Panos Kouklis, Maria Konstantoulaki, Stephen Vogel, Michael Broman, Asrar B. Malik
Journal: Circulation Research (2003)

The mechanisms involved in the restoration of endothelial cell junctions subsequent to barrier disruption remain unclear. It is known that formation of adherens junctions (AJs) affects cytoskeletal actin arrangement and that Rho GTPases regulate the state of actin polymerization. In the present study, we examined the role of the Rho GTPases, Rho, Rac, and Cdc42 in the reannealing of AJs. We studied the response to thrombin, which increases endothelial permeability through disassembly of AJs, followed by recovery of barrier function through junctional reannealing within 2 hours. Cdc42 was activated late, at approximately 1 hour after thrombin exposure, concurrent with its translocation from the cytoplasm to the membrane. Activation and translocation of Cdc42 preceded the reformation of AJs. Expression of the dnCdc42 mutant (N17Cdc42) significantly delayed the reformation of the VE-cadherin-containing AJs and restoration of endothelial barrier function. We also studied the lung microcirculation to address the in vivo relevance of Cdc42 signaling in barrier restoration. N17Cdc42 expression in the mouse lung endothelium markedly attenuated the endothelial barrier recovery after the permeability increase induced by activation of the thrombin receptor protease-activated receptor-1. These findings demonstrate the critical function of Cdc42 in restoring AJ-dependent, endothelial cell homotypic adhesion and barrier function. The delayed activation of Cdc42 represents a negative-feedback mechanism that signals AJ reassembly after the increase in endothelial permeability induced by inflammatory mediators such as thrombin.
Body-Weight–Supported Treadmill Rehabilitation after Stroke
Authors: Pamela W. Duncan, Katherine J. Sullivan, Andrea L. Behrman, Stanley P. Azen, Samuel S. Wu, Stephen E. Nadeau, Bruce H. Dobkin, Dorian K. Rose, Julie K. Tilson, Steven Cen, Sarah K. Hayden
Journal: New England Journal of Medicine (2011)

Locomotor training, including the use of body-weight support in treadmill stepping, is a physical therapy intervention used to improve recovery of the ability to walk after stroke. The effectiveness and appropriate timing of this intervention have not been established.We stratified 408 participants who had had a stroke 2 months earlier according to the extent of walking impairment--moderate (able to walk 0.4 to <0.8 m per second) or severe (able to walk <0.4 m per second)--and randomly assigned them to one of three training groups. One group received training on a treadmill with the use of body-weight support 2 months after the stroke had occurred (early locomotor training), the second group received this training 6 months after the stroke had occurred (late locomotor training), and the third group participated in an exercise program at home managed by a physical therapist 2 months after the stroke (home-exercise program). Each intervention included 36 sessions of 90 minutes each for 12 to 16 weeks. The primary outcome was the proportion of participants in each group who had an improvement in functional walking ability 1 year after the stroke.At 1 year, 52.0% of all participants had increased functional walking ability. No significant differences in improvement were found between early locomotor training and home exercise (adjusted odds ratio for the primary outcome, 0.83; 95% confidence interval [CI], 0.50 to 1.39) or between late locomotor training and home exercise (adjusted odds ratio, 1.19; 95% CI, 0.72 to 1.99). All groups had similar improvements in walking speed, motor recovery, balance, functional status, and quality of life. Neither the delay in initiating the late locomotor training nor the severity of the initial impairment affected the outcome at 1 year. Ten related serious adverse events were reported (occurring in 2.2% of participants undergoing early locomotor training, 3.5% of those undergoing late locomotor training, and 1.6% of those engaging in home exercise). As compared with the home-exercise group, each of the groups receiving locomotor training had a higher frequency of dizziness or faintness during treatment (P=0.008). Among patients with severe walking impairment, multiple falls were more common in the group receiving early locomotor training than in the other two groups (P=0.02).Locomotor training, including the use of body-weight support in stepping on a treadmill, was not shown to be superior to progressive exercise at home managed by a physical therapist. (Funded by the National Institute of Neurological Disorders and Stroke and the National Center for Medical Rehabilitation Research; LEAPS ClinicalTrials.gov number, NCT00243919.).