tbuckley/cabot-search huggingface dataset:
Distinct aetiopathogenesis in subgroups of functional dyspepsia according to the Rome III criteria
Authors: Yu-Jen Fang, Jyh-Ming Liou, Chieh-Chang Chen, Ji-Yuh Lee, Yao-Chun Hsu, Mei-Jyh Chen, Ping-Huei Tseng, Chien-Chuan Chen, Chi-Yang Chang, Tsung-Hua Yang, Wen-Hsiung Chang, Jeng-Yi Wu, Hsiu-Po Wang, Jiing-Chyuan Luo, Jaw-Town Lin, Chia-Tung Shun, Ming-Shiang Wu
Journal: Gut (2014)

<h3>Background and objective</h3> Whether there is distinct pathogenesis in subgroups of functional dyspepsia (FD), the postprandial distress syndrome (PDS) and epigastric pain syndrome (EPS) remains controversial. We aimed to identify the risk factors of FD and its subgroups in the Chinese population. <h3>Methods</h3> Patients with dyspepsia and healthy subjects who underwent gastric cancer screening were enrolled in this multicentre study from 2010 to 2012. All patients were evaluated by questionnaire, oesophagoduodenoscopy, histological examination and <i>Helicobacter pylori</i> tests. Subgroups of FD were classified according to the Rome III criteria. Psychiatric stress was assessed by the short form Brief Symptom Rating Scale. CagA and VacA genotypes were determined by PCR. <h3>Results</h3> Of 2378 patients screened for eligibility, 771 and 491 fulfilled the diagnostic criteria of uninvestigated dyspepsia and FD, respectively. 298 (60.7%) and 353 (71.9%) individuals were diagnosed with EPS and PDS, respectively, whereas 169 (34.4%) had the overlap syndrome. As compared with 1031 healthy controls, PDS and EPS shared some common risk factors, including younger age (OR 0.95; 99.5% CI 0.93 to 0.98), non-steroidal anti-inflammatory drugs (OR 6.60; 99.5% CI 3.13 to 13.90), anxiety (OR 3.41; 99.5% CI 2.01 to 5.77) and concomitant IBS (OR 6.89; 99.5% CI 3.41 to 13.94). By contrast, <i>H. pylori</i> (OR 1.86; 99.5% CI 1.01 to 3.45), unmarried status (OR 4.22; 99.5% CI 2.02 to 8.81), sleep disturbance (OR 2.56; 99.5% CI 1.29 to 5.07) and depression (OR 2.34; 99.5% CI 1.04 to 5.36) were associated with PDS. Moderate to severe antral atrophy and CagA positive strains were also more prevalent in PDS. <h3>Conclusions</h3> Different risk factors exist among FD subgroups based on the Rome III criteria, indicating distinct aetiopathogenesis of the subdivisions that may necessitate different therapeutic strategies.
The Basic Helix-Loop-Helix Transcription Factor Family in Plants: A Genome-Wide Study of Protein Structure and Functional Diversity
Authors: M. A. Heim
Journal: Molecular Biology and Evolution (2003)

Basic helix-loop-helix (bHLH) transcription factors (TFs) belong to a family of transcriptional regulators present in three eukaryotic kingdoms. Many different functions have been identified for these proteins in animals, including the control of cell proliferation and development of specific cell lineages. Their mechanism for controlling gene transcription often involves homodimerization or heterodimerization. In plants, little is known about the bHLH family, but we have determined that there are 133 bHLH genes in Arabidopsis thaliana and have confirmed that at least 113 of them are expressed. The AtbHLH genes constitute one of the largest families of transcription factors in A. thaliana with significantly more members than are found in most animal species and about an equivalent number to those in vertebrates. Comparisons with animal sequences suggest that the majority of plant bHLH genes have evolved from the ancestral group B class of bHLH genes. By studying the AtbHLH genes collectively, twelve subfamilies have been identified. Within each of these main groups, there are conserved amino acid sequence motifs outside the DNA binding domain. Potential gene redundancy among members of smaller subgroups has been analyzed, and the resulting information is presented to provide a simplified visual interpretation of the gene family, identifying related genes that are likely to share similar functions. Based on the current characterization of a limited number of plant bHLH proteins, we predict that this family of TFs has a range of different roles in plant cell and tissue development as well as plant metabolism.
Meniscal injuries and hyperlaxity
Authors: M A Akhtar, J F Keating
Journal: British Journal of Sports Medicine (2010)

This study assessed the incidence of generalised ligament laxity in patients presented with meniscal injuries. Prospective data were collected for 33 patients undergoing meniscal surgery, and a control group of 43 patients with clavicle fractures between June 2008 and July 2009, including demographic details, mechanism of injury and hyperlaxity. Clinical examination was used to assess the ligament laxity using the Beighton score. Laxity is scored on a 0-9 scale. Scores of 4 or above are indicative of generalised ligament laxity. Brighton criteria are used to diagnose benign joint hypermobility syndrome (BJHS) and use signs and symptoms along with Beighton score. The average Beighton score for the patients with meniscal injuries was 1.5 with a range from 0 to 8. Four patients (12%) in this group had a Beighton score of 4 or more as compared to control group that had eight patients (18%) There was no statistically significant difference between the two groups with a p value of 0.24. Three patients (9%) fulfilled the Brighton criteria for BJHS. The most common cause of meniscal injury was sports related injuries in 13 patients (46%). The most common sport was football in five patients (38%). The most common procedure performed was partial medial menisectomy in 24 (72%) patients. The authors looked at the incidence of generalised ligament laxity in patients with meniscal injuries which was 12%. The authors concluded that patients with meniscal injuries does not have higher incidence of generalised ligament laxity as compared to a control group of clavicle fractures. Appropriate advice should be given to athletes about the risk of injuries after careful assessment for evidence of generalised ligament laxity.
Continuous Heparin Infusion Requirements
Authors: T. Michael White
Journal: JAMA (1979)

A prospective study was undertaken to investigate the relation between hourly heparin sodium requirements and the presence or absence of thromboembolic disease (TED). Twelve patients with verified TED required 1,696±394 units/hr (mean±SD), and nine patients without disease required 1,033±343 units/hr of continuous heparin sodium to attain a target-activated partial thromboplastin time. The requirements in relation to body weight were 25±4 units/kg/hr for the 12 with verified TED and 15±3 units/kg/hr for the nine without disease. These data support the conclusion that a patient's heparin requirements are related to the presence or absence of TED and suggest the diagnostic importance of heparin requirements; large requirements coincide with active TED, and lesser requirements suggest absence of a thromboembolic process. (<i>JAMA</i>241:2717-2720, 1979)
The Case for Reassessment of Health Care Technology
Authors: H. David Banta
Journal: JAMA (1990)

Assessment of health care technologies should be an iterative process, not a single event. In the United States there are an increasing number of organized attempts at reassessment of technologies by the health industry, professional societies, and national government agencies, such as the Medical Necessity Project of Blue Cross/Blue Shield, the Clinical Efficacy Assessment Project of the American College of Physicians, and the work of the US Preventive Services Task Force. We examine four clinical practices--electronic fetal monitoring, episiotomy, electroencephalography, and hysterectomy--to illustrate the need to continuously reassess existing technologies and to challenge our current inertia in this critical arena of health practice.The authors emphasize the need to consider continuous reassessment of health care technologies already in use in the face of rising health care costs and of questions about quality and effectiveness. Among the issues covered by Banta and Thacker are the definition and history of technology assessment, the life cycle of a health care technology, and examples of attempts at technology reassessment. They make a case for reassessing four technologies currently in use: electronic fetal monitoring, episiotomy, electroencephalography, and hysterectomy. These technologies are offered as examples of technologies already in place whose introduction into health care was preceded by an initial, nonsystematic assessment. Technologies that are being applied in ways for which they were not intended originally are also candidates for reevaluation and reassessment.
Randomized, Double-Blind, Placebo-Controlled, Phase III Chemoprevention Trial of Selenium Supplementation in Patients With Resected Stage I Non–Small-Cell Lung Cancer: ECOG 5597
Authors: Daniel D. Karp, Sandra J. Lee, Steven M. Keller, Gail Shaw Wright, Seena Aisner, Steven Alan Belinsky, David H. Johnson, Michael R. Johnston, Gary Goodman, Gerald Clamon, Gordon Okawara, Randolph Marks, Eric Frechette, Worta McCaskill-Stevens, Scott M. Lippman, John Ruckdeschel, Fadlo R. Khuri
Journal: Journal of Clinical Oncology (2013)

Selenium has been reported to have chemopreventive benefits in lung cancer. We conducted a double-blind, placebo-controlled trial to evaluate the incidence of second primary tumors (SPTs) in patients with resected non-small-cell lung cancer (NSCLC) receiving selenium supplementation.Patients with completely resected stage I NSCLC were randomly assigned to take selenized yeast 200 μg versus placebo daily for 48 months. Participation was 6 to 36 months postoperatively and required a negative mediastinal node biopsy, no excessive vitamin intake, normal liver function, negative chest x-ray, and no other evidence of recurrence.The first interim analysis in October 2009, with 46% of the projected end points accumulated, showed a trend in favor of the placebo group with a low likelihood that the trial would become positive; thus, the study was stopped. One thousand seven hundred seventy-two participants were enrolled, with 1,561 patients randomly assigned. Analysis was updated in June 2011 with the maturation of 54% of the planned end points. Two hundred fifty-two SPTs (from 224 patients) developed, of which 98 (from 97 patients) were lung cancer (38.9%). Lung and overall SPT incidence were 1.62 and 3.54 per 100 person-years, respectively, for selenium versus 1.30 and 3.39 per 100 person-years, respectively, for placebo (P = .294). Five-year disease-free survival was 74.4% for selenium recipients versus 79.6% for placebo recipients. Grade 1 to 2 toxicity occurred in 31% of selenium recipients and 26% of placebo recipients, and grade ≥ 3 toxicity occurred in less than 2% of selenium recipients versus 3% of placebo recipients. Compliance was excellent. No increase in diabetes mellitus or skin cancer was detected.Selenium was safe but conferred no benefit over placebo in the prevention of SPT in patients with resected NSCLC.
Increased hepatic degradation of amino acids (AA) during hemodialysis (HD) in pigs is followed by AA efflux from skeletal muscles
Authors: T. Grøfte, P. Ivarsen, K. Roelsgård, J. Greisen, N.K. Aagaard, C. Skjærbæk, H.E. Hansen, H. Ørskov, H. Vilstrup
Journal: Journal of Hepatology (1998)
On Neanderthal speech and human evolution
Authors: Philip Lieberman
Journal: Behavioral and Brain Sciences (1996)

Abstract Loring Brace's assertion that “Neanderthals were just as capable of articulate speech as we are” reflects ignorance of speech anatomy and physiology. Metrical analyses of hyoid bone morphology cannot predict supralaryngeal vocal tract (SVT) shape. Houghton's (1993) “modern” Neanderthal SVT reconstruction yields an impossible creature who had a larynx positioned in his chest. The reconstructed modem SVTs of early fossil Homo sapiens indicate brains that can regulate speech, consistent with Merlin Donalds timetable for the evolution of language.
Risk of Assessing Mortality Risk in Elective Cardiac Operations
Authors: Marco Ranucci, Serenella Castelvecchio, Lorenzo Menicanti, Alessandro Frigiola, Gabriele Pelissero
Journal: Circulation (2009)

Several mortality risk scores exist in cardiac surgery. All include a considerable number of independent risk factors. In elective cardiac surgery patients, the operative mortality is low, the number of events recorded per year is limited, and the risk model may be overfitted. The present study aims to develop and validate an operative mortality risk score for elective patients based on a limited number of factors.The development series included 4557 adult patients who had undergone an elective cardiac operation at our institution from 2001 to 2003; the validation series includes the 4091 patients who subsequently underwent an operation. Three independent factors were included in the mortality risk model: age, creatinine, and left ventricular ejection fraction (ACEF). The ACEF score was computed as follows: age (years)/ejection fraction (%)+1 (if serum creatinine value was >2 mg/dL). The ACEF score was compared with 5 other risk scores in the validation series. Discriminatory power (accuracy) was defined with a receiver-operating characteristics analysis. The best accuracy was achieved by the Cleveland Clinic score (0.812), with ACEF score just below it (0.808). In coronary operations, the 2 scores performed equally well (0.815 versus 0.813), and in isolated coronary operations, the best accuracy was achieved by ACEF (0.826), with the Cleveland Clinic score at 0.806.A risk model limited to 3 independent predictors has similar or better accuracy and calibration compared with more complex risk scores if applied to elective cardiac operations.
Diagnosis of hepatocellular carcinoma in cirrhosis by dynamic contrast imaging: The importance of tumor cell differentiation
Authors: Massimo Iavarone, Angelo Sangiovanni, Laura Virginia Forzenigo, Sara Massironi, Mirella Fraquelli, Alessio Aghemo, Guido Ronchi, Piero Biondetti, Massimo Roncalli, Massimo Colombo
Journal: Hepatology (2010)

Dynamic contrast imaging techniques are considered the standard of care for the radiological diagnosis of hepatocellular carcinoma (HCC) in cirrhosis. However, the accuracy of radiological diagnosis depends largely on the degree of arterial hypervascularization, which increases with tumor size. Owing to the interplay and prognostic relevance of tumor vascularization and cell differentation, we asked ourselves whether tumor grade also affects the outcome of radiological diagnosis. Sixty-two HCCs (47 of which measured 1-2 cm) were consecutively detected in 59 patients with compensated cirrhosis under surveillance with ultrasound and confirmed by way of echo-guided biopsy and concurrent investigations with contrast-enhanced ultrasound (CE-US), computed tomography (CT), and gadolinium magnetic resonance imaging (MRI). Tumor cell differentiation was evaluated using Edmondson-Steiner criteria in liver cores of 0.9-5.0 cm (median 1.6 cm). Eighteen (29%) HCCs were grade I (1.5 cm), 28 (45%) were grade II (1.5 cm), 16 (26%) were grade III (1.8 cm), and none were grade IV. Contrast wash-in and wash-out were concurrently demonstrated in 21 (34%) tumors by way of CE-US, including three (16%) grade I and 18 (41%) grade II-III ( P = 0.08); in 32 (52%) tumors by way of CT, including three (16%) grade I and 29 (66%) grade II-III ( P = 0.0006); and 28 (47%) tumors by way of MRI, including three grade I (16%) and 25 (57%) grade II-III ( P = 0.01). Among 1- to 2-cm tumors, the radiological diagnosis was achieved in two of 16 grade I and 17of 31 grade II-III tumors ( P = 0.006). Conclusion: Tumor grade, a relevant predictor of disease severity, influences the accuracy of dynamic contrast techniques in the diagnosis of HCC. Hepatology 2010
Immune activation in α1 antitrypsin deficiency (AATD) emphysema: Beyond the protease/antiprotease hypothesis
Authors: Erica Bazzan, Simonetta Baraldo, Francesca Lunardi, Kim Lokar Oliani, Andrea Ballarin, Marco Schiavon, Graziella Turato, Elisabetta Balestro, Federico Rea, Monica Loy, Manuel Cosio, Marina Saetta, Fiorella Calabrese
Journal: European Respiratory Journal (2012)

The protease/antiprotease hypothesis has long set the field in the pathogenesis of AATD related emphysema, while activation of lymphocyte-driven responses has been scarcely investigated in this condition. We performed this study to evaluate the involvement of adaptive immune responses in AATD patients. By immunohistochemistry and molecular analysis we evaluated number, topographical distribution and clonality of lymphoid follicles in native lungs of AATD patients undergoing transplantation for severe emphysema (n=10). Results were compared to patients with similar disease severity, but with normal AAT levels (n=26) and to smoking (n=17) and nonsmoking (n=12) controls. Lymphoid follicles (LF) were significantly increased in the lungs of emphysematous patients, either with AATD (4.1;0.7-13 LF/cm2) or without AATD (1.5;0-5.1) as compared to smoking (0;0-5) and nonsmoking controls (0;0-1, all p<0.05). Somewhat surprisingly the number of LF was even more prominent in patients with AATD than in those with normal AAT levels (p<0.05). Follicles in patients with AATD were predominantly located in the lower lobe, where lung destruction predominates. Molecular analysis confirmed an oligoclonal response in B cells isolated from these follicles. In conclusion, our study shows that organization of lymphocytes in follicles is a prominent feature of subjects with severe emphysema and AATD. These results challenge the current paradigm of α1antitrypsin deficiency-related emphysema from a protease/antiprotease driven process only to a more complex scenario entailing activation of adaptive immune responses.

Funded by Padua University, CARIPARO, Chiesi farmaceutici.
Recurrent acute retrograde intragastric intussusception
Authors: J. A. Williams, J. F. Fielding
Journal: Gut (1970)

A case of recurrent acute retrograde jejunogastric intussusception is described in a 45-year-old man who five years previously had had an antecolic gastrojejunostomy. Two previous haematemases imply that this complication was recurrent and self reducing an unusual and fortuitous outcome. Awareness of the possibility of acute intussusception following gastroenterostomy or partial gastrectomy is stressed.
No Ethnic Differences in the Association of Glycated Hemoglobin With Retinopathy
Authors: Julie K. Bower, Frederick L. Brancati, Elizabeth Selvin
Journal: Diabetes Care (2012)

Current recommendations for the use of hemoglobin A(1c) (HbA(1c)) in diabetes screening and diagnosis aim to identify those at greatest risk for diabetic microvascular complications. However, there is current controversy regarding the clinical implications of ethnic differences in HbA(1c) values. The objective of this study was to determine whether the association between HbA(1c) and retinopathy differs by ethnic group in a representative sample of U.S. adults.The study was a cross-sectional analysis of 2,945 non-Hispanic white, 1,046 non-Hispanic black, and 1,231 Hispanic American participants aged ≥40 years from the 2005-2008 National Health and Nutrition Examination Survey.Among nondiabetic adults, the mean HbA(1c) was 5.5% in non-Hispanic whites, 5.7% in non-Hispanic blacks, and 5.6% in Hispanic Americans. Among those with diagnosed diabetes, mean HbA(1c) was 6.9% in non-Hispanic whites, 7.5% in non-Hispanic Blacks, and 7.7% in Hispanic Americans. Overall, non-Hispanic blacks had the highest prevalence of retinopathy. In multivariable logistic models, HbA(1c) clinical categories were strongly associated with prevalent retinopathy. However, the magnitude of the association did not differ by ethnic group (all P values for interaction ≥ 0.7). Similar results were observed with HbA(1c) modeled continuously (per one percentage point) and stratified by diabetes status (all P for interactions > 0.3).We observed no ethnic differences in the association of HbA(1c) with retinopathy. These data do not support ethnic-specific cut points for HbA(1c) for diagnosis or screening of diabetes mellitus.
HLA-Mismatched Stem-Cell Microtransplantation As Postremission Therapy for Acute Myeloid Leukemia: Long-Term Follow-Up
Authors: Mei Guo, Kai-Xun Hu, Guang-Xian Liu, Chang-Lin Yu, Jian-Hui Qiao, Qi-Yun Sun, Jun-Xiao Qiao, Zheng Dong, Wan-Jun Sun, Xue-Dong Sun, Hong-Li Zuo, Qiu-Hong Man, Zhi-Qing Liu, Tie-Qiang Liu, Hong-Xia Zhao, Ya-Jing Huang, Li Wei, Bing Liu, Juan Wang, Xu-Liang Shen, Hui-Sheng Ai
Journal: Journal of Clinical Oncology (2012)

Despite best current therapies, approximately half of patients with acute myeloid leukemia in first complete remission (AML-CR1) with no HLA-identical donors experience relapse. Whether HLA-mismatched stem-cell microtransplantation as a novel postremission therapy in these patients will improve survival and avoid graft-versus-host disease (GVHD) is still unknown.One hundred one patients with AML-CR1 (9 to 65 years old) from four treatment centers received programmed infusions of G-CSF-mobilized HLA-mismatched donor peripheral-blood stem cells after each of three cycles of high-dose cytarabine conditioning without GVHD prophylaxis. Donor chimerism and microchimerism and WT1+CD8+ T cells were analyzed.The 6-year leukemia-free survival (LFS) and overall survival (OS) rates were 84.4% and 89.5%, respectively, in the low-risk group, which were similar to the rates in the intermediate-risk group (59.2% and 65.2%, respectively; P=.272 and P=.308). The 6-year LFS and OS were 76.4% and 82.1%, respectively, in patients who received a high dose of donor CD3+ T cells (≥1.1×10(8)/kg) in each infusion, which were significantly higher than the LFS and OS in patients who received a lower dose (<1.1×10(8)/kg) of donor CD3+ T cells (49.5% and 55.3%, respectively; P=.091 and P=.041). No GVHD was observed in any of the patients. Donor microchimerism (2 to 1,020 days) was detected in 20 of the 23 female patients who were available for Y chromosome analysis. A significant increase in WT1+CD8+ T cells (from 0.2% to 4.56%) was observed in 33 of 39 patients with positive HLA-A*02:01 antigen by a pentamer analysis.Microtransplantation as a postremission therapy may improve outcomes and avoid GVHD in patients with AML-CR1.