tbuckley/cabot-search huggingface dataset:
How reliable are Functional Movement Screening scores? A systematic review of rater reliability
Authors: Robert W Moran, Anthony G Schneiders, Katherine M Major, S John Sullivan
Journal: British Journal of Sports Medicine (2015)

Background Several physical assessment protocols to identify intrinsic risk factors for injury aetiology related to movement quality have been described. The Functional Movement Screen (FMS) is a standardised, field-expedient test battery intended to assess movement quality and has been used clinically in preparticipation screening and in sports injury research. Aim To critically appraise and summarise research investigating the reliability of scores obtained using the FMS battery. Study design Systematic literature review. Methods Systematic search of Google Scholar, Scopus (including ScienceDirect and PubMed), EBSCO (including Academic Search Complete, AMED, CINAHL, Health Source: Nursing/Academic Edition), MEDLINE and SPORTDiscus. Studies meeting eligibility criteria were assessed by 2 reviewers for risk of bias using the Quality Appraisal of Reliability Studies checklist. Overall quality of evidence was determined using van Tulder's levels of evidence approach. Results 12 studies were appraised. Overall, there was a ‘moderate’ level of evidence in favour of ‘acceptable’ (intraclass correlation coefficient ≥0.6) inter-rater and intra-rater reliability for composite scores derived from live scoring. For inter-rater reliability of composite scores derived from video recordings there was ‘conflicting’ evidence, and ‘limited’ evidence for intra-rater reliability. For inter-rater reliability based on live scoring of individual subtests there was ‘moderate’ evidence of ‘acceptable’ reliability (κ≥0.4) for 4 subtests (Deep Squat, Shoulder Mobility, Active Straight-leg Raise, Trunk Stability Push-up) and ‘conflicting’ evidence for the remaining 3 (Hurdle Step, In-line Lunge, Rotary Stability). Conclusions This review found ‘moderate’ evidence that raters can achieve acceptable levels of inter-rater and intra-rater reliability of composite FMS scores when using live ratings. Overall, there were few high-quality studies, and the quality of several studies was impacted by poor study reporting particularly in relation to rater blinding.
N-Terminal Pro-Brain Natriuretic Peptide on Admission Has Prognostic Value Across the Whole Spectrum of Acute Coronary Syndromes
Authors: Marcello Galvani, Filippo Ottani, Luigi Oltrona, Diego Ardissino, Gian Franco Gensini, Aldo P. Maggioni, Pier Mannuccio Mannucci, Nicola Mininni, Maria Domenica Prando, Marco Tubaro, Arialdo Vernocchi, Carlo Vecchio
Journal: Circulation (2004)

The prognostic value of natriuretic peptide elevations in patients with acute coronary syndromes (ACS) is still incompletely defined. We measured N-terminal pro-brain natriuretic peptide (NT-proBNP) on admission in patients with ACS and ECG evidence of myocardial ischemia.The NT-proBNP was measured at a median time of 3 hours after symptom onset in 1756 patients. The outcome measure was death at 30 days, which occurred in 113 patients (6.4%). The median NT-proBNP level was 353 ng/L (107 to 1357 ng/L). Compared with the lowest quartile, patients in the second, third, and fourth quartiles had a relative risk of subsequent death of 2.94 (95% CI, 1.15 to 7.52), 5.32 (95% CI, 2.19 to 12.91), and 11.5 (95% CI, 4.90 to 26.87), respectively. The NT-proBNP was independently associated with death in a logistic regression model, which included clinical variables, ECG, and troponin T in patients either with (OR of highest versus lowest quartile, 7.0; 95% CI, 1.9 to 25.6) or without (OR of highest versus lowest quartile, 4.1; 95% CI, 1.1 to 14.6) persistent ST-segment elevation. NT-proBNP was also an independent predictor of severe heart failure.The measurement of NT-proBNP on admission improves the early risk stratification of patients with ACS, suggesting the need for the development of targeted therapeutic strategies.
Bidirectional Role of Tumor Necrosis Factor-α in Coronary Microembolization
Authors: Andreas Skyschally, Petra Gres, Simone Hoffmann, Michael Haude, Raimund Erbel, Rainer Schulz, Gerd Heusch
Journal: Circulation Research (2006)

In patients with unstable angina, plaque rupture and coronary microembolization (ME) can precede complete coronary artery occlusion and impending infarction. ME-induced microinfarcts initiate an inflammatory reaction with increased tumor necrosis factor-alpha (TNF-alpha) expression, resulting in progressive contractile dysfunction. However, TNF-alpha is not only a negative inotrope but can also protect the myocardium against infarction. In anesthetized pigs, we studied whether ME protects against infarction when TNF-alpha expression is increased. ME (group1; n=7) was induced by intracoronary infusion of microspheres (42 microm; 3000 per mL/min inflow). Controls (group 2; n=8) received saline. Groups 3 and 4 (n=4 each) were pretreated with ovine TNF-alpha antibodies (25 mg/kg body weight) 30 minutes before ME or placebo, respectively. Ischemia (90 minutes) was induced 6 hours after ME when TNF-alpha was increased (66+/-21 pg/g wet weight; mean+/-SEM) or after placebo (TNF-alpha, 21+/-10 pg/g; P<0.05). Infarct size (percentage area at risk) was determined after 2 hours of reperfusion (triphenyl tetrazolium chloride staining). ME decreased systolic wall thickening progressively over 6 hours (group 1 versus group 2, 65+/-4% versus 90+/-1%; percentage of baseline; P<0.05). TNF-alpha antibodies attenuated the progressive decrease in systolic wall thickening following ME (group 3, 77+/-5% of baseline; P<0.05 versus group 1) with no effect in controls (group 4; 90+/-8% of baseline). With ME, infarct size was decreased to 18+/-4% versus 33+/-4% in group 2 (P<0.05). The infarct size reduction was abolished by TNF-alpha antibodies (group 3 versus group 4, 29+/-3% versus 35+/-5%). In ME, TNF-alpha is responsible for both progressive contractile dysfunction and delayed protection against infarction.
The Requirement of Membrane Lymphotoxin for the Presence of Dendritic Cells in Lymphoid Tissues
Authors: Qiang Wu, Yang Wang, Jing Wang, Elizabeth O. Hedgeman, Jeffrey L. Browning, Yang-Xin Fu
Journal: The Journal of Experimental Medicine (1999)

Although several cytokines, including tumor necrosis factor (TNF), can promote the growth of dendritic cells (DCs) in vitro, the cytokines that naturally regulate DC development and function in vivo have not been well defined. Here, we report that membrane lymphotoxin (LT), instead of TNF, regulates the migration of DCs in the spleen. LTalpha(-/-) mice, lacking membrane LTalpha/beta and LTalpha(3), show markedly reduced numbers of DCs in the spleen. Unlike wild-type mice and TNF(-/-) mice that have densely clustered DCs in the T cell zone and around the marginal zone, splenic DCs in LTalpha(-/-) mice are randomly distributed. The reduced number of DCs in lymphoid tissues of LTalpha(-/-) mice is associated with an increased number of DCs in nonlymphoid tissues. The number of splenic DCs in LTalpha(-/-) mice is restored when additional LT-expressing cells are provided. Blocking membrane LTalpha/beta in wild-type mice markedly diminishes the accumulation of DCs in lymphoid tissues. These data suggest that membrane LT is an essential ligand for the presence of DCs in the spleen. Mice deficient in TNF receptor, which is the receptor for both soluble LTalpha(3) and TNF-alpha(3) trimers, have normal numbers of DCs. However, LTbetaR(-/-) mice show reduced numbers of DCs, similar to the mice lacking membrane LT alpha/beta. Taken together, these results support the notion that the signaling via LTbetaR by membrane LTalpha/beta is required for the presence of DCs in lymphoid tissues.
Clinical characteristics of chronic idiopathic intestinal pseudo-obstruction in adults
Authors: S D Mann, H S Debinski, M A Kamm
Journal: Gut (1997)

Background —Chronic idiopathic intestinal pseudo-obstruction, a syndrome of ineffectual motility due to a primary disorder of enteric nerve or muscle, is rare. Aims —To determine the clinical spectrum, underlying pathologies, response to treatments, and prognosis in a consecutive unselected group of patients. Methods —Cross sectional study of all patients with clinical and radiological features of intestinal obstruction in the absence of organic obstruction, associated with dilated small intestine (with or without dilated large intestine), being actively managed in one tertiary referral centre at one time. Results —Twenty patients (11 men and nine women, median age 43 years, range 22–67) fulfilled the diganostic criteria. Median age at onset of symptoms was 17 years (range two weeks to 59 years). Two patients had an autosomally dominant inherited visceral myopathy. Major presenting symptoms were pain (80%), vomiting (75%), constipation (40%), and diarrhoea (20%). Eighteen patients required abdominal surgery, and a further patient had a full thickness rectal biopsy. The mean time interval from symptom onset to first operation was 5.8 years. Histology showed visceral myopathy in 13, visceral neuropathy in three, and was indeterminate in three. In the one other patient small bowel motility studies were suggestive of neuropathy. Two patients died within two years of symptom onset, one from generalised thrombosis and the other from an inflammatory myopathy. Of the remaining 18 patients, eight were nutritionally independent of supplements, two had gastrostomy or jejunostomy feeds, and eight were receiving home parenteral nutrition. Five patients were opiate dependent, only one patient had benefited from prokinetic drug therapy, and five patients required formal psychological intervention and support. Conclusions —In a referral setting visceral myopathy is the most common diagnosis in this heterogeneous syndrome, the course of the illness is usually prolonged, and prokinetic drug therapies are not usually helpful. Ongoing management problems include pain relief and nutritional support.
Respiratory function in the morbidly obese before and after weight loss.
Authors: P S Thomas, E R Cowen, G Hulands, J S Milledge
Journal: Thorax (1989)

The morbidly obese are known to have impaired respiratory function. A prospective study of the changes in lung volumes, carbon monoxide transfer, and arterial blood gas tensions was undertaken in 29 morbidly obese patients before and after surgery to induce weight loss. Before surgery the predominant abnormality in respiratory function was a reduction in lung volumes. These increased towards normal predicted values after weight loss, with significant increases in functional residual capacity, residual volume, total lung capacity, and expiratory reserve volume. The increases ranged from 14% for total lung capacity to 54% for expiratory reserve volume. After weight loss had been induced the smokers showed mild hyperinflation and air trapping. Resting arterial blood gas tensions improved, with a rise in arterial oxygen tension from 10.63 to 13.02 kPa and a fall in arterial carbon dioxide tension from 5.20 to 4.64 kPa. There was no correlation between weight loss and the changes in blood gas tensions or lung volumes. Loss of weight in the morbidly obese is thus associated with improved lung function. The effects of smoking on lung function could be detected after weight loss, but were masked before treatment by the opposing effects of obesity on residual volume and functional residual capacity.
Myocyte Cell Death in the Diseased Heart
Authors: Piero Anversa, Jan Kajstura
Journal: Circulation Research (1998)

Karwatowska-Prokopczuk et al 1 and Takemura et al 2 report, respectively, that inhibition of the vacuolar proton ATPase (VPATPase) enhances apoptosis in neonatal cardiac myocytes during metabolic recovery and that the progression of the healing process after infarction involves apoptotic death of inflammatory and interstitial cells.We will discuss these 2 studies separately, because the first addresses important mechanisms of myocyte death and survival, and the second provides new information on scarring of the postinfarcted heart.Both studies emphasize directly or indirectly through in vitro 1 and in vivo 2 experiments the role of apoptosis in ischemic injury.Two different phases of cardiac damage are examined: myocyte death and reparative fibrosis.In the first article, 1 the recognition that alkalinization of myocytes is regulated not only by activation of the Na ϩ -H ϩ antiport and the Na ϩ -HCO 3 Ϫ symport but also via a third proton-extruding system, VPATPase, 1,3 may elucidate some of the critical events affecting the ischemic myocardium.Whether myocardial ischemia occurs in vivo in the absence 4,5 or presence 5,6 of reperfusion, cell death by apoptosis is the predominant pathological consequence; its etiology, however, remains to be defined.Similarly, the paradoxical beneficial impact of Na ϩ -H ϩ exchange inhibition during ischemia 1 is unclear.The documentation that the ATP-dependent vacuolar proton pump may play a role in hypoxia-induced myocyte apoptosis is significant because it points to alterations in pH i as critical for the transmission of a death signal to myocytes in vivo.Impairment of VPATPase affects the extrusion of protons from the cytoplasm to intracellular acidic complexes, decreasing pH i , and abolishes the protective influence of attenuation of the Na ϩ -H ϩ exchanger on Ca 2ϩ overload. 1The observations by Karwatowska-Prokopczuk et al 1 have been paralleled by results from Lakatta's laboratory recently published in The Journal of Clinical Investigation.
Levamisole therapy for multiple warts
Authors: BENJAMIN MONCADA, MARIA LUISA RODRIGUEZ
Journal: British Journal of Dermatology (2006)

Levamisole, a wide-spectrum antiparasitic drug, increases cellular immunity in vivo and in vitro. Patients with verruca vulgaris may have defective cell mediated immune mechanisms. Levamisole was given to twenty-two patients with multiple warts, 5 mg/kg body weight on 3 consecutive days every fortnight. Patients' lymphocytes were studied for E-rosette formation before therapy. E-rosette counts were lower in patients compared with controls and a significant increase was obtained after in vitro incubation with levamisole. Seventeen patients were cured in 1-4 months, there were four failures and one patient showed marked improvement. It is concluded that patients with multiple warts have defective cell-mediated mechanisms as far as the E-rosette count is concerned and that levamisole increases in vitro E-rosette formation and is useful in the treatment of these patients.
T-Cell Immunity to the Folate Receptor Alpha Is Prevalent in Women With Breast or Ovarian Cancer
Authors: Keith L. Knutson, Christopher J. Krco, Courtney L. Erskine, Karin Goodman, Linda E. Kelemen, Peter J. Wettstein, Philip S. Low, Lynn C. Hartmann, Kimberly R. Kalli
Journal: Journal of Clinical Oncology (2006)

Studies have demonstrated that the generation of immunity to tumor antigens is associated with improved prognosis for many cancers. A candidate antigen is the folate receptor alpha (FRalpha), which is overexpressed in breast and ovarian cancers. Our goal in this study was to attain a better understanding of the extent of endogenous FRalpha immunity.Using a CD4+ T cell epitope prediction algorithm, we predicted promiscuous epitopes of FRalpha, and tested for immunity in 30 breast (n = 17) or ovarian (n = 13) cancer patients and 18 healthy donors using enzyme-linked immunospot analysis.Fourteen peptides were predicted, seven each from the carboxy- and amino-terminus halves of the protein. More than 70% of patients demonstrated immunity to at least one FRalpha peptide. Patients responded to an average of 3 +/- 0.5 peptides, whereas healthy donors responded to 1 +/- 0.4 peptides (P = .004). Five peptides were recognized by more than 25% of patients. Responses to three peptides were higher (P < .05) in patients than in healthy donors, suggesting augmented immunity. Compared with healthy individuals, patients developed higher immunity to the amino-terminus half of the receptor (P = .03). There was no difference between each group in the responses to nonspecific (P = .2) and viral stimuli (P = .5). Lastly, patients demonstrated elevated levels of FRalpha antibodies consistent with a coordinated immune response.These findings demonstrate that the FRalpha is a target of the immune system in breast and ovarian cancer patients. Understanding which antigens are targeted by the immune system may be important for prognosis or immune-based therapies.
Management of Bacteremia Associated with Tunneled-Cuffed Hemodialysis Catheters
Authors: GERALD A. BEATHARD
Journal: Journal of the American Society of Nephrology (1999)

Abstract. The dominant problem associated with the use of tunneled-cuffed catheters is infection. When this occurs, two issues must be addressed: treatment of the infection and management of the catheter. The purpose of this 2-yr study was to report the results of a prospective observational series in which catheter management was based on the clinical picture presented by the patient. Data were collected on patients with catheter-related bacteremia (CRB) dealt with in one of three ways: ( 1 ) minimal symptoms with a normal-appearing tunnel and exit site (exchange over guidewire within 48 h of antibiotic initiation [Xchng group], 49 cases); ( 2 ) minimal symptoms but with tunnel or exit site infection (exchange over a guidewire with creation of a new tunnel [Nutunl group], 28 cases); and ( 3 ) severe clinical symptoms (catheter removal with delayed replacement after defervescence [Delay group], 37 cases). All cases were treated immediately with empiric antibiotics followed by 3 wk of antibiotic therapy based on culture sensitivities. A cure was defined as a 45-d symptom-free interval after antibiotic therapy was complete. A cure rate total of 87.8% for the Xchng group, 75% for the Nutunl group, and 86.5% for the Delay group was seen for the 114 episodes of CRB. It is concluded that in selected patients, catheter exchange over a guidewire within 48 h of antibiotic initiation followed by 3 wk of specific antibiotic therapy is a viable treatment option. Additionally, replacing the catheter in patients presenting with severe symptoms of sepsis as soon as they have defervesced is a reasonable approach to therapy.
Binding and uptake of native and modified low-density lipoproteins by human hepatocytes in primary culture
Authors: Vladimir R. Babaev, Vladimir A. Kosykh, Vladimir P. Tsibulsky, Vadim O. Ivanov, Vadim S. Repin, Vladimir N. Smirnov
Journal: Hepatology (1989)

The binding and uptake of native low-density lipoproteins and malondialdehyde-treated low density lipoproteins by human hepatocytes in primary culture has been analyzed. Experiments with 125I-labeled malondialdehyde-treated low-density lipoproteins showed that cultured liver cells took up and degraded malondialdehyde-treated low-density lipoproteins, but the cell type(s) responsible for this action remain unclear. Immunofluorescent visualization of receptor-bound low-density lipoproteins revealed that low-density lipoprotein binding sites were distributed on the surface of nearly all cells of the culture. Binding sites for malondialdehyde-treated low-density lipoproteins were found in only 5% of the cultured cells, and these cells differed from hepatocytes in shape and size. Cultured hepatocytes internalized and native low-density lipoproteins, but not malondialdehyde-treated low-density lipoproteins, labeled with the fluorescent dye 3',3'-dioctadecylindocarbocyanine. About 15% of the cells that take up 3',3'-dioctadecylindocarbocyanine-labeled malondialdehyde-treated low-density lipoproteins could be identified as liver endothelial cells and macrophages, since they internalized formaldehyde-treated human albumin and fluorescent carboxylated microspheres. Our results indicate that human hepatocytes in primary culture express surface receptors for native low-density lipoproteins but not for modified low-density lipoproteins.
Exercise Standards for Testing and Training
Authors: Gerald F. Fletcher, Philip A. Ades, Paul Kligfield, Ross Arena, Gary J. Balady, Vera A. Bittner, Lola A. Coke, Jerome L. Fleg, Daniel E. Forman, Thomas C. Gerber, Martha Gulati, Kushal Madan, Jonathan Rhodes, Paul D. Thompson, Mark A. Williams
Journal: Circulation (2013)
Can non-fundable trials be conducted anyway? The case for open, randomised, actively controlled trials in rheumatology
Authors: E. H GIANNINI
Journal: Annals of the Rheumatic Diseases (1998)

Can non-fundable trials be conducted anyway?The case for open, randomised, actively controlled trials in rheumatology Clinicians are encouraged to practice "evidence-based medicine", a term implying that a practitioner can access, summarise, and apply information from the literature to day to day clinical problems and questions. 1 But how convincing should the evidence be for a clinician to accept the data and adopt the approach into his or her practice?Undoubtedly the double blind, placebo controlled, randomised trial remains as the ultimate tool for gathering the strongest evidence of therapeutic eYcacy and safety.However, this study design is at times unfeasible, unethical or may not even be appropriate for obtaining the information needed (for example, long term outcome), and less stringent alternatives have to be considered. 2 3In rheumatology, where the optimal therapeutic approach to many conditions is still uncertain, approved drugs are frequently used "oV label" (implying that the agent is being used to treat a disease for which it has not gained formal approval, or at a dosage level other than that recommended on the label).Diverse combinations of drugs are also commonly tried as clinicians attempt to retain or reclaim a higher functional outcome and quality of life for their patients.Understandably, one frequently encounters conflicting data when searching for evidence about the clinical utility of these new approaches. 4 Furthermore, the likelihood of a pivotal trial ever being done to establish unequivocal evidence of eVectiveness and safety may be remote.Less rigorous designs may not produce evidence as compelling to the practitioner as a pivotal study, but they can provide at least some insight into therapeutic eVectiveness and safety where otherwise none would exist.One such approach is the open, randomised, actively controlled trial (ORACT), a mainstay of haematology-oncology research studies of the US based Pediatric Oncology Group (POG) and Children's Cancer Study Group. 5 Virtually all newly diagnosed children with cancer are randomly assigned to one of two or more active treatment arms of approved drugs and continue "on-protocol" for the duration of their follow up.Thus, each child becomes a resource of information for future patients (particularly crucial in rare conditions) as their data are entered into the constantly expanding database.The premise of this leader is that the ORACT design oVers an opportunity to conduct studies in rheumatology that would otherwise not be possible.