tbuckley/cabot-search huggingface dataset:
A Behavioral and Systems View of Professionalism
Authors: Cara S Lesser, Catherine R Lucey, Barry Egener, Clarence H Braddock, Stuart L Linas, Wendy Levinson
Journal: JAMA (2010)

Professionalism may not be sufficient to drive the profound and far-reaching changes needed in the US health care system, but without it, the health care enterprise is lost. Formal statements defining professionalism have been abstract and principle based, without a clear description of what professional behaviors look like in practice. This article proposes a behavioral and systems view of professionalism that provides a practical approach for physicians and the organizations in which they work. A more behaviorally oriented definition makes the pursuit of professionalism in daily practice more accessible and attainable. Professionalism needs to evolve from being conceptualized as an innate character trait or virtue to sophisticated competencies that can and must be taught and refined over a lifetime of practice. Furthermore, professional behaviors are profoundly influenced by the organizational and environmental context of contemporary medical practice, and these external forces need to be harnessed to support--not inhibit--professionalism in practice. This perspective on professionalism provides an opportunity to improve the delivery of health care through education and system-level reform.
Serum anticardiolipin antibodies (ACA) levels in patients with chronic hepatitis-B (CHB) and its association with extra-hepatic manifestations
Authors: J.S. Elefsiniotis, I.S. Papanikolaou, I.A. Magaziotou, S.S. Goulas, E.N. Georgakopoulos, D.B. Panagiotakos, A. Foutsitzi, V.S. Papanicolaou, Z. Athanassa, C. Mavrogiannis, G.G. Carvountzis
Journal: Journal of Hepatology (2001)
Structural Biology of Innate Immunity
Authors: Qian Yin, Tian-Min Fu, Jixi Li, Hao Wu
Journal: Annual Review of Immunology (2015)

Innate immune responses depend on timely recognition of pathogenic or danger signals by multiple cell surface or cytoplasmic receptors and transmission of signals for proper counteractions through adaptor and effector molecules. At the forefront of innate immunity are four major signaling pathways, including those elicited by Toll-like receptors, RIG-I-like receptors, inflammasomes, or cGAS, each with its own cellular localization, ligand specificity, and signal relay mechanism. They collectively engage a number of overlapping signaling outcomes, such as NF-κB activation, interferon response, cytokine maturation, and cell death. Several proteins often assemble into a supramolecular complex to enable signal transduction and amplification. In this article, we review the recent progress in mechanistic delineation of proteins in these pathways, their structural features, modes of ligand recognition, conformational changes, and homo- and hetero-oligomeric interactions within the supramolecular complexes. Regardless of seemingly distinct interactions and mechanisms, the recurring themes appear to consist of autoinhibited resting-state receptors, ligand-induced conformational changes, and higher-order assemblies of activated receptors, adaptors, and signaling enzymes through conserved protein-protein interactions.
HUMAN T LYMPHOCYTE "E" ROSETTE FUNCTION
Authors: Francis V. Chisari, Thomas S. Edgington
Journal: The Journal of Experimental Medicine (1974)

The capacity of normal human T lymphocytes to form rosettes with sheep red blood cells can be inhibited by drugs or agents which induce elevations in intracellular levels of cyclic AMP. The effect is early in the presence of agents which elicit rapid elevations in intracellular cyclic AMP (isoproterenol, aminophylline) and occurs later in the presence of cholera toxin which induces a dalayed increase in endogenous cyclic AMP. Dibutyryl cyclic AMP is inhibitory, and the effects of dibutyryl cyclic AMP and the adenyl cyclase stimulators are potentiated by inhibition of phosphodiesterase. These data provide substantial evidence that elevation of intracellular cyclic AMP diminishes E rosette function of lymphocytes.
Regulatory interdependence of myeloid transcription factors revealed by Matrix RNAi analysis
Authors: Yasuhiro Tomaru, Christophe Simon, Alistair RR Forrest, Hisashi Miura, Atsutaka Kubosaki, Yoshihide Hayashizaki, Masanori Suzuki
Journal: Genome biology (2009)

With the move towards systems biology, we need sensitive and reliable ways to determine the relationships between transcription factors and their target genes. In this paper we analyze the regulatory relationships between 78 myeloid transcription factors and their coding genes by using the matrix RNAi system in which a set of transcription factor genes are individually knocked down and the resultant expression perturbation is quantified.Using small interfering RNAs we knocked down the 78 transcription factor genes in monocytic THP-1 cells and monitored the perturbation of the expression of the same 78 transcription factors and 13 other transcription factor genes as well as 5 non-transcription factor genes by quantitative real-time RT-PCR, thereby building a 78 x 96 matrix of perturbation and measurement. This approach identified 876 cases where knockdown of one transcription factor significantly affected the expression of another (from a potential 7,488 combinations). Our study also revealed cell-type-specific transcriptional regulatory networks in two different cell types.By considering whether the targets of a given transcription factor are naturally up- or downregulated during phorbol 12-myristate 13-acetate-induced differentiation, we could classify these edges as pro-differentiative (229), anti-differentiative (76) or neither (571) using expression profiling data obtained in the FANTOM4 study. This classification analysis suggested that several factors could be involved in monocytic differentiation, while others such as MYB and the leukemogenic fusion MLL-MLLT3 could help to maintain the initial undifferentiated state by repressing the expression of pro-differentiative factors or maintaining expression of anti-differentiative factors.
Anti-apoptotic effects of Z α<sub>1</sub>-antitrypsin in human bronchial epithelial cells
Authors: C. M. Greene, S. D. W. Miller, T. P. Carroll, I. K. Oglesby, F. Ahmed, M. O'Mahony, C. C. Taggart, N. G. McElvaney, S. J. O'Neill
Journal: European Respiratory Journal (2009)

α 1 -antitrypsin (α 1 -AT) deficiency is a genetic disease which manifests as early-onset emphysema or liver disease. Although the majority of α 1 -AT is produced by the liver, it is also produced by bronchial epithelial cells, amongst others, in the lung. Herein, we investigate the effects of mutant Z α 1 -AT (ZAAT) expression on apoptosis in a human bronchial epithelial cell line (16HBE14o-) and delineate the mechanisms involved. Control, M variant α 1 -AT (MAAT)- or ZAAT-expressing cells were assessed for apoptosis, caspase-3 activity, cell viability, phosphorylation of Bad, nuclear factor (NF)-κB activation and induced expression of a selection of pro- and anti-apoptotic genes. Expression of ZAAT in 16HBE14o- cells, like MAAT, inhibited basal and agonist-induced apoptosis. ZAAT expression also inhibited caspase-3 activity by 57% compared with control cells (p = 0.05) and was a more potent inhibitor than MAAT. Whilst ZAAT had no effect on the activity of Bad, its expression activated NF-κB-dependent gene expression above control or MAAT-expressing cells. In 16HBE14o- cells but not HEK293 cells, ZAAT upregulated expression of cIAP-1, an upstream regulator of NF-κB. cIAP1 expression was increased in ZAAT versus MAAT bronchial biopsies. The data suggest a novel mechanism by which ZAAT may promote human bronchial epithelial cell survival.
Improving Access to Geriatric Mental Health Services: A Randomized Trial Comparing Treatment Engagement With Integrated Versus Enhanced Referral Care for Depression, Anxiety, and At-Risk Alcohol Use
Authors: Stephen J Bartels, Eugenie H Coakley, Cynthia Zubritsky, James H Ware, Keith M Miles, Patricia A Areán, Hongtu Chen, David W Oslin, Maria D Llorente, Giuseppe Costantino, Louise Quijano, Jack S McIntyre, Karen W Linkins, Thomas E Oxman, James Maxwell, Sue E Levkoff
Journal: American Journal of Psychiatry (2004)

The authors sought to determine whether integrated mental health services or enhanced referral to specialty mental health clinics results in greater engagement in mental health/substance abuse services by older primary care patients.This multisite randomized trial included 10 sites consisting of primary care and specialty mental health/substance abuse clinics. Primary care patients 65 years old or older (N=24,930) were screened. The final study group consisted of 2,022 patients (mean age=73.5 years; 26% female; 48% ethnic minority) with depression (N=1,390), anxiety (N=70), at-risk alcohol use (N=414), or dual diagnosis (N=148) who were randomly assigned to integrated care (mental health and substance abuse providers co-located in primary care; N=999) or enhanced referral to specialty mental health/substance abuse clinics (i.e., facilitated scheduling, transportation, payment; N=1,023).Seventy-one percent of patients engaged in treatment in the integrated model compared with 49% in the enhanced referral model. Integrated care was associated with more mental health and substance abuse visits per patient (mean=3.04) relative to enhanced referral (mean=1.91). Overall, greater engagement was predicted by integrated care and higher mental distress. For depression, greater engagement was predicted by integrated care and more severe depression. For at-risk alcohol users, greater engagement was predicted by integrated care and more severe problem drinking. For all conditions, greater engagement was associated with closer proximity of mental health/substance abuse services to primary care.Older primary care patients are more likely to accept collaborative mental health treatment within primary care than in mental health/substance abuse clinics. These results suggest that integrated service arrangements improve access to mental health and substance abuse services for older adults who underuse these services.
Osteoprotegerin Is a Risk Factor for Progressive Atherosclerosis and Cardiovascular Disease
Authors: Stefan Kiechl, Georg Schett, Gregor Wenning, Kurt Redlich, Martin Oberhollenzer, Agnes Mayr, Peter Santer, Josef Smolen, Werner Poewe, Johann Willeit
Journal: Circulation (2004)

Osteoprotegerin is a novel member of the tumor necrosis factor receptor superfamily and a soluble decoy receptor of the receptor activator of nuclear factor-kappaB ligand. Recent experimental research has implicated osteoprotegerin in atherogenesis, but epidemiological confirmation of this concept is sparse.As part of the prospective, population-based Bruneck Study, severity, initiation, and progression of atherosclerosis were assessed in carotid arteries. Cases of incident cardiovascular disease and vascular mortality were carefully recorded over a 10-year period (1990 to 2000). Osteoprotegerin levels were measured in samples obtained at baseline and during follow-up. Serum osteoprotegerin showed a strong association with numerous vascular risk factors, including age, diabetes, markers of systemic inflammation, chronic infection, and smoking. In multivariate analyses, osteoprotegerin was significantly related to severity and 10-year progression of carotid atherosclerosis. Furthermore, a high level of osteoprotegerin was an independent risk factor for incident cardiovascular disease (adjusted relative risk for the top versus bottom tertile group for osteoprotegerin 2.2 [1.3 to 3.8]; P=0.001) and vascular mortality (adjusted relative risk for the top versus bottom tertile group for osteoprotegerin 3.1 [1.2 to 8.2]; P=0.010) but not for mortality due to nonvascular causes.Osteoprotegerin is an independent risk factor for the progression of atherosclerosis and onset of cardiovascular disease.
Decision Making in Oncology: A Review of Patient Decision Aids to Support Patient Participation
Authors: D. Stacey, R. Samant, C. Bennett
Journal: CA A Cancer Journal for Clinicians (2008)

Although cancer management is becoming more structured with disease- specific guidelines and clinical pathways, many decisions remain complex. Contributing to this complexity is the need to make value tradeoffs between benefits and harms across cancer treatment and/or screening options. Since there is no "best" option for everyone, decisions are defined as being of higher quality when informed with the latest scientific evidence and based on patients' informed values associated with outcomes of options. However, clinicians are not good judges of patients' values, and patients often have inadequate knowledge, unrealistic expectations, and decisional conflict that interfere with their involvement in decision making. Effective approaches to support patient involvement into clinical decisions include clinicians trained in shared decision making, question prompt sheets, patient decision aids, and decision coaching by nurses and other allied health professionals. Based on systematic review of 23 randomized trials of cancer patient decision aids, patients exposed to decision aids are more likely to participate in decision making and achieve higher-quality decisions. This review highlights key historical changes leading to patient involvement in decision making, summarizes evidence on effective interventions to support shared decision making, explores strategies to implement these interventions in oncology practices, and identifies future directions.
EFFECT OF UNILATERAL AND BILATERAL USE OF LATERALLY WEDGED INSOLES WITH ARCH SUPPORTS ON IMPACT LOADING IN MEDIAL KNEE OSTEOARTHRITIS
Authors: Amira Abdallah
Journal: British Journal of Sports Medicine (2013)

Background Increased impact loading is implicated in knee osteoarthritis development and progression. This study examined the initial impact force and first ground reaction force (GRF) peaks, their loading rates, their relative timing to the stance phase timing and the walking speed during unilateral and bilateral use of different inclinations of laterally wedged insoles (LWI) with arch supports. Methods Data were collected from 33 female patients with medial knee osteoarthritis, using an AMPTI forceplate, under five insole conditions (unilateral 6° &amp; 11° and bilateral 0°, 6° &amp; 11°) and a without-insole one. Results Repeated measures MANOVA revealed significant (p&lt;0.05) increase in the impact force in the bilateral 11° vs each of the unilateral 6° and without-insole conditions. The impact loading rate decreased significantly in the unilateral 11° vs the bilateral 6° insole condition. The relative timing of the impact force increased significantly in each of the bilateral 6°, bilateral 11° and unilateral 11° vs the bilateral 0° insole condition and in each of the bilateral 11° and unilateral 11° vs the without-insole condition. Moreover, there were significant (p=0.000) positive correlations between the impact and GRF loading rates and the walking speed and each of the impact force, impact loading rate and GRF loading rate. Finally, the Chi-square test revealed insignificant (p&gt;0.05) association between the insole conditions and the presence of impact forces. Discussion/Conclusion Patients with medial knee osteoarthritis are advised to use unilateral 11° LWI and walk slowly to decrease impact loading. Unilateral use of 11° LWI decreases impact loading possibly through increasing foot pronation (Abdallah A.A. &amp; Radwan A.Y., 2011)*.
A clinicopathological study of fatal chronic airways obstruction.
Authors: K W Scott
Journal: Thorax (1976)

A clinicopathological study of 21 patients who died as a result of chronic airways obstruction was carried out. Thirteen patients had been in right ventricular failure for at least one year before death and the other eight patients did not have right ventricular failure. The patients with long-standing right ventricular failure died at a younger age, on average, than those without failure. There were no significant quantitative differences between the two groups in the length of history of chest disease, blood gas estimations, respiratory function tests or degree of polycythaemia. The group with right ventricular failure had significantly larger mean right and left ventricular weights than the group without failure, but there were no significant differences in amounts of emphysema, size of bronchial mucous glands, proportion of small airways lumen in the lung or number of thick-walled peripheral lung vessels between the two groups. The findings did not support the division of this series of patients, with fatal chronic airways obstruction, into two distinct groups broadly defined as 'emphysematous' and 'bronchitic', either clinically or pathologically. A history of right ventricular failure correlated well with the finding of right ventricular hypertrophy at necropsy. Electrocardiographic evidence of right ventricular hypertrophy was found to correspond with the size of the right ventricle at necropsy in 66% of cases. The radiographic diagnosis of emphysema proved an accurate assessment when compared to the necropsy findings, and radiographic estimations of right ventricular enlargement were accurate in 65% of cases. Histological evidence of acute bronchitis was present in 20 of the 21 patients (95%), and five patients showed histological evidence of minor pulmonary thromboembolism. Ten patients in the series showed an increase in the weight of the left ventricular as well as the right ventricle.
Complete Repair of Transposition of the Great Arteries with Pulmonary Stenosis
Authors: G. C. RASTELLI, ROBERT B. WALLACE, PATRICK A. ONGLEY
Journal: Circulation (1969)

Complete surgical correction of transposition of the great arteries associated with subvalvular pulmonary stenosis carries a high mortality rate. A new surgical technique that achieves redirection of the ventricular outflows and relieves pulmonary stenosis by bypassing it, was successfully used to repair complete transposition of the great arteries associated with ventricular septal defect (VSD) and valvular and subvalvular pulmonary stenosis in a 14½-year-old patient. The repair consists of (1) division of the pulmonary artery, the cardiac end of which is oversewn, (2) repair of the VSD with a patch in such a way as to connect the left ventricle with the aorta, and (3) reconstruction of the pulmonary artery with an aortic homograft, including the aortic valve, which is anastomosed between the distal end of the pulmonary artery and the right ventricle. A review of the cases in which the current techniques were used indicates that the location and nature of the obstruction in the left ventricular outflow tract defies successful repair in most instances. Localized ridges and diffuse hypoplastic outflow tracts are recognized causes of obstruction, but anomalies of the mitral valve commonly contribute to or are the primary cause of subvalvular obstruction.
Rhabdomyosarcoma Lysis by T Cells Expressing a Human Autoantibody-Based Chimeric Receptor Targeting the Fetal Acetylcholine Receptor
Authors: Stefan Gattenlöhner, Alexander Marx, Birgit Markfort, Sibylle Pscherer, Silke Landmeier, Heribert Juergens, Hans-Konrad Müller-Hermelink, Ian Matthews, David Beeson, Angela Vincent, Claudia Rossig
Journal: Cancer Research (2006)

Abstract Rhabdomyosarcomas are the most frequent malignant soft tissue tumors of childhood; however, because current multimodality treatments fail to improve the poor survival rate of children with metastatic rhabdomyosarcoma, new treatments are required. We previously identified the γ-subunit of the fetal acetylcholine receptor (fAChR) as a specific cell surface target in rhabdomyosarcoma. Here, we engineered human T lymphocytes to express chimeric receptors composed of the antigen-binding domain of a human anti-fAChR antibody joined to the signaling domain of the human T-cell receptor ζ-chain. The interaction of fAChRζ-transduced T cells with fAChR-positive rhabdomyosarcoma cell lines, but not with fAChR-negative control cells, induced T-cell activation characterized by strong secretion of IFN-γ and delayed lysis of tumor cells. Importantly, we found that in six of six rhabdomyosarcoma patients, chemotherapy increased fAChR expression on residual tumor cells in vivo. Our observations suggest that these fully human chimeric fAChRζ-transduced T cells, which should be well tolerated by the patient, have potential use in vivo both as a primary treatment for rhabdomyosarcoma and as a complementary approach to eradicate residual tumor cells after chemotherapy. (Cancer Res 2006; 66(1): 24-28)
Acute pleural effusions in inactive ankylosing spondylitis.
Authors: W J Kinnear, J M Shneerson
Journal: Thorax (1985)

Apical pleural thickening in ankylosing spondylitis is common in association with apical fibrobullous disease.' Pleural disease is otherwise rare.We report a patient with ankylosing spondylitis and quiescent joint disease who developed bilateral pleural effusions.
Accuracy of postmortem radiography of excised air-inflated human lungs in assessment of pulmonary emphysema.
Authors: S Sutinen, P Lohela, P Paakko, R Lahti
Journal: Thorax (1982)

The accuracy of radiography of excised air-inflated lungs in assessing pulmonary emphysema at necropsy was evaluated in a series of 107 adults who had died in hospital by reading the radiographs and examining the pathological specimens independently. The radiographic and pathological assessments of the severity of emphysema correlated significantly (r = 0.87, p less than 0.0001). Mild emphysema was recognised radiographically in 88.7% and moderate in 94.9% of the lungs. One of 16 normal lungs (6.3%) was radiographically diagnosed as showing mild emphysema. Six out of 53 lungs (11.3%) with mild emphysema were radiographically assessed as normal. The correct radiographic recognition of the type of emphysema was possible in 86% of lungs with mild and 97.4% with moderate centrilobular emphysema and in 81.8% and 87.5% respectively of the lungs with mild and moderate paracicatricial emphysema, but in only 25.0% and 28.6% of the lungs with mild and moderate panlobular emphysema. Radiographical diagnosis of centrilobular and paracicatricial emphysema was verified pathologically in all lungs showing mild emphysema, but that of panlobular emphysema in only 66.7%. Radiography of excised air-inflated lungs is a rapid, convenient, and reliable method of recognising and assessing the severity of appreciable degrees of centrilobular and paracicatricial emphysema, but less reliable in recognising panlobular emphysema. After the procedure the specimen remains available for almost any other technique.
A Nucleomorph-Encoded CbbX and the Phylogeny of RuBisCo Regulators
Authors: U G Maier, M Fraunholz, S Zauner, S Penny, S Douglas
Journal: Molecular Biology and Evolution (2000)

Chloroplasts contain proteins that are encoded by different genetic systems, the plastid genome and the nuclear chromosomes. By comparing the gene content of plastid genomes of different taxa, some predictions about nuclear-encoded genes for plastid proteins are possible. However, early in evolution, many genes were transferred from the plastid to the cell nucleus and are therefore missing from all known plastid genomes and escape such predictions. By sequencing the miniaturized chromosomes of the nucleomorph of the cryptophyte Guillardia theta, as well as the plastid genome, we uncovered two genes encoding CbbX which are predicted to be involved in plastid function. Our findings suggest that (1) red-type plastid rbcLS genes evolved together with cbbX, which is related to cbbX genes of purple bacteria; (2) early in rhodoplast evolution, the cbbX gene was duplicated and transferred into the nucleus; (3) the plastid-encoded LysR transcriptional activator gene, rbcR, is homologous to rbcR and cbbR transcriptional activator genes of purple bacteria and cyanobacteria; and (4) the ancestral plastid probably harbored both types of form I RuBisCo.