tbuckley/cabot-search huggingface dataset:
Force-Velocity-Length-Time Relations of the Contractile Elements in Heart Muscle of the Cat
Authors: DIRK L. BRUTSAERT, Edmund H. Sonnenblick
Journal: Circulation Research (1969)

The instantaneous force-velocity-length relations of the contractile elements of the cat papillary muscle have been obtained by determining the phase-plane trajectories of velocity of shortening relative to length during isotonic contractions and correcting these measurements for the series elastic extension during the isometric phase of contraction. The load-extension curve of the series elastic component was obtained by quick release. The velocity-length relations for a given load were independent of initial muscle length and largely independent of the time after stimulation. Velocity-length traces at varying lengths diverged only late in contraction because of a fall in the intensity of the active state. Thus the surface created by the instantaneous force-velocity-length relations serves to define a given contractile state for the contractile element of heart muscle. Further, the linear length-tension relations observed for the contractile element permits an estimation of the maximum development of isometric force with the creation of truly hyperbolic force-velocity curves. Limitations of velocities obtained following quick releases have also been noted.
Postal survey of approaches to learning among Ontario physicians: implications for continuing medical education
Authors: M D. Delva
Journal: BMJ (2002)

<h3>Abstract</h3> <b>Objectives:</b> To understand the approaches to learning of practising physicians in their workplace and to assess the relation of these approaches to their motivation for, preferred methods of, and perceived barriers to continuing medical education. <b>Design:</b> Postal survey of 800 Ontario physicians. <b>Participants:</b> 373 physicians who responded. <b>Main outcome measures:</b> Correlations of approaches to learning and perceptions of workplace climate with methods, motives, and barriers to continuing medical education. <b>Results:</b> Perceived heavy workload was significantly associated with the surface disorganised (<i>r</i>=0.463, P&lt;0.01) and surface rational approach (<i>r</i>=0.135, P&lt;0.05) to learning. The deep approach to learning was significantly correlated with a perception of choice-independence and a supportive-receptive climate at work (<i>r</i>=0.341 and 0.237, P&lt;0.01). Physicians who adopt a deep approach to learning seem to be internally motivated to learn, whereas external motivation is associated with surface approaches to learning. Heavy workload and a surface disorganised approach to learning were correlated with every listed barrier to continuing medical education. The deep approach to learning was associated with independent learning activities and no barriers. <b>Conclusions:</b> Perception of the workplace climate affects physicians9 approaches to learning at work and their motivation for and perceived barriers to continuing medical education. Younger, rural, family physicians may be most vulnerable to feeling overworked and adopting less effective approaches to learning. Further work is required to determine if changing the workplace environment will help physicians learn more effectively. <h3>What is already known on this topic</h3> Throughout their careers physicians face enormous challenges in managing the growth of medical knowledge Students who perceive choice, independence, and good teaching at university take a deep, integrative approach to learning whereas those who feel overworked or overwhelmed tend to learn by rote <h3>What this study adds</h3> Feeling overwhelmed at work is associated with a disorganised and superficial approach to learning and perception of many barriers to continuing medical education Physicians who believe they have choice, independence, and support in their work take a deep approach to learning, are internally motivated, and use independent learning methods Younger, rural, and family physicians are most likely to feel overworked
The role of hepatic resection in the treatment of hepatocellular cancer
Authors: Sasan Roayaie, Ghalib Jibara, Parissa Tabrizian, Joong‐Won Park, Jijin Yang, Lunan Yan, Myron Schwartz, Guohong Han, Francesco Izzo, Mishan Chen, Jean‐Frédéric Blanc, Philip Johnson, Masatoshi Kudo, Lewis R. Roberts, Morris Sherman
Journal: Hepatology (2015)

Current guidelines recommend surgical resection as the primary treatment for a single hepatocellular cancer (HCC) with Child's A cirrhosis, normal serum bilirubin, and no clinically significant portal hypertension. We determined how frequently guidelines were followed and whether straying from them impacted survival. BRIDGE is a multiregional cohort study including HCC patients diagnosed between January 1, 2005 and June 30, 2011. A total of 8,656 patients from 20 sites were classified into four groups: (A) 718 ideal resection candidates who were resected; (B) 144 ideal resection candidates who were not resected; (C) 1,624 nonideal resection candidates who were resected; and (D) 6,170 nonideal resection candidates who were not resected. Median follow‐up was 27 months. Log‐rank and Cox's regression analyses were conducted to determine differences between groups and variables associated with survival. Multivariate analysis of all ideal candidates for resection (A+B) revealed a higher risk of mortality with treatments other than resection. For all resected patients (A+C), portal hypertension and bilirubin &gt;1 mg/dL were not associated with mortality. For all patients who were not ideal candidates for resection (C+D), resection was associated with better survival, compared to embolization and “other” treatments, but was inferior to ablation and transplantation. Conclusions : The majority of patients undergoing resection would not be considered ideal candidates based on current guidelines. Not resecting ideal candidates was associated with higher mortality. The study suggests that selection criteria for resection may be modestly expanded without compromising outcomes, and that some nonideal candidates may still potentially benefit from resection over other treatment modalities. (H epatology 2015;62:440–451
Depressive Symptoms and Physical Decline in Community-Dwelling Older Persons
Authors: Brenda W. J. H. Penninx, Jack M. Guralnik, Luigi Ferrucci, Eleanor M. Simonsick, Dorly J. H. Deeg, Robert B. Wallace
Journal: JAMA (1998)

Significant symptoms of depression are common in the older community-dwelling population. Although depressive symptoms and disability may commonly occur in the same person, whether depressive symptoms contribute to subsequent functional decline has not been elucidated.To determine whether depressive symptoms in older persons increase the risk of subsequent decline in physical function as measured by objective performance-based tests.A 4-year prospective cohort study.The communities of Iowa and Washington counties, Iowa.A total of 1286 persons aged 71 years and older who completed a short battery of physical performance tests in 1988 and again 4 years later.Baseline depressive symptoms were assessed by the Center for Epidemiological Studies Depression Scale. Physical performance tests included an assessment of standing balance, a timed 2.4-m (8-ft) walk, and a timed test of 5 repetitions of rising from a chair and sitting down.After adjustment for baseline performance score, health status, and sociodemographic factors, increasing levels of depressive symptoms were predictive of greater decline in physical performance over 4 years (odds ratio for decline in those with depressed mood vs those without, 1.55; 95% confidence interval [CI], 1.02-2.34). Even among those at the high end of the functional spectrum, who reported no disability, the severity of depressive symptoms predicted subsequent decline in physical performance (odds ratio for decline, 1.03; 95% CI, 1.00-1.08).This study provides evidence that older persons who report depressive symptoms are at higher risk of subsequent physical decline. These results suggest that prevention or reduction of depressed mood could play a role in reducing functional decline in older persons.
Rapid Measurement of Urinary Trypsinogen-2 as a Screening Test for Acute Pancreatitis
Authors: Esko A. Kemppainen, Johan I. Hedström, Pauli A. Puolakkainen, Vesa S. Sainio, Reijo K. Haapiainen, Vesa Perhoniemi, Sirpa Osman, Eero O. Kivilaakso, Ulf-Håkan Stenman
Journal: New England Journal of Medicine (1997)

Acute pancreatitis can be difficult to diagnose. We developed a rapid dipstick screening test for pancreatitis, based on the immunochromatographic measurement of urinary trypsinogen-2.We prospectively compared the urinary trypsinogen-2 dipstick test with a quantitative urinary trypsinogen-2 assay, a urinary dipstick test for amylase, and serum and urinary amylase assays in 500 consecutive patients with acute abdominal pain at two emergency departments. Acute pancreatitis was diagnosed according to standardized criteria.The urinary trypsinogen-2 dipstick test was positive in 50 of the 53 patients with acute pancreatitis (sensitivity, 94 percent), including all 7 with severe pancreatitis. Two patients with urinary trypsinogen-2 concentrations below the sensitivity threshold of the test (50 ng per milliliter) and one with a very high concentration had false negative results. The test was also positive in 21 of the 447 patients without pancreatitis (specificity, 95 percent), including 7 with abdominal cancers, 3 with cholangitis, and 2 with chronic pancreatitis. The sensitivity and specificity of the dipstick test were similar to those of the quantitative urinary trypsinogen-2 assay and higher than those of the urinary amylase dipstick test. The serum amylase assay had a sensitivity of 85 percent (with a cutoff value of 300 U per liter for the upper reference limit) and a specificity of 91 percent. The sensitivity and specificity of the urinary amylase assay (cutoff value, 2000 U per liter) were 83 and 88 percent, respectively.In patients with acute abdominal pain seen in the emergency department, a negative dipstick test for urinary trypsinogen-2 rules out acute pancreatitis with a high degree of probability. A positive test usually identifies patients in need of further evaluation.
Validation of the Dermatology Life Quality Index among patients with podoconiosis in southern Ethiopia
Authors: L. Henok, G. Davey
Journal: British Journal of Dermatology (2008)

Journal Article Validation of the Dermatology Life Quality Index among patients with podoconiosis in southern Ethiopia Get access L. Henok, L. Henok School of Public Health, Addis Ababa University, PO Box 26905/1000, Addis Ababa, Ethiopia Search for other works by this author on: Oxford Academic Google Scholar G. Davey G. Davey School of Public Health, Addis Ababa University, PO Box 26905/1000, Addis Ababa, Ethiopia Correspondence: Gail Davey. E‐mail: nerurkar@ethionet.et Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 159, Issue 4, 1 October 2008, Pages 903–906, https://doi.org/10.1111/j.1365-2133.2008.08773.x Published: 01 October 2008
Coexpression of Matrix Metalloproteinase-7 (MMP-7) and Epidermal Growth Factor (EGF) Receptor in Colorectal Cancer
Authors: Koshi Mimori, Keishi Yamashita, Mitsuhiko Ohta, Keiji Yoshinaga, Kenji Ishikawa, Hideshi Ishii, Tohru Utsunomiya, Graham F. Barnard, Hiroshi Inoue, Masaki Mori
Journal: Clinical Cancer Research (2004)

Abstract Purpose: Matrix metalloproteinase-7 (MMP-7) plays an important role in carcinoma invasion and metastasis of cancer. Recent studies focus on diverse roles of MMP-7, other than as a protease, during cancer progression. MMP-7 activates the epidermal growth factor (EGF) receptor by releasing an EGF ligand, tumor growth factor (TGF)-α. Experimental Design: We examined expression of MMP-7 and EGF receptor in an immunohistochemical study of 40 colorectal cancer (CRC) cases. To determine the relationship between the EGF receptor and MMP-7, with a potential curative application, we compared the antitumor activity of the EGF receptor tyrosine kinase inhibitor (gefitinib) between MMP-7 transfectant, KYSE150 and HT29, and control cells. Results: We found a statistically significant correlation (P = 0.04) between MMP-7 and activated (phosphorylated) EGF receptor expression, both being positive in six (15%) cases. Gefitinib reduced the cell number ratio more for MMP-7 transfectant than mock cells, and the proportion of apoptotic cells was 1.5 times higher in MMP-7 transfectant than mock cells by annexin/propidium iodide staining. This was mediated by activation of a TGF-β signal as confirmed by the abundant expression of TGF-β protein, the cytoplasmic to nuclear translocation of Smad4 protein by the administration of gefitinib, and the quantitative assay of the plasminogen activator inhibitor-1 promoter/luciferase construction. Conclusions: We propose that there are some cancers with up-regulated MMP-7 expression that leads to the activation of apoptotic activity of TGF-β, which is susceptible to treatment with EGF receptor tyrosine kinase inhibitor.
Challenges in Systematic Reviews of Diagnostic Technologies
Authors: Athina Tatsioni
Journal: Annals of Internal Medicine (2005)

Diagnostic tests are critical components of effective health care. They help determine treatments that are most beneficial for a given patient. Their assessment is a complex process that includes such challenges as a dearth of studies that evaluate clinical outcomes and lack of data on use of the test in realistic clinical settings. The methodologic quality of studies of diagnostic tests also lags behind the qual ity of studies of therapeutic interventions. Statistical methods to combine diagnostic accuracy data are more complex and not as well developed, leading to difficulties in the interpretation of results. The Agency for Healthcare Research and Quality Technology Assessment Program has adopted a 6-level framework for evaluating diagnostic technologies. The model emphasizes the need for systematic reviews of diagnostic test studies to go beyond the assessment of technical feasibility and accuracy to examine the impact of the test on health outcomes. In this paper, we use examples from 3 Evidence-based Practice Center reports to illustrate 3 challenges reviewers may face when reviewing diagnostic test literature: finding relevant studies, assessing methodologic quality of diagnostic accuracy studies, and synthesizing studies that evaluate tests in different patient populations or use different outcomes.
Quantification of serum hepatitis B surface antigen: is it useful for the management of chronic hepatitis B?
Authors: Harry L A Janssen, Milan J Sonneveld, Maurizia R Brunetto
Journal: Gut (2011)

Chronic hepatitis B infection is a global health problem affecting more than 350 million people worldwide.1 Prolonged liver inflammation caused by active infection with the hepatitis B virus (HBV) may result in progression to liver fibrosis, cirrhosis and ultimately hepatocellular carcinoma and death.1

Since the 1960s, hepatitis B virus surface antigen (HBsAg) has been the hallmark of HBV infection with concentrations reaching several hundred micrograms per millilitre.2 Recently, studies with newly available automated quantitative assays have shown that serum HBsAg levels vary significantly during the different phases of chronic HBV infection and are inversely correlated with the immune control of HBV: the higher control, the lower HBsAg level.3–6 These findings are consistent with the hypothesis that serum levels of HBsAg reflect the complex interplay between virus and immune system and provide complementary information to viral load as measured using HBV DNA levels. In fact, serum HBsAg levels result not only from virions (42 nm, Dane particles) but mainly from non-infectious HBsAg particles (20 nm diameter filaments of variable length and 20–22 nm spheres) which do not contain viral nucleic acids and exceed virions by a factor ranging between 102 and 105. The ratios between defective HBsAg particles and virions are not stable, but change over time. Filaments and spherical particles are produced in large excess in highly viraemic hepatitis B ‘e’ antigen (HBeAg)-positive carriers. While filaments decline in parallel with virions, spherical particles remain in moderate excess in low viraemic HBeAg-negative carriers.7 8 Thus, HBsAg production varies both quantitatively and qualitatively over time and appears to be dynamically regulated during different phases of the infection. HBsAg derives mainly from the intrahepatic viral minichromosome (cccDNA) by translation of specific RNAs that are distinct from pregenomic RNA, and HBsAg synthesis follows a pathway that is distinct from …
Timing models of reward learning and core addictive processes in the brain
Authors: Don Ross
Journal: Behavioral and Brain Sciences (2008)

Abstract People become addicted in different ways, and they respond differently to different interventions. There may nevertheless be a core neural pathology responsible for all distinctively addictive suboptimal behavioral habits. In particular, timing models of reward learning suggest a hypothesis according to which all addiction involves neuroadaptation that attenuates serotonergic inhibition of a mesolimbic dopamine system that has learned that cues for consumption of the addictive target are signals of a high-reward-rate environment.
Defining asymptomatic status following sports concussion: fact or fallacy?
Authors: Sridhar Alla, S John Sullivan, Paul McCrory
Journal: British Journal of Sports Medicine (2011)

The current management of sports concussion involves a return to the baseline 'asymptomatic' status prior to returning to play and training. Unfortunately, although the term 'asymptomatic' is widely used it has not been operationally defined. This review identifies the need to formally define the term 'asymptomatic' as used in sports concussion, discusses some of the challenges associated with its definition and offers some possible solutions for further debate. The operational definition of the term 'asymptomatic' may provide the stimulus for further informed discussion at a future meeting of the international Concussion in Sport group, and by other peak sports medicine bodies involved in management guideline development.
Acquired Bernard-Soulier syndrome. Evidence for the role of a 210,000-molecular weight protein in the interaction of platelets with von Willebrand factor.
Authors: R B Stricker, D Wong, S R Saks, L Corash, M A Shuman
Journal: Journal of Clinical Investigation (1985)

A patient with a lymphoproliferative disorder developed bleeding associated with a prolonged bleeding time and a selective defect of platelet aggregation in response to ristocetin. The patient's purified IgG was shown to inhibit aggregation of washed normal platelets by ristocetin and von Willebrand factor (F VIII:vWF). By Western blotting, it was shown that antibody bound specifically to an antigen of Mr 210,000 present on normal platelets but missing on platelets from patients with congenital Bernard-Soulier syndrome (BSS). Binding was effected by the F(ab)2 portion of the IgG, indicating the presence of an autoantibody rather than an immune complex. These results suggest that the 210,000-Mr protein is involved in the interaction of F VIII:vWF with platelets. Furthermore, we have demonstrated the apparent absence of an additional protein on congenital BSS platelets. Heat-aggregated IgG was also shown to bind to the 210,000-Mr protein, suggesting that this protein may function as an Fc receptor on platelets. The relationship of the 210,000-Mr protein to glycoprotein Ib and the precise role of this protein in the interaction of platelets with F VIII:vWF need to be characterized.
THE EFFECT OF EXPERIMENTALLY INDUCED HYPERVOLEMIA ON CARDIAC FUNCTION IN NORMAL SUBJECTS AND PATIENTS WITH MITRAL STENOSIS*
Authors: Truman G. Schnabel, Harald Eliasch, Bengt Thomasson, Lars Werkö
Journal: Journal of Clinical Investigation (1959)

The physiologic differences between various types of laboratory preparations and unanesthetized man have been in part responsible for a wide diversion of opinion concerning the control of cardiac function in man (1).While numerous studies of the regulation of cardiac performance have been carried out in animals, relatively few studies have been done in man(2).The present work was undertaken in an attempt to clarify some of the mechanisms concerned with the control of cardiac function in man and has included studies in normal subjects and patients with mitral stenosis.During a study of the relation existing between renal and cardiac function, rapid intra- venous infusions were given to normal individuals and patients with various types of cardiac dis- orders (3).When the infusions consisted of isotonic solutions of dextran 1 it was possible to analyze the relation of right heart filling pressure to cardiac output or right ventricular work, in a manner which closely simulated that used by Sarnoff and Berglund in the anesthetized dog (4), or Warren, Brannon, Weens and Stead in man (5).The present report is concerned with the effects on cardiac performance of varied de- grees of expansion of the blood volume during 32 studies in 31 normal subjects and 16 studies in 15 patients with mitral stenosis.MATERIAL
Development and Validation of a Prognostic Nomogram for Terminally Ill Cancer Patients
Authors: Jaime Feliu, Ana María Jiménez-Gordo, Rosario Madero, José Ramón Rodríguez-Aizcorbe, Enrique Espinosa, Javier Castro, Jesús Domingo Acedo, Beatriz Martínez, Alberto Alonso-Babarro, Raquel Molina, Juan Carlos Cámara, María Luisa García-Paredes, Manuel González-Barón
Journal: JNCI Journal of the National Cancer Institute (2011)

BackgroundDetermining life expectancy in terminally ill cancer patients is a difficult task. We aimed to develop and validate a nomogram to predict the length of survival in patients with terminal disease.