tbuckley/cabot-search huggingface dataset:
Costs of Screening for Pre-diabetes Among U.S. Adults
Authors: Ping Zhang, Michael M. Engelgau, Rodolfo Valdez, Stephanie M. Benjamin, Betsy Cadwell, K.M. Venkat Narayan
Journal: Diabetes Care (2003)

OBJECTIVE—We evaluated various strategies to identify individuals aged 45–74 years with pre-diabetes (either impaired glucose tolerance or impaired fasting glucose). RESEARCH DESIGN AND METHODS—We conducted a cost analysis to evaluate the effectiveness (proportion of cases identified), total costs, and efficiency (cost per case identified) of five detection strategies: an oral glucose tolerance test (OGTT), a fasting plasma glucose (FPG) test, an HbA1c test, a capillary blood glucose (CBG) test, and a risk assessment questionnaire. For the first strategy, all individuals received an OGTT. For the last four strategies, only those with a positive screening test received an OGTT. Data were from the Third U.S. National Health and Nutrition Examination Survey, 2000 census, Medicare, and published literature. One-time screening costs were estimated from both a single-payer perspective and a societal perspective. RESULTS—The proportion of pre-diabetes and undiagnosed diabetes identified ranged from 69% to 100% (12.1–17.5 million). The cost per case identified ranged from $176 to $236 from a single-payer perspective and from $247 to $332 from a societal perspective. Testing all with OGTT was the most effective strategy, but the CBG test and risk assessment questionnaire were the most efficient. If people are substantially less willing to take an OGTT than a FPG test, then the FPG testing strategy was the most effective strategy. CONCLUSIONS—There is a tradeoff between effectiveness and efficiency in choosing a strategy. The most favorable strategy depends on if the goal of the screening program is to identify more cases or to pursue the lowest cost per case. The expected percentage of the population willing to take an OGTT is also a consideration.
Costs of Lower-Extremity Ulcers Among Patients With Diabetes
Authors: Karen Stockl, Ann Vanderplas, Eskinder Tafesse, Eunice Chang
Journal: Diabetes Care (2004)

OBJECTIVE—The objective of this study was to characterize health care costs associated with diabetic lower-extremity ulcers. RESEARCH DESIGN AND METHODS—Adult patients with diabetes who had a lower-extremity ulcer episode during 2000 and 2001 were identified using claims data. Ulcer-related direct health care costs were computed for each episode. Episodes were stratified according to severity level based on the Wagner classification. RESULTS—A total of 2,253 patients were identified. The mean age was 68.9 years, and 59% of the patients were male. The average episode duration was 87.3 ± 82.8 days. Total ulcer-related costs averaged $13,179 per episode and increased with severity level, ranging from $1,892 (level 1) to $27,721 (level 4/5). Inpatient hospital charges accounted for 77% ($10,188) of the overall cost, indicating that hospitalization was a major cost driver. Total ulcer-related costs were significantly higher for patients &amp;lt;65 years of age compared with those of older patients ($16,390 vs. $11,925, P = 0.02) and for patients with inadequate vascular status compared with patients with adequate vascular status ($23,372 vs. $5,218, P &amp;lt; 0.0001). Patients who progressed to a higher severity level also had significantly higher ulcer-related costs compared with patients who did not progress ($20,136 vs. $3,063, P &amp;lt; 0.0001). CONCLUSIONS—The high costs of treating diabetic lower-extremity ulcers emphasize the value of intensive outpatient interventions designed to prevent ulcer progression.
999 THE PROGNOSTIC ROLES OF PREOPERATIVE AFP AND PIVKA-II IN PATIENTS WITH HEPATOCELLULAR CARCINOMA UNDERGOING HEPATECTOMY (CURATIVE RESECTION)
Authors: J.Y. Park, M.H. Lee, G.H. Choi, D.Y. Kim, S.H. Ahn, K.S. Kim, J.S. Choi, K.H. Han, C.Y. Chon
Journal: Journal of Hepatology (2011)
Evidence of Real-World Effectiveness of a Telephone Quitline for Smokers
Authors: Shu-Hong Zhu, Christopher M. Anderson, Gary J. Tedeschi, Bradley Rosbrook, Cynthia E. Johnson, Michael Byrd, Elsa Gutiérrez-Terrell
Journal: New England Journal of Medicine (2002)

Telephone services that offer smoking-cessation counseling (quitlines) have proliferated in recent years, encouraged by positive results of clinical trials. The question remains, however, whether those results can be translated into real-world effectiveness.
Can Intensive Support Improve Continuous Positive Airway Pressure Use in Patients with the Sleep Apnea/Hypopnea Syndrome?
Authors: CAROL J. HOY, MARJORIE VENNELLE, RUTH N. KINGSHOTT, HEATHER M. ENGLEMAN, NEIL J. DOUGLAS
Journal: American Journal of Respiratory and Critical Care Medicine (1999)

Continuous positive airway pressure (CPAP) therapy is widely prescribed for patients with the sleep apnea/hypopnea syndrome (SAHS), but the use of CPAP for such patients is disappointingly low. We postulated that providing intensive educational programs and nursing support to SAHS patients might improve CPAP use and outcomes. We also examined the hypothesis that CPAP use would be greater among patients who had initiated their own referral than among those asked to seek help by a partner. We randomized 80 consecutive, new patients with SAHS to receive either usual support or additional nursing input including CPAP education at home and involving their partners, a 3-night trial of CPAP in our institution's sleep center, and additional home visits once they had begun CPAP. The primary outcome variable was objective CPAP use; symptoms, mood, and cognitive function were also assessed after 6 mo. CPAP use over 6 mo was greater (p = 0.003) among patients receiving intensive than among those receiving standard support (5.4 ± 0.3 versus 3.9 ± 0.4 h/night [mean ± SEM]), with greater improvements (p < 0.05) in SAHS symptoms, mood, and reaction time in the intensively supported group. CPAP use was greater (p = 0.002) among patients who initiated their own referrals. CPAP use and outcomes of therapy can be improved by provision of a nurse-led intensive CPAP education and support program. CPAP use is lower among patients whose partners ask them to seek treatment.
A randomized trial of nocturnal oxygen therapy in chronic obstructive pulmonary disease patients
Authors: A Chaouat, E Weitzenblum, R Kessler, C Charpentier, M Enrhart, R Schott, P Levi-Valensi, J Zielinski, L Delaunois, R Cornudella, J Moutinho dos Santos
Journal: European Respiratory Journal (1999)

The beneficial effects of nocturnal oxygen therapy (NOT) in chronic obstructive pulmonary disease (COPD) patients with mild-to-moderate daytime hypoxaemia (arterial oxygen tension (Pa,O2) in the range 7.4-9.2 kPa (56-69 mmHg)) and exhibiting sleep-related oxygen desaturation remains controversial. The effectiveness of NOT in that category of COPD patients was studied. The end points included pulmonary haemodynamic effects after 2 yrs of follow-up, survival and requirement for long-term oxygen therapy (LTOT). Seventy-six patients could be randomized, 41 were allocated to NOT and 35 to no NOT (control). The goal of NOT was to achieve an arterial oxygen saturation of >90% throughout the night. All these patients underwent polysomnography to exclude an associated obstructive sleep apnoea syndrome. The two groups exhibited an identical meansD daytime Pa,O2 of 8.4+/-0.4 kPa (63+/-3 mmHg) at baseline. Twenty-two patients (12 in the NOT group and 10 in the control group, p=0.98) required LTOT during the whole follow-up (35+/-14 months). Sixteen patients died, nine in the NOT group and seven in the control group (p=0.84). Forty-six patients were able to undergo pulmonary haemodynamic re-evaluation after 2 yrs, 24 in the NOT and 22 in the control group. In the control group, mean resting pulmonary artery pressure increased from 19.8+/-5.6 to 20.5+6.5 mmHg, which was not different from the change in mean pulmonary artery pressure in the NOT group, from 18.3+/-4.7 to 19.5+/-5.3 mmHg (p= 0.79). Nocturnal oxygen therapy did not modify the evolution of pulmonary haemodynamics and did not allow delay in the prescription of long-term oxygen therapy. No effect of NOT on survival was observed, but the small number of deaths precluded any firm conclusion. These results suggest that the prescription of nocturnal oxygen therapy in isolation is probably not justified in chronic obstructive pulmonary disease patients.
Implanted Electrochemical Glucose Sensors for the Management of Diabetes
Authors: Adam Heller
Journal: Annual Review of Biomedical Engineering (1999)

▪ Abstract By maintaining a near normal (70–120 mg/dL) glucose concentration, diabetic patients can drastically reduce the likelihood of the occurrence of diabetes complications. In the near future, subcutaneously implanted electrochemical glucose sensors will be available to provide frequent or continuous information on which timely treatment decisions, such as insulin injection or glucose source intake, can be based, as well as timely alarm signals. The currently engineered devices are of three types: (a) innocuous microsensors, with actively mass-transporting areas &lt;10 −3 cm 2 , replaced twice a week by the patient; (b) self-contained, surgeon-implanted, transmitter-containing packages of &gt;1 cm 2 area, operating for &gt;100 days; and (c) devices transporting subcutaneous fluid to an external sensor, based on implanted microfiltration or microdialysis fibers or on iontophoretic transport of the subcutaneous fluid through the skin.
1001-17 Cardiac conduction system-L acZ expression in the atrioventricular ring and moderator band of transgenic murine embryos: A developmental substrate for Wolff-Parkinson-White syndrome and mahaim tachycardia?
Authors: Monique R.m Jongbloed, Martin J Schalij, Robert E Poelmann, Glenn I Fishman, Zhiyong Wang, Adriana C Gittenberger-de Groot
Journal: Journal of the American College of Cardiology (2004)
Wake up of transposable elements following Drosophila simulans worldwide colonization
Authors: C. Vieira, D. Lepetit, S. Dumont, C. Biemont
Journal: Molecular Biology and Evolution (1999)

Transposable elements (TEs) make up around 10%-15% of the Drosophila melanogaster genome, but its sibling species Drosophila simulans carries only one third as many such repeat sequences. We do not, however, have an overall view of copy numbers of the various classes of TEs (long terminal repeat [LTR] retrotransposons, non-LTR retrotransposons, and transposons) in genomes of natural populations of both species. We analyzed 34 elements in individuals from various natural populations of these species. We show that D. melanogaster has higher average chromosomal insertion site numbers per genome than D. simulans for all TEs except five. The LTR retrotransposons gypsy, ZAM, and 1731 and the transposon bari-1 present similar low copy numbers in both species. The transposon hobo has a large number of insertion sites, with significantly more sites in D. simulans. High variation between populations in number of insertion sites of some elements of D. simulans suggests that these elements can invade the genome of the entire species starting from a local population. We propose that TEs in the D. simulans genome are being awakened and amplified as they had been a long time ago in D. melanogaster.
T cell specific expression of a short splice variant of the tumor suppressor gene CYLD amplifies the development of allergic airway disease
Authors: Sebastian Reuter, Marc Becker, Nina Dehzad, Helen Martin, Ari Waisman, Michael Stassen, Roland Buhl, Christian Taube
Journal: European Respiratory Journal (2011)

Regulation of transcription factors like NF-κB decides about type and strength of developing inflammatory and immune responses. CYLD acts as a negative regulatory element of NF-κB activation, however the naturally occurring short splice variant CYLD Ex7/8  (sCYLD) has positive regulatory properties. An exclusively expression of sCYLD leads to a hyperactive phenotype of dendritic cells (DC) and increased numbers of long living antibody secreting B cells. In the present study we investigated the function of sCYLD on T cells in a murine model of allergic airway disease. Following sensitization and challenge towards the model antigen Ovalbumin (OVA), wild type (WT) and animals with a T cell specific expression of CYLD Ex7/8  (CyldFL*CD4cre) were analyzed for the induction of an allergic airway disease. 48 hours following the last challenge animals with exclusively T cells expressing sCYLD demonstrating increased numbers of eosinophils in BAL, enhanced inflammation in the lung and increased numbers of goblet cells in comparison to WT animals. Moreover the T cell specific sCYLD expression leads to increased secretion of total IgE and all classes of antigen specific immunoglobulines were clearly upregulated in comparison to sensitized and challenged WT. These data suggest that CYLD plays an important role in the regulation of T cell responses. Beside the modulation of DC and B cell the short splice variant of CYLD affects also T cells and seems to induce a hyper responsive T cell phenotype. This work provides a new few in T cell regulation and underlines the important role of CYLD and T cells for the induction of allergic responses.
Estimation of body composition in Chinese and British men by ultrasonographic assessment of segmental adipose tissue volume.
Authors: R Eston, R Evans, F Fu
Journal: British Journal of Sports Medicine (1994)

It has been shown that ultrasonographic measurements can be used to predict body composition in adults. The purpose of this study was to assess the relationship between ultrasonograph and caliper (SKF) measurements of subcutaneous adipose tissue thickness in athletic Caucasian (English, E) and Asian (Chinese, C) men against estimates of body composition determined from hydrodensitometry (HYD). The usefulness of a proposed ultrasonographic method of estimating lean and fat proportions in the upper and lower limbs was also evaluated as a potential method of predicting body composition. Ultrasonography (US) was used to measure adipose and skin thickness at the following sites: biceps, triceps, subscapular, suprailiac, abdominal, pectoral, thigh and calf. Caliper measurements were also made at the above sites. Subcutaneous fat thickness and segmental radius were measured directly from the display screen of the ultrasonic scanner (Aloka 500 SD). By applying the geometry of a cone, the proximal and distal radii of the upper arm and upper leg were used to calculate the proportionate volumes of adipose tissue. The best correlations for US and SKF were obtained at the quadriceps, subscapular and pectoral sites for E (r = 0.96, 0.93 and 0.90, respectively) and at the quadriceps, calf and abdominal sites for C (r = 0.90, 0.81 and 0.75, respectively). The best ultrasonographic predictor of the percentage fat in both groups was the percentage adipose tissue volume in the upper leg (r = 0.83 and 0.79 for C and E, respectively). Stepwise multiple regression analysis indicated that the prediction of percentage fat was improved by the addition of the ultrasonographic abdomen measurement in both groups: Chinese sample: %fat = %fat(leg) (0.491) + US abdomen (0.337) + 0.95 ( R = 0.89, s.e.e. = 1.9%); English sample: %fat = %fat(leg) (0.435) + US abdomen (0.230) - 0.765 ( R = 0.80, s.e.e. = 3.6%). It is concluded that ultrasonographic measurements of subcutaneous adipose tissue and volumetric assessment of percentage adipose tissue in the thigh are useful estimates of body composition in athletic English and Chinese males.
Adiponectin Is Present in Cord Blood but Is Unrelated to Birth Weight
Authors: Robert S. Lindsay, James D. Walker, Peter J. Havel, Barbara A. Hamilton, Andrew A. Calder, Frank D. Johnstone
Journal: Diabetes Care (2003)

OBJECTIVE—In adults, adiponectin is reduced in association with excess adiposity, type 2 diabetes, and hyperinsulinemia. We assessed whether adiponectin was 1) present in the fetal circulation, 2) altered in the fetal circulation in the presence of maternal diabetes, and 3) had relations to fetal cord blood insulin or adiposity. RESEARCH DESIGN AND METHODS—We assessed adiponectin in cord blood in a large cohort of singleton offspring of diabetic mothers (ODM; n = 134) and control mothers (n = 45). RESULTS—Adiponectin was present in cord blood and, in ODM, was higher in those delivered at later gestational ages (Spearman r = 0.18, P = 0.03). Adiponectin was slightly lower in ODM than control subjects (ODM 19.7 ± 6.1 vs. control 21.8 ± 5.3 μg/ml; P = 0.04), although this difference could potentially reflect different gestational ages in the two groups (ODM 37.6 ± 1.5 and control 40.1 ± 1.1 weeks). In contrast to adults, adiponectin levels in the fetus were unrelated to the degree of adiposity, blood insulin, or leptin in either control subjects or ODM. CONCLUSIONS—Adiponectin is present in cord blood but does not show expected physiological relations with adiposity as observed in adults.
A Treatise on Madness
Authors: John Beard
Journal: BMJ (2007)

William Battie (1703-76) was one of the most eminent psychiatrists of 18th century Britain. Educated at Eton and Cambridge, Battie was a fellow of the Royal Society and a fellow and later president of the Royal College of Physicians. He was reputed both for his scholarly work (including an edition of Aristotle's Rhetoric ) and his anatomical demonstrations. Yet it was the “mad business,” as he described it, that really caught his imagination. Already a governor at Bethlem Hospital and owner of two other private institutions, Battie was the founding physician …
Development and Validation of the Good Outcome Following Attempted Resuscitation (GO-FAR) Score to Predict Neurologically Intact Survival After In-Hospital Cardiopulmonary Resuscitation
Authors: Mark H. Ebell, Woncheol Jang, Ye Shen, Romergryko G. Geocadin
Journal: JAMA Internal Medicine (2013)

<h3>Importance</h3> Informing patients and providers of the likelihood of survival after in-hospital cardiac arrest (IHCA), neurologically intact or with minimal deficits, may be useful when discussing do-not-attempt-resuscitation orders. <h3>Objective</h3> To develop a simple prearrest point score that can identify patients unlikely to survive IHCA, neurologically intact or with minimal deficits. <h3>Design, Setting, and Participants</h3> The study included 51 240 inpatients experiencing an index episode of IHCA between January 1, 2007, and December 31, 2009, in 366 hospitals participating in the Get With the Guidelines–Resuscitation registry. Dividing data into training (44.4%), test (22.2%), and validation (33.4%) data sets, we used multivariate methods to select the best independent predictors of good neurologic outcome, created a series of candidate decision models, and used the test data set to select the model that best classified patients as having a very low (&lt;1%), low (1%-3%), average (&gt;3%-15%), or higher than average (&gt;15%) likelihood of survival after in-hospital cardiopulmonary resuscitation for IHCA with good neurologic status. The final model was evaluated using the validation data set. <h3>Main Outcomes and Measures</h3> Survival to discharge after in-hospital cardiopulmonary resuscitation for IHCA with good neurologic status (neurologically intact or with minimal deficits) based on a Cerebral Performance Category score of 1. <h3>Results</h3> The best performing model was a simple point score based on 13 prearrest variables. The C statistic was 0.78 when applied to the validation set. It identified the likelihood of a good outcome as very low in 9.4% of patients (good outcome in 0.9%), low in 18.9% (good outcome in 1.7%), average in 54.0% (good outcome in 9.4%), and above average in 17.7% (good outcome in 27.5%). Overall, the score can identify more than one-quarter of patients as having a low or very low likelihood of survival to discharge, neurologically intact or with minimal deficits after IHCA (good outcome in 1.4%). <h3>Conclusions and Relevance</h3> The Good Outcome Following Attempted Resuscitation (GO-FAR) scoring system identifies patients who are unlikely to benefit from a resuscitation attempt should they experience IHCA. This information can be used as part of a shared decision regarding do-not-attempt-resuscitation orders.
Particle Traps Prevent Adverse Vascular and Prothrombotic Effects of Diesel Engine Exhaust Inhalation in Men
Authors: Andrew J. Lucking, Magnus Lundbäck, Stefan L. Barath, Nicholas L. Mills, Manjit K. Sidhu, Jeremy P. Langrish, Nicholas A. Boon, Jamshid Pourazar, Juan J. Badimon, Miriam E. Gerlofs-Nijland, Flemming R. Cassee, Christoffer Boman, Kenneth Donaldson, Thomas Sandstrom, David E. Newby, Anders Blomberg
Journal: Circulation (2011)

In controlled human exposure studies, diesel engine exhaust inhalation impairs vascular function and enhances thrombus formation. The aim of the present study was to establish whether an exhaust particle trap could prevent these adverse cardiovascular effects in men.Nineteen healthy volunteers (mean age, 25±3 years) were exposed to filtered air and diesel exhaust in the presence or absence of a particle trap for 1 hour in a randomized, double-blind, 3-way crossover trial. Bilateral forearm blood flow and plasma fibrinolytic factors were assessed with venous occlusion plethysmography and blood sampling during intra-arterial infusion of acetylcholine, bradykinin, sodium nitroprusside, and verapamil. Ex vivo thrombus formation was determined with the use of the Badimon chamber. Compared with filtered air, diesel exhaust inhalation was associated with reduced vasodilatation and increased ex vivo thrombus formation under both low- and high-shear conditions. The particle trap markedly reduced diesel exhaust particulate number (from 150 000 to 300 000/cm(3) to 30 to 300/cm(3); P<0.001) and mass (320±10 to 7.2±2.0 μg/m(3); P<0.001), and was associated with increased vasodilatation, reduced thrombus formation, and an increase in tissue-type plasminogen activator release.Exhaust particle traps are a highly efficient method of reducing particle emissions from diesel engines. With a range of surrogate measures, the use of a particle trap prevents several adverse cardiovascular effects of exhaust inhalation in men. Given these beneficial effects on biomarkers of cardiovascular health, the widespread use of particle traps on diesel-powered vehicles may have substantial public health benefits and reduce the burden of cardiovascular disease.