tbuckley/cabot-search huggingface dataset:
Comparing Medical Costs and Use After Laparoscopic Adjustable Gastric Banding and Roux-en-Y Gastric Bypass
Authors: Kristina H. Lewis, Fang Zhang, David E. Arterburn, Dennis Ross-Degnan, Matthew W. Gillman, J. Frank Wharam
Journal: JAMA Surgery (2015)

There is conflicting evidence about how different bariatric procedures impact health care use.To compare the impact of laparoscopic adjustable gastric banding (AGB) and laparoscopic Roux-en-Y gastric bypass (RYGB) on health care use and costs.Retrospective interrupted time series with comparison series study using a national claims data set. The data analysis was initiated in September 2011 and completed in January 2015. We identified bariatric surgery patients aged 18 to 64 years who underwent a first AGB or RYGB between 2005 and 2011. We propensity score matched 4935 AGB to 4935 RYGB patients according to baseline age group, sex, race/ethnicity, socioeconomic variables, comorbidities, year of procedure and baseline costs, emergency department (ED) visits, and hospital days. Median postoperative follow-up time was 2.5 years.Quarterly and yearly total health care costs, ED visits, hospital days, and prescription drug costs. We used segmented regression to compare pre-to-post changes in level and trend of these measures in the AGB vs the RYGB groups and difference-in-differences analysis to estimate the magnitude of difference by year.Both AGB and RYGB were associated with downward trends in costs; however, by year 3, AGB patients had total annual costs that were 16% higher than RYGB patients (P < .001; absolute change: $818; 95% CI, $278 to $1357). In postoperative years 1 and 2, AGB was associated with 27% to 29% fewer ED visits than RYGB (P < .001; absolute changes: -0.6; 95% CI, -0.9 to -0.4 and -0.4; 95% CI, -0.6 to -0.1 visits/person, respectively); however, by year 3, there were no detectable differences. Postoperative annual hospital days were not significantly different between the groups. Although both procedures lowered prescription costs, annual postoperative prescription costs were 17% to 32% higher for AGB patients than RYGB patients (P < .001).Both laparoscopic AGB and RYGB were associated with flattened total health care cost trajectories but RYGB patients experienced lower total and prescription costs by 3 years postsurgery. On the other hand, RYGB was associated with increased ED visits in the 2 years after surgery. Clinicians and policymakers should weigh such differences in use and costs when making recommendations or shaping regulatory guidance about these procedures.
Multiple Genome Comparison within a Bacterial Species Reveals a Unit of Evolution Spanning Two Adjacent Genes in a Tandem Paralog Cluster
Authors: T. Tsuru, I. Kobayashi
Journal: Molecular Biology and Evolution (2008)

It has been assumed that an open reading frame (ORF) represents a unit of gene evolution as well as a unit of gene expression and function. In the present work, we report a case in which a unit comprising the 3′ region of an ORF linked to a downstream intergenic region that is in turn linked to the 5′ region of a downstream ORF has been conserved, and has served as the unit of gene evolution. The genes are tandem paralogous genes from the bacterium Staphylococcus aureus, for which more than ten entire genomes have been sequenced. We compared these multiple genome sequences at a locus for the lpl (lipoprotein-like) cluster (encoding lipoprotein homologs presumably related to their host interaction) in the genomic island termed νSaα. A highly conserved nucleotide sequence found within every lpl ORF is likely to provide a site for homologous recombination. Comparison of phylogenies of the 5′-variable region and the 3′-variable region within the same ORF revealed significant incongruence. In contrast, pairs of the 3′-variable region of an ORF and the 5′-variable region of the next downstream ORF gave more congruent phylogenies, with distinct groups of conserved pairs. The intergenic region seemed to have coevolved with the flanking variable regions. Multiple recombination events at the central conserved region appear to have caused various types of rearrangements among strains, shuffling the two variable regions in one ORF, but maintaining a conserved unit comprising the 3′-variable region, the intergenic region, and the 5′-variable region spanning adjacent ORFs. This result has strong impact on our understanding of gene evolution because most gene lineages underwent tandem duplication and then diversified. This work also illustrates the use of multiple genome sequences for high-resolution evolutionary analysis within the same species.
CALCIUM AND BONE MINERAL METABOLISM IN CHILDREN WITH CHRONIC ILLNESSES
Authors: S.A. Abrams, K.O. O'Brien
Journal: Annual Review of Nutrition (2004)

▪ Abstract Increased longevity and improved medical management of children with chronic illnesses has led to a focus on the short- and long-term consequences of these conditions on bone health. Bone loss is influenced by diet, malabsorption, and disease-related imbalances in bone turnover. It may be exacerbated by common medications, especially corticosteroids. Assessment of bone mass and quality, calcium absorption, kinetically derived rates of bone turnover, and biochemical markers of bone turnover have increased our knowledge of the pathophysiology of bone loss in these children as well as provided insights into possible therapeutic interventions. Increased intake of calcium and vitamin D, while useful, is unlikely to prevent or resolve bone loss in many chronically ill children. Emphasis on combination of nutritional interventions with exercise and newer bone-sparing therapies may be necessary.
Rising Incidence Rates of Breast Carcinoma With Micrometastatic Lymph Node Involvement
Authors: D. P. Cronin-Fenton, L. A. Ries, L. X. Clegg, B. K. Edwards
Journal: JNCI Journal of the National Cancer Institute (2007)

We investigated the increased incidence of early-stage breast cancer with micrometastatic lymph node involvement. Breast cancer incidence trends from 1990 through 2002 in the US Surveillance, Epidemiology, and End Results Program catchment area were analyzed. Joinpoint regression was used to show the annual percentage change (APC) in breast cancer incidence trends. The overall incidence of breast cancer among women aged 50–64 years increased 1.8% (95% confidence interval [CI] = 1.4% to 2.2%) per annum from 1990 through 2002 but decreased in all other age groups. Stage IIA and stage IIB tumor incidence increased (APC for stage IIA from 1996 to 2002 = 61.9%, 95% CI = 51.1% to 73.4%, and APC for stage IIB from 1998 to 2002 = 53.7%, 95% CI = 20.6% to 96.0%). The incidence of micrometastatic lymph node involvement for stage IIA and stage IIB tumors increased during the 1990s, especially after 1997 (APC = 17.3% for both stages), more for estrogen receptor–positive than estrogen receptor–negative disease. Increased use of mammography screening partly explains the increased incidence of early-stage breast cancer. Increases in small tumors with micrometastatic lymph node involvement may be attributable to the increased use of the sentinel lymph node biopsy in community practice.
Depressive Symptoms in Mothers of Infants Identified as Genetically at Risk for Type 1 Diabetes
Authors: Korey K. Hood, Suzanne Bennett Johnson, Stacy K. Carmichael, Lori M.B. Laffel, Jin-Xiong She, Desmond A. Schatz
Journal: Diabetes Care (2005)

OBJECTIVE—This study describes maternal depression associated with newborn genetic screening for type 1 diabetes after risk notification. RESEARCH DESIGN AND METHODS—Mothers of at-risk infants (n = 192), identified through newborn genetic screening as part of the Prospective Assessment of Newborns for Diabetes Autoimmunity study, were administered a structured telephone interview assessing maternal depressive symptoms 1 and 3.5 months after risk notification. Statistical analyses were conducted to examine predictors and correlates of maternal depressive symptoms. RESULTS—For the total sample, maternal depressive symptoms in response to infant risk status were not elevated at 1 and 3.5 months after risk notification. However, at the first interview, mothers from ethnic minority backgrounds (P &amp;lt; 0.002), with limited education (P &amp;lt; 0.001), and with postpartum depression symptomatology (P &amp;lt; 0.001) reported significantly more depressive symptoms in response to risk notification (r2 = 0.354). At the second interview, postpartum depression symptomatology remained a powerful predictor of depressive symptoms in response to risk notification (P &amp;lt; 0.001). In addition, certain coping styles (wishful thinking, self-blame, and seeking social support) were associated with increased depressive symptoms. A history of major depression was a correlate of both postpartum depressive symptomatology (r = 0.26) and maternal depressive response to risk notification (r = 0.21). CONCLUSIONS—For the most part, mothers of infants genetically at risk for type 1 diabetes do not appear to evidence elevated depressive symptoms. This suggests that most mothers are resilient when notified of infant risk. However, certain maternal characteristics such as ethnic minority status, less than a high school education, postpartum depression symptomatology, a history of major depression, and certain coping strategies (wishful thinking, self-blame, and seeking social support) appear to be associated with a more difficult maternal response to the news of an infant’s increased genetic risk for type 1 diabetes.
Array Comparative Genomic Hybridization Identifies Genetic Subgroups in Grade 4 Human Astrocytoma
Authors: Anjan Misra, Malgorzata Pellarin, Janice Nigro, Ivan Smirnov, Dan Moore, Kathleen R. Lamborn, Daniel Pinkel, Donna G. Albertson, Burt G. Feuerstein
Journal: Clinical Cancer Research (2005)

Abstract Alterations of DNA copy number are believed to be important indicators of tumor progression in human astrocytoma. We used an array of bacterial artificial chromosomes to map relative DNA copy number in 50 primary glioblastoma multiforme tumors at ∼1.4-Mb resolution. We identified 33 candidate sites for amplification and homozygous deletion in these tumors. We identified three major genetic subgroups within these glioblastoma multiforme tumors: tumors with chromosome 7 gain and chromosome 10 loss, tumors with only chromosome 10 loss in the absence of chromosome 7 gain, and tumors without copy number change in chromosomes 7 or 10. The significance of these genetic groups to therapeutics needs further study.
Visceral pain---central sensitisation
Authors: F Cervero
Journal: Gut (2000)

Visceral pain is the most common form of pain produced by disease and one of the most frequent reasons for patients to seek medical attention. Yet much of what we know about the basic mechanisms of pain derives from experimental studies of somatic nociception. This would be justified if the mechanisms of somatic and visceral pain were similar so that information obtained by studying one form of pain could be extrapolated to interpret the mechanisms of the other. However, the more we know about the mechanisms of somatic and visceral sensation the more we realise that these two processes, while having many common features, also have important differences. We seldom have any sensory experiences from our internal organs other than pain and discomfort and even when other sensations occur, such as bladder or stomach fullness, these can easily evolve towards pain if the stimulus persists.

The five main characteristics of visceral pain—that is, those clinical features that make visceral pain unique—are that visceral pain1:

(i)
:   is not evoked from all viscera,
(ii)
:   is not linked to visceral injury,
(iii)
:   is referred to other locations,
(iv)
:   is diffuse and poorly localised, and
(v)
:   is accompanied by motor and autonomic reflexes.



Properties (i) and (ii) generated the notion that some viscera lacked an afferent innervation. We now know that …
Functional separation of the senses is a requirement of perception/action research
Authors: Kipp McMichael, Geoffrey Bingham
Journal: Behavioral and Brain Sciences (2001)

Stoffregen &amp; Bardy's arguments against separation of the senses fail to consider the functional differences between the kinds of information potentially available in the structured energy arrays that correspond to the traditional senses. Since most perception/action research pursues a strategy of information perturbation presupposing differential contributions from the various ambient arrays, the global array hypothesis can only be extended and tested by analyses that consider the functional aspects along which the senses can, in fact, be separated.
STUDIES ON THE AGENT OF INFECTIOUS HEPATITIS
Authors: Werner Henle, Susanna Harris, Gertrude Henle, T. N. Harris, Miles E. Drake, Francoise Mangold, Joseph Stokes
Journal: The Journal of Experimental Medicine (1950)

Two viral agents have been procured from patients with infectious hepatitisin two widely separated outbreaks of the disease by transfer of acute stage serum and stool filtrates to and passage in tissue cultures of rabbit liver cells in roller tubes and minced chick embryos in Simms-Sanders medium followed by passage in the amniotic cavity of the chick. Cultures of both agents, designated the Akiba and NL strains of virus, induced mild hepatitis without jaundice in the majority of volunteers tested after an incubation period of from 9 to 38 days. Although these agents have not been identified definitely as the virus of infectious hepatitis, the available evidence, as discussed, is compatible with the suggestion that such they are.
<i>In vivo</i> 19F Magnetic Resonance Spectroscopy and Chemical Shift Imaging of Tri-Fluoro-Nitroimidazole as a Potential Hypoxia Reporter in Solid Tumors
Authors: Daniel Procissi, Filip Claus, Paul Burgman, Jacek Koziorowski, J. Donald Chapman, Sunitha B. Thakur, Cornelia Matei, C. Clifton Ling, Jason A. Koutcher
Journal: Clinical Cancer Research (2007)

Abstract Purpose: 2-Nitro-α-[(2,2,2-trifluoroethoxy)methyl]-imidazole-1-ethanol (TF-MISO) was investigated as a potential noninvasive marker of tissue oxygen levels in tumors using 19F magnetic resonance spectroscopy (MRS) and 19F chemical shift imaging. Experimental Designs: In vitro data were obtained using high-performance liquid chromatography on tumor cells incubated under varying oxygen conditions to determine the oxygen-binding characteristics. In vivo data were obtained using a well-characterized hypoxic murine breast tumor (MCa), in addition to studies on a rat prostate tumor model (R3327-AT) implanted in nude mice. Detection of intratumor 19F signal from TF-MISO was done using MRS for up to 10 h following a 75 mg/kg i.v. injection. Localized distribution of the compound in the implanted MCa tumor has been imaged using slice-selective two-dimensional chemical shift imaging 6 h after injection. Results: The in vitro results showed that TF-MISO preferentially accumulates in cells incubated under anoxic conditions. The in vivo 19F MR spectral features (line width and chemical shift) were recorded as a function of time after injection, and the results indicate that the fluorine atoms are indeed sensitive to changes in the local environment while still providing a detectable MR signal. Ex vivo spectra were collected and established the visibility of the 19F signal under conditions of maximum hypoxia. Late time point (&amp;gt;6 h) tumor tissue concentrations, as obtained from 19F MRS, suggest that TF-MISO is reduced and retained in hypoxic tumor. The feasibility of obtaining TF-MISO tumor distribution maps in a reasonable time frame was established. Conclusions: Based on the results presented herein, it is suggested that TF-MISO has the potential to be a valid magnetic resonance hypoxia imaging reporter for both preclinical hypoxia studies and hypoxia-directed clinical therapy.
Evaluation of Vascular Tone in Portacaval Shunts Comparing the Index of Contractility and Resistance in Cats
Authors: Andrés C. Inglés, Dallas J. Legare, Wayne W. Lautt
Journal: Hepatology (1994)

A model of prehepatic chronic portal hypertension in cats was used to determine portacaval shunt responses to infused norepinephrine and to possible transmitter overflow into portal blood from nerves supplying the gut. Responses are compared using a new index of contractility. Four weeks after application of a slowly constricting occluder, the portal vein was completely occluded and acute experiments were carried out under pentobarbital anesthesia. Portal pressure was elevated to 15.0 ± 0.9 mmHg and all portal flow passed through the shunts. In response to intraportal norepinephrine (0.25, 0.5 and 1.25 μg ± min kg-1) shunt resistance rose by 6% ± 3%, 19% ± 4% and 26% ± 5%, respectively, whereas the index of contractility rose (by 22% ± 8%, 46% ± 10% and 89% ± 20%, respectively), the distending blood pressure also rose (5% ± 1%, 7% ± 1% and 14% ± 3%, respectively). The difference in percentage increase of resistance and the index of contractility is a result of the passive dilator effect of the elevated distending pressure acting on the distensible shunt vessels. Stimulation of mesenteric nerves caused the mesenteric artery to constrict, but the shunt vessels showed no effect. In conclusion, the shunt vessels respond actively to norepinephrine and passively to altered distending pressure. However, transmitter overflow from nerves supplying the intestines is unlikely to play a role in determining resistance in the shunts. Vascular resistance is affected by both active and passive effects, so that the active contractile responses are best evaluated using the index of contractility, which is not altered passively. (Hepatology 1994;20:1242-1246).
Bone marrow origin of decidual cell precursors in the pseudopregnant mouse uterus.
Authors: M Kearns, P K Lala
Journal: The Journal of Experimental Medicine (1982)

Decidual cells are considered to be the endproduct of a hormonally induced transformation of endometrial stromal cells of the uterus. However, the source of these precursors remains unknown. This study of evaluated the possibility of their bone marrow origin by an examination of the H-2 phenotype of decidual cells in pseudopregnant bone marrow chimeras. These chimeras were produced by repopulating lethally irradiated CBA/J female (H-2k) mice with bone marrow from (CBA/J x C57BL/6J) F1 female (H-2kb) mice. Pseudopregnancy was produced with a hormonal regimen followed by an oil-induced decidual stimulus. Chimerism was evaluated radioautographically by an identification of the donor-specific Kb phenotype on cells with an immunolabeling technique with monospecific anti-H-2 serum followed by radioiodinated protein A. The extent of chimerism as indicated by the degree of Kb labeling on decidual cells as well as macrophages contained within the decidual nodules was quantitatively compared with that seen on splenic lymphocytes. Fair to good chimerism, as reflected by labeling for the donor-specific marker (Kb), was seen on splenic lymphocytes and macrophages within the decidual nodules in 6 out of 11 animals. A similar level of chimerism was detected on decidual cells in all but one of these six, in which case this was low. One animal showed low chimerism in the spleen but good chimerism on the decidual cells. The remaining four mice were nonchimeric for all three cell types. These results indicate that decidual cells and macrophages appearing within the decidual nodules of pseudopregnant mice are ultimate descendants of bone marrow cells.
Epigenetic control of embryonic stem cell fate
Authors: Nicolaj Strøyer Christophersen, Kristian Helin
Journal: The Journal of Experimental Medicine (2010)

Embryonic stem (ES) cells are derived from the inner cell mass of the preimplantation embryo and are pluripotent, as they are able to differentiate into all cell types of the adult organism. Once established, the pluripotent ES cells can be maintained under defined culture conditions, but can also be induced rapidly to differentiate. Maintaining this balance of stability versus plasticity is a challenge, and extensive studies in recent years have focused on understanding the contributions of transcription factors and epigenetic enzymes to the "stemness" properties of these cells. Identifying the molecular switches that regulate ES cell self-renewal versus differentiation can provide insights into the nature of the pluripotent state and enhance the potential use of these cells in therapeutic applications. Here, we review the latest models for how changes in chromatin methylation can modulate ES cell fate, focusing on two major repressive pathways, Polycomb group (PcG) repressive complexes and promoter DNA methylation.
Apoptosis as a Possible Cause of Gradual Development of Complete Heart Block and Fatal Arrhythmias Associated With Absence of the AV Node, Sinus Node, and Internodal Pathways
Authors: Thomas N. James, Edward St. Martin, Park W. Willis, Thomas O. Lohr
Journal: Circulation (1996)

Background Gradually progressive development of complete heart block in young people often is associated with cardiac arrhythmia and sudden death, but the pathogenesis remains unexplained. Methods and Results A young woman with complete heart block died suddenly. Her mother had serological but no clinical evidence of antiphospholipid syndrome. Five brothers of another family had arrhythmia and heart block. Three died suddenly; the other two have automatic defibrillators and are alive. The hearts from the young woman and two of the three brothers who died were available for our histological examination of their cardiac conduction systems. In two of the three hearts, the AV node was absent; in the third heart, only fragments of the AV node remained. In all three hearts, the sinus node was nearly destroyed by a noninflammatory degeneration with no abnormal fibrosis or infiltrate. In each heart, the interatrial and internodal pathways were similarly involved, and in the young woman, there were no myocardial cells in which these pathways normally exist. Conclusions In these three subjects with progressive development of complete heart block and various arrhythmias, all of whom died suddenly, the histological abnormalities of their cardiac conduction systems are best interpreted as resulting from apoptosis. Programmed cell death is a logical explanation for the pathogenesis of this puzzling clinical picture.
Independence of Herpesvirus-Induced T Cell Lymphoma from Viral Cyclin D Homologue
Authors: Armin Ensser, Diana Glykofrydes, Henk Niphuis, Eva M. Kuhn, Brigitte Rosenwirth, Jonathan L. Heeney, Gerald Niedobitek, Ingrid Müller-Fleckenstein, Bernhard Fleckenstein
Journal: The Journal of Experimental Medicine (2001)

Cyclin D family members are cellular protooncogenes, and their viral homologues in the Kaposi's sarcoma-associated herpesvirus (KSHV, human herpesvirus type 8 [HHV-8]) and the closely related Herpesvirus saimiri have been implicated as putative cofactors of viral transformation and pathogenesis. KSHV is regularly found in Kaposi's sarcoma and in the primary effusion B cell lymphoma and Castleman's disease associated with immunosuppression and AIDS. H. saimiri strain C488 transforms human and marmoset T cells in vitro and causes polyclonal T cell lymphoma in New World monkeys. The viral cyclins stimulate cell cycle progression of quiescent fibroblasts, and they form active cyclin-dependent kinase (CDK)6 complexes of broad substrate specificity that can resist and downregulate cellular CDK inhibitors. This study shows that the viral cyclin of H. saimiri strain C488 is not required for viral replication, T cell transformation, and pathogenicity in New World primates.