tbuckley/cabot-search huggingface dataset:
Environmental approaches to promote healthy eating: Is ensuring affordability and availability enough?
Authors: Pablo Monsivais, Claire Thompson, Chloe Clifford Astbury, Tarra L Penney
Journal: BMJ (2021)

Pablo Monsivais and colleagues reflect on the evidence for interventions to improve access to healthy food and discuss considerations for evidence generation Improving diet is a key goal of public health, as a substantial fraction of global morbidity and mortality is attributable to dietary imbalances.1 These imbalances include insufficient consumption of vegetables, fruits, and whole grains, and excessive intake of refined carbohydrates and meat. Moreover, inequities in health are driven in part by inequities in diet, and tackling them is a key dimension to improving diet and health at the population level. The past 20 years have seen increasing concern over structural factors that promote unhealthy dietary patterns and undermine the adoption of healthy eating. This trend has paralleled a growing understanding of the multifactorial "causes of the causes" of the modern pandemics of obesity and non-communicable disease,2 and interest in the physical, economic, and social environments that cue and shape behavioural risk factors.34 For food selection and diet specifically, there is recognition of the importance of affordability and availability, two dimensions of a wider conceptualisation of food access (box 1).5 The general consideration of "access to healthy food" is now a central pillar of policy, systems, and environments (PSE) interventions7 as well as so called "whole systems" approaches8 to improve nutrition and reduce obesity and chronic disease. As policy makers and communities act to forge more healthful, sustainable, and equitable food systems and environments, researchers recognise the uneven evidence base and debate the importance of economic and geographical factors as population level determinants of diet and health. Box 1 ### Access, affordability, and availabilityRETURN TO TEXT
LDL-C–lowering therapies reduce major vascular events in patients aged ≥75 y
Authors: Islam Y. Elgendy, Mohamed B. Elshazly
Journal: Annals of Internal Medicine (2021)

Source Citation Gencer B, Marston NA, Im K, et al. Efficacy and safety of lowering LDL cholesterol in older patients: a systematic review and meta-analysis of randomised controlled trials. Lancet. 2020;396:1637-43. 33186535
New indexes for assessing aortic regurgitation with two-dimensional Doppler echocardiographic measurement of the regurgitant aortic valvular area.
Authors: CVeyrat, ALessana, GAbitbol, AAmeur, RBenaim, DKalmanson
Journal: Circulation (1983)

Direct examination of the aortic orifice at the level of the aortic valves (aortic valvular orifice area, AVOA) in the short-axis plane was performed with a 3 MHz two-dimensional pulsed Doppler echocardiographic apparatus. The AVOA was mapped with the Doppler gate to detect or rule out the presence of a regurgitant aortic valvular area (RAVA) established by recording of abnormal diastolic Doppler signals on a yes or no basis. A group of 12 normal subjects and 83 patients, including 40 patients with aortic regurgitation proven by aortography, were investigated with this procedure. In the 38 patients with aortic regurgitation diagnosed by Doppler echocardiography (diagnostic sensitivity 95%, specificity 100%), planimetric measurements of the RAVA and AVOA were performed with calculation of two indexes: the RAVA/square meter of body surface area and the RAVA/AVOA ratio. These indexes correlated well with independently performed angiographic grading on a three-point scale (r = .87 for the RAVA, .88 for the ...
Relation between steady-state force and intracellular [Ca2+] in intact human myocardium. Index of myofibrillar responsiveness to Ca2+.
Authors: J KGwathmey, R JHajjar
Journal: Circulation (1990)

A novel approach was developed allowing the measurement of steady-state force and intracellular calcium concentration ([Ca2+]i) in tetanized human ventricular trabeculae carneae without pharmacological intervention. We compared and contrasted three methods of assessing calcium sensitivity of the myofilaments: 1) force-[Ca2+] relations in skinned fiber preparations, 2) peak twitch force-peak [Ca2+]i relations, and 3) steady-state force-[Ca2+]i relations in intact muscles. Steady-state contractile activation was achieved rapidly by tetanizing intact human trabeculae, loaded with aequorin, a Ca2(+)-sensitive bioluminescent protein, at a stimulation frequency of 15-20 Hz. Steady-state force and [Ca2+]i were measured during tetani, and the force versus [Ca2+]i relation was obtained by varying the extracellular calcium concentration ([Ca2+]o). Force-[Ca2+]i relations obtained from control and myopathic hearts were fitted to the Hill equation: %Force = [Ca2+]inh/([Ca2+]inh50% + [Ca2+]inh), where nh is the Hill c...
Novel triterpenoid saponins from Androsace umbellata induce apoptosis in human hepatoma cells
Authors: Dongmei Zhang, Kwok Pui Fung
Journal: Cancer Research (2007)

1468  Chemotherapy has been the current leader in first-line therapy for liver cancer. Unfortunately, its drawbacks include severe side effects and development of multi-drug resistance (MDR). A research project was initiated to develop effective and safe anti-hepatomic agents from Herbal Medicine for treatment of liver cancer, as well as cases with MDR phenomenon.  Phytochemical study of Androsace umbellata was firstly conducted. Three novel triterpenoid sapogenins {3β, 16α-dihydroxy-13β, 28-epoxy-oleanan-30-al 3-O-β-D-glucopyranosyl(1→2)-α-L-arabinopyranoside (AU-1),3β-hydroxy-13β, 28-epoxy-oleanan-16-oxo-30-al 3-O-β-D-xylopyranosyl(1→2)-β-D-glucopyranosyl(1→4) [β-D-glucopyranosyl(1→2)]-α-L-arabinopyranoside (AU-2) and 3β-hydroxy-13β, 28-epoxy-oleanan- 16-oxo-30-al 3-O-β-D-xylopyranosyl(1→2)-β-D-glucopyranosyl(1→4)-α-L-arabinopyranoside (AU-3)}, and four known compounds primulaninb [(AU-4), saxifragifolin B (AU-5), saxifragifolin C (AU-6) and saxifragifolin D (AU-7)], were isolated and characterized by HI-ESI-MS, 1H NMR, 13C NMR, DEPT, HMQC, HMBC spectroscopic analyses. The anti-tumor activities of these compounds were firstly reported in human hepatoma cells (HepG2 and Hep3B) and multidrug resistant human hepotoma cells (R-HepG2). Among them, AU-5 and -7 are more potent with IC50 values ~10 μM. Structure-activity relationship suggested introduction of glucose moieties in arabinose linked at aglycone could enhance the cytotoxicities of tritepenes.  Mechanistic studies of AU-5 and -7 were carried out in both HepG2 and R-HepG2 cells. The results of cell cycle, DNA ladder, and annexin-V staining assay indicated that their antitumor effects were established by induction of programmed cell death, which was confirmed by the activation of apoptosis mediators PARP and caspase-3. The induction of apoptosis was mediated by activation of caspase-8 and 9, up-regulation of Bax and Bcl-XL, which were accompanied by mitochondrial membrane potential collapse and leakage of cytochrome c. In addition, generation of reactive oxygen species and increase of intracellular calcium level were also observed, whereas co-incubation with an antioxidant N-Acetyl-cysteine would reverse the cell growth inhibitory effect. Preliminary results of in vivo assay demenstrated the anti-proliferative effect in HepG2-transplanted tumors in nude mice. In conclusion, seven anti-tumor triterpenes including three novel compounds were seperated and identified from Androsace umbellata. In our study, AU-5 and -7 induce apoptosis in human hepatoma cells via extrinsic and intrinsic pathways.
Detection and estimation of the degree of mitral regurgitation by range-gated pulsed doppler echocardiography.
Authors: A SAbbasi, M WAllen, DDeCristofaro, IUngar
Journal: Circulation (1980)

Sensitivity and specificity of detection of mitral regurgitation was assessed by range-gated Doppler echocardiography. The degree of mitral regurgitation was also estimated by the depth and width of the regurgitant jet detected with Doppler and compared with that assessed by left ventriculography. Of 47 patients with an adequate Doppler study, 24 had no mitral regurgitation by ventriculography. All but one were also negative for mitral regurgitation by Doppler, for a specificity of 96%. Of 23 cases with mitral regurgitation documented by ventriculography, Doppler detected mitral regurgitation in 21, for a sensitivity of 92%. Two cases with mitral regurgitation undiagnosed by Doppler had mild mitral regurgitation due to papillary muscle dysfunction. All cases with rheumatic mitral regurgitation were detected. The degree of mitral regurgitation estimated with Doppler had a high correlation with that determined by ventriculography (r = 0.88, p less than 0.01).
Longitudinal Assessment of Physical Activity and Cognitive Outcomes Among Women at Midlife
Authors: Gail A. Greendale, Weijuan Han, MeiHua Huang, Dawn M. Upchurch, Carrie Karvonen-Gutierrez, Nancy E. Avis, Arun S. Karlamangla
Journal: JAMA Network Open (2021)

<h3>Importance</h3> The increasing prevalence of cognitive decline, impairment, and dementia spurs intense interest in cognitive preservation strategies. <h3>Objective</h3> To explore the longitudinal association between physical activity (PA) and cognitive performance among women at midlife. <h3>Design, Setting, and Participants</h3> This cohort study is an analysis from the Study of Women's Health Across the Nation. Enrollment occurred from 1996 through 1997, and follow-up extended into 2017. Included individuals were those who had undergone cognitive measures during the first 3 cognitive test visits and had at least 1 additional cognitive measurement. Stroke prior to baseline was an exclusion, and observations were censored for subsequent stroke. Data were analyzed from June 2018 through August 2019. <h3>Exposures</h3> Engaging in sport or exercise PA (self-reported). <h3>Main Outcomes and Measures</h3> The Symbol Digit Modalities Test (SDMT) was used to assess cognitive processing speed. The East Boston Memory Test-Delayed (EBMT-D) was used to measure verbal episodic memory. The digit span backwards (DSB) test was used to evaluate working memory. <h3>Results</h3> Among 1718 women with a median (range) observation time of 11.9 (0.6-13.5) years, the mean (SD) baseline age was 45.7 (2.5) years. From baseline through age 61 years, mean change in SDMT score was −0.20 annually (95% CI, −0.26 to −0.15;<i>P</i> &lt; .001). After age 61 years, the mean change in SDMT was −0.51 yearly (95% CI, −0.54 to −0.41;<i>P</i> &lt; .001). Beginning at age 58 years, the mean change in EBMT was −0.03 yearly (95% CI, −0.04 to −0.02;<i>P</i> &lt; .001). Starting at age 61 years, mean (SD) change in DSB was −0.03 annually (95% CI, −0.04 to −0.01;<i>P</i> = .001). When adjusted for attrition and practice effect, PA was associated with higher concurrent SDMT and EBMT scores and a smaller decrease in SDMT score. For each unit increment in PA, there was a 0.36 increment in concurrent SDMT score (95% CI, 0.14 to 0.59;<i>P</i> = .002) and a 0.10 increment in concurrent EBMT score (95% CI, 0.05 to 0.15;<i>P</i> &lt; .001). Greater PA was associated with a smaller annual mean decrease in SDMT score (0.06 yearly; 95% CI, 0.02 to 0.09;<i>P</i> = .001). After additional adjustment for demographic characteristics, menopause symptoms, hormone therapy use, and the presence of diabetes and hypertension, PA was not associated with trajectories (ie, levels or slopes) of any cognitive outcome. <h3>Conclusions and Relevance</h3> This cohort study found no association between greater PA levels and cognitive outcomes among women in midlife, unlike cohort studies that begin observations at later ages, which may be associated with confounding by reverse causation (ie, cognitive decline associated with an outcome of lower PA levels).
Balloon dilation of congenital aortic valve stenosis. Results and influence of technical and morphological features on outcome.
Authors: G FSholler, J FKeane, S BPerry, S PSanders, J ELock
Journal: Circulation (1988)

We evaluated dilation technique (n = 80) and aortic valve morphology by two-dimensional echocardiography (n = 58) in patients with congenital aortic valve stenosis to determine their influence on outcome. Patients' age (9 +/- 9 years; range, 1 day-39 years) and a history of surgical valvotomy did not influence outcome. The number of dilating balloons (one vs. two) and balloon: annulus ratio based on the largest balloon used in each case (97 +/- 12%; range, 71-133%) did not demonstrably influence the percent reduction in valvar gradient. In contrast, with a balloon: annulus ratio greater than 100%, the incidence (26%) of significant, dilation-induced aortic regurgitation was higher than occurred when the ratio was equal to or less than 100% (11%). Fifty bicommissural and eight unicommissural valves were identified echocardiographically. Relief of obstruction was associated with apparent commissural division in 24 of 32 patients with suitable postdilation studies. The sites of fusion and stenosis relief did...
Hierarchy of levels of ischemia-induced impairment in regional left ventricular systolic function in man.
Authors: A MZeiher, HWollschlaeger, TBonzel, WKasper, HJust
Journal: Circulation (1987)

We tested the hypothesis that different subsets of ischemia-induced wall motion disorders are characterized by specific patterns of abnormal regional left ventricular systolic function. Regional contraction was quantitatively assessed from two-dimensional echocardiograms by an automated integrative analysis considering the time course of wall motion during the entire contraction sequence in 20 patients with chronic myocardial infarction, in 13 patients with impending myocardial infarction (less than 2 hr after the onset of symptoms), and in nine patients during transient myocardial ischemia. Wall motion abnormalities were detected in all patients by the integrative analysis. In contrast, the sensitivity for detecting wall motion abnormalities was 80% during chronic infarction, 77% during impending infarction, and 56% during transient ischemia if only end-diastolic and end-systolic frames were compared for assessment of overall regional systolic function. There were distinct differences in the time course ...
Deletion polymorphism of the angiotensin I-converting enzyme gene is associated with serum ACE concentration and increased risk for CAD in the Japanese.
Authors: KNakai, CItoh, YMiura, KHotta, TMusha, TItoh, TMiyakawa, RIwasaki, KHiramori
Journal: Circulation (1994)

BACKGROUNDThe angiotensin I-converting enzyme (ACE) is a key component of the renin-angiotensin system thought to be important in the pathogenesis of hypertension and cardiovascular disease. Deletion polymorphism in the ACE gene may be a risk factor for myocardial infarction in the Caucasian population. However, this finding has not yet been investigated in the Japanese population.METHODS AND RESULTSA 287-bp insertion/deletion polymorphism in intron 16 of the ACE gene was examined by polymerase chain reaction in a cross-sectional study of 100 healthy subjects and 178 patients with coronary artery disease (CAD) (70 angina pectoris, 108 myocardial infarction), whose serum ACE levels were concomitantly measured. Polymorphism of the ACE gene was characterized by three genotypes: two deletion alleles (genotype DD), two insertion alleles (genotype II), and heterozygous alleles (genotype ID). No differences could be detected among the three genotypes for total cholesterol, HDL cholesterol, and body mass index. S...
Early Experience of Spyglass Discover Cholangioscope for Percutaneous And Intraoperative Cholangioscopy
Authors: S Phillpotts, W Fateen, B Kok, J Potts, G Webster
Journal: Endoscopy (2021)

Aims Peroral cholangioscopy may be a useful tool for targeted therapy of biliary stones and diagnosis of biliary strictures where a conventional retrograde endoscopic approach is not possible (eg. due to surgically altered anatomy). Previously available equipment was not designed or well suited to percutaneous cholangioscopy. The new SpyGlass Discover cholangioscope (Boston Scientific Inc) has been designed specifically for percutaneous or intraoperative use. The scope has a 65cm working length (compared to the longer, 214cm SpyScope DS II). The working channel is 3.6Fr, through which devices such as biopsy forceps and EHL probes can be passed.We describe our technique and early experience of using SpyGlass Discover in our joint tertiary centre since introduction of the system to the UK in July 2020.
Prognostic Value of Pancreatic Fistula in Resected Patients With Pancreatic Cancer With Neoadjuvant Therapy—Reply
Authors: Thomas Hank, Marta Sandini, Carlos Fernández-del Castillo
Journal: JAMA Surgery (2019)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA Surgery HomeNew OnlineCurrent IssueFor Authors Podcast Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA Surgery journal
Redistribution of canine left ventricular myocardial blood flow in unloaded systole.
Authors: R BWilliams, H MTremer, S SSobin
Journal: Circulation Research (1981)

The left coronary arteries of dogs were cannulated and perfused with blood from support dogs. The experimental hearts were unloaded by severing the aortas to maximize strains and minimize fiber stress. In each heart we compared the transmural distribution of blood flow in two states: (1) provision of perfusion pressure (40 mm Hg) only during systole and then (2) provision of perfusion pressure throughout the cardiac cycle. The distribution of flow in each of these perfusion states was labeled with a diffusible radioisotope (42K or 86Rb, one labeling the first state; the other labeling the second). Quantitative, paired autoradiography was used to visualize the two flow distributions. The differences between the two distributions after standardization was plotted as differences between activity vs. depth in the myocardium (r = 0.91). This was fitted with a line by least squares, the slope of which was significantly different from zero at the 0.005 level. The magnitude of the gradient of the systolic flow wa...
Shall The Journal be Removed to Washington?
Authors: J. W. Davis
Journal: JAMA (1891)

<h3>To the Editor:</h3> —About the removal ofThe Journaland building a house of our own; I think it advisable to do so, and would suggest Louisville, which is neither an Eastern, Western, Northern or Southern city, but truly a central one. Smyrna, Tenn., December 23, 1890.
The Prevalence and Causes of Colonic Cancer
Authors: David L. Sherr
Journal: JAMA (1986)

<h3>To the Editor.—</h3> In their recently published CASE REPORT, Ehrlich et al<sup>1</sup>assert that carcinomas involving the gastrointestinal tract, as a group, are the most common forms of cancer in the United States. This is in error. Based on data obtained by the National Cancer Institute's Surveillance, Epidemiology, and End Results Program during the years 1977 to 1981,<sup>2</sup>the American Cancer Society estimates that a total of 215,200 cases of cancer of the digestive tract will be diagnosed in 1985, while more than 400,000 cases of nonmelanoma skin cancer and an additional 22,000 cases of melanoma will be diagnosed during the same period. Therefore, skin carcinomas—not gastrointestinal tract carcinomas—are the most common forms of cancer in the United States.
HIV Drug Resistance
Authors: Alexandra Calmy, Fernando Pascual, Nathan Ford
Journal: New England Journal of Medicine (2004)

significantly more often than those without a response (loss of HBsAg, 52 percent vs. 9 percent; loss of HBV DNA, 70 percent vs. 30 percent).In addition, our results indicated that, after correction for baseline factors, a response to interferon alfa significantly increased the rate of survival and reduced the risk of hepatocellular carcinoma.Ganem and Prince also suggest that reducing the viral load with lamivudine therapy may allow the immune response to clear infected hepatocytes.Although a restored HBV-specific T-cell reactivity during treatment with lamivudine has been reported, hepatitis B core antigen-specific T-cell reactivity remained undetectable in another study. 3,4 We found that an HBeAg response induced by lamivudine was significantly less durable than a response after therapy with interferon alfa. 5This difference with respect to relapse suggests a lack of efficient immune control after treatment with lamivudine.Both these arguments should encourage us to reconsider the rapid displacement of interferon from the roster of first-line therapies for HBV infection.
Continuous positive-pressure ventilation decreases right and left ventricular end-diastolic volumes in the dog.
Authors: J EFewell, D RAbendschein, C JCarlson, J FMurray, ERapaport
Journal: Circulation Research (1980)

We investigated the mechanism(s) responsible for the decreased cardiac output during continuous positive-pressure ventilation (CPPV). Seven dogs were anesthetized with chloralose-urethane, intubated, and ventilated using a volume ventilator. We measured heart rate, stroke volume, and the determinants of stroke volume: left and right ventricular end-diastolic volumes, isovolumic and ejection phase indices of myocardial contractility, and pulmonary and systemic arterial pressures. Myocardial blood flow was estimated using radioactive microspheres. Variables were measured during a control period of intermittent positive-pressure ventilation (IPPV), 8-20 minutes after the initiation of CPPV using 12 cm H2O positive end-expiratory pressure (PEEP), and 8-20 minutes after the removal of PEEP. CPPV decreased cardiac output but did not affect total or regional myocardial blood flow or the ratio of subendocardial to subepicardial blood flow. Isovolumic and ejection phase indices of myocardial cointractility, heart ...
Impact Of Restrictions Due To Covid -19 On A Quality Assured Screening Colonoscopy Program
Authors: A Hinterberger, L Jiricka, E Waldmann, D Penz, B Majcher, A Asaturi, A Szymanska, L Rockenbauer, A Ferlitsch, M Trauner, M Ferlitsch
Journal: Endoscopy (2021)

Aims On February 25th, the first patient was diagnosed with COVID-19 in Austria. On March 16th (week 12) Austrian government imposed restrictions and subsequently the Austrian Medical Association has recommended to minimize screening examinations in compliance with government restrictions.