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Institution

VA Palo Alto Healthcare System

HealthcarePalo Alto, California, United States
About: VA Palo Alto Healthcare System is a healthcare organization based out in Palo Alto, California, United States. It is known for research contribution in the topics: Population & Health care. The organization has 2548 authors who have published 4605 publications receiving 209938 citations.


Papers
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Journal ArticleDOI
TL;DR: The results suggest that a highly diverse repertoire is maintained despite thymic involution; however, peripheral fitness selection of T cells leads to repertoire perturbations that can influence the immune response in the elderly.
Abstract: T-cell receptor (TCR) diversity, a prerequisite for immune system recognition of the universe of foreign antigens, is generated in the first two decades of life in the thymus and then persists to an unknown extent through life via homeostatic proliferation of naive T cells. We have used next-generation sequencing and nonparametric statistical analysis to estimate a lower bound for the total number of different TCR beta (TCRB) sequences in human repertoires. We arrived at surprisingly high minimal estimates of 100 million unique TCRB sequences in naive CD4 and CD8 T-cell repertoires of young adults. Naive repertoire richness modestly declined two- to fivefold in healthy elderly. Repertoire richness contraction with age was even less pronounced for memory CD4 and CD8 T cells. In contrast, age had a major impact on the inequality of clonal sizes, as estimated by a modified Gini–Simpson index clonality score. In particular, large naive T-cell clones that were distinct from memory clones were found in the repertoires of elderly individuals, indicating uneven homeostatic proliferation without development of a memory cell phenotype. Our results suggest that a highly diverse repertoire is maintained despite thymic involution; however, peripheral fitness selection of T cells leads to repertoire perturbations that can influence the immune response in the elderly.

567 citations

Journal ArticleDOI
TL;DR: The RE-AIM ratings suggest that, although often efficacious for those participating, traditional face-to-face intervention modalities will have limited impact if they cannot be delivered consistently to large segments of the target population.

555 citations

Journal ArticleDOI
TL;DR: periods of high ED crowding were associated with increased inpatient mortality and modest increases in length of stay and costs for admitted patients, and those days within the top quartile of diversion hours for a specific facility.

542 citations

Journal ArticleDOI
12 Jun 2015-Science
TL;DR: It is shown that functional brain networks defined with resting-state functional magnetic resonance imaging can be recapitulated by using measures of correlated gene expression in a post mortem brain tissue data set.
Abstract: During rest, brain activity is synchronized between different regions widely distributed throughout the brain, forming functional networks. However, the molecular mechanisms supporting functional connectivity remain undefined. We show that functional brain networks defined with resting-state functional magnetic resonance imaging can be recapitulated by using measures of correlated gene expression in a post mortem brain tissue data set. The set of 136 genes we identify is significantly enriched for ion channels. Polymorphisms in this set of genes significantly affect resting-state functional connectivity in a large sample of healthy adolescents. Expression levels of these genes are also significantly associated with axonal connectivity in the mouse. The results provide convergent, multimodal evidence that resting-state functional networks correlate with the orchestrated activity of dozens of genes linked to ion channel activity and synaptic function.

536 citations


Authors

Showing all 2575 results

NameH-indexPapersCitations
Gregg C. Fonarow1611676126516
Jongmin Lee1502257134772
Roger J. Davis147498103478
Eugene C. Butcher14644672849
Gerald M. Reaven13379980351
Paul G. Shekelle132601101639
Helena C. Kraemer13256265755
Glenn M. Chertow12876482401
Lawrence Steinman11963955583
Rudolf H. Moos11962249816
Cornelia M. Weyand11646044948
Jiahuai Han11137949379
Jörg J. Goronzy11142037634
Adolf Pfefferbaum10953040358
Michael F. Green10648545707
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Performance
Metrics
No. of papers from the Institution in previous years
YearPapers
202316
202226
2021439
2020391
2019304
2018311