tbuckley/cabot-search huggingface dataset:
Rationing health care: moving the debate forward
Authors: R. Smith
Journal: BMJ (1996)

Groups in Britain are encouraging the debate that the government won't lead

When governments and politicians do not act, the people may. In Britain neither the government nor the main opposition party will openly acknowledge the inevitability of rationing health care. Instead, they talk of increasing the effectiveness of health care, spending more on the health service, and setting priorities locally.

Their implication to the public is that nobody will be denied potentially beneficial treatments. But almost all of those who spend any time studying this subject recognise that people have always been denied potentially beneficial treatments, and they always will be no matter how much is spent on health services. These commentators believe that governments should come clean with the public and lead a debate on how best to ration health care. Because British political leaders will not accept this challenge, various organisations and ad hoc groups have begun to try to find ways to include the public in the debate on rationing health care. Some of these initiatives are covered in this week's and last week's BMJ.

Most commentators accept that rationing is inevitable, but the debate keeps returning …
ABC of asthma. Clinical course.
Authors: J Rees
Journal: BMJ (1984)

Growing out of asthmaParents ofasthmatic children usually ask whether their child will "grow out of" his asthma.Most wheezy children improve during their teens, but the outlook depends to some extent on the severity of their early disease.5yrq~toniMore than halfof the children with infrequent wheezing will be free of tree yw symptoms by the time they are 21.In contrast, of those with frequent,
Evolution of a Pseudogene: Exclusive Survival of a Functional Mitochondrial nad7 Gene Supports Haplomitrium as the Earliest Liverwort Lineage and Proposes a Secondary Loss of RNA Editing in Marchantiidae
Authors: M. Groth-Malonek, U. Wahrmund, M. Polsakiewicz, V. Knoop
Journal: Molecular Biology and Evolution (2007)

Gene transfer from the mitochondrion into the nucleus is a corollary of the endosymbiont hypothesis. The frequent and independent transfer of genes for mitochondrial ribosomal proteins is well documented with many examples in angiosperms, whereas transfer of genes for components of the respiratory chain is a rarity. A notable exception is the nad7 gene, encoding subunit 7 of complex I, in the liverwort Marchantia polymorpha, which resides as a full-length, intron-carrying and transcribed, but nonspliced pseudogene in the chondriome, whereas its functional counterpart is nuclear encoded. To elucidate the patterns of pseudogene degeneration, we have investigated the mitochondrial nad7 locus in 12 other liverworts of broad phylogenetic distribution. We find that the mitochondrial nad7 gene is nonfunctional in 11 of them. However, the modes of pseudogene degeneration vary: whereas point mutations, accompanied by single-nucleotide indels, predominantly introduce stop codons into the reading frame in marchantiid liverworts, larger indels introduce frameshifts in the simple thalloid and leafy jungermanniid taxa. Most notably, however, the mitochondrial nad7 reading frame appears to be intact in the isolated liverwort genus Haplomitrium. Its functional expression is shown by cDNA analysis identifying typical RNA-editing events to reconstitute conserved codon identities and also confirming functional splicing of the 2 liverwort-specific group II introns. We interpret our results 1) to indicate the presence of a functional mitochondrial nad7 gene in the earliest land plants and strongly supporting a basal placement of Haplomitrium among the liverworts, 2) to indicate different modes of pseudogene degeneration and chondriome evolution in the later branching liverwort clades, 3) to suggest a surprisingly long maintenance of a nonfunctional gene in the presumed oldest group of land plants, and 4) to support the model of a secondary loss of RNA-editing activity in marchantiid liverworts.
Transcriptional Activation of the p34 <sup>cdc2</sup> Gene by cdc2 Promoter Binding Factor/Nuclear Factor-Y in Fetal Rat Ventricular Myocytes
Authors: Qingquan Liu, Huajun Yan, Nicola J. Dawes, Yujuan Lu, Hong Zhu
Journal: Circulation Research (1998)

Abstract —To determine how myocardial terminal differentiation is regulated by cell cycle control genes, we studied cdc2 expression in rat cardiac muscle and found that cdc2 mRNA and protein levels were reduced in neonatal compared with fetal ventricles and became undetectable in juvenile and adult ventricles. To further determine whether cdc2 downregulation is attributed to a decrease in transcription, transient expression assay was performed using the progressively truncated 6.2-, 1.8-, 1.1-, 0.7-, and 0.1-kb human cdc2 5′ flanking regions. All five fragments activated reporter expression in fetal myocytes and were significantly less active in neonatal myocytes. The 0.1-kb fragment showed 65% of the activity of the 6.2-kb fragment. A protein binding site that contains an inverted CCAAT box was identified within the 0.1-kb fragment by DNase I footprint assay and named the cdc2 promoter binding factor (CPBF) site. Point mutations within the CPBF site that abolish CPBF binding significantly decreased both 0.1- and 6.2-kb promoter activities. Competition and antibody supershift assays suggested that CPBF was identical or related to the transcription factor, nuclear factor Y (NF-Y). The 0.1-kb promoter activity was suppressed by a dominant-negative NF-Y mutant in fetal myocytes. Taken together, our results demonstrate that cardiac cdc2 expression is downregulated after birth and turned off when the juvenile stage is attained. A 0.1-kb promoter fragment of cdc2 contains major information for both cdc2 transcriptional activation and suppression in fetal and neonatal myocytes, respectively. NF-Y or its related factor plays a critical role in activating the 0.1-kb cdc2 promoter.
The market for medical journals is anticompetitive, says expert
Authors: R. Smith
Journal: BMJ (2003)

The market for scientific and medical journals is suffering from “true market failure,” says Mark McCabe, an economist who worked for the US Department of Justice's antitrust division for seven years.

The result, said McCabe, who is now an assistant professor at the Georgia Institute of Technology, is that prices for journals have risen around 200% in the past 10 years, but the number of journals has fallen by only 5-10% ( Information Today www.infotoday.com/it/dec02/poynder.htm). Libraries have met the increases by cutting other parts of their budgets, including the purchase of books.

McCabe was assigned by the Department of Justice to look at the merger between Wolters Kluwer and Reed Elsevier in 1998. Traditional economic models …
Mammary Souffle of Pregnancy
Authors: JAMES T. SCOTT, EDMOND A. MURPHY
Journal: Circulation (1958)

Little attention has been paid to the continuous parasternal murmur that may occur during pregnancy and that disappears after lactation. We have encountered 2 cases of this phenomenon. The murmur probably arises from arteries supplying the breast. The mechanism of its production has not been established, but it may depend on some permanent anatomic anomaly. This benign murmur has special characters by which it may be readily distinguished from significant continuous murmurs.
Busulfan Conditioning Enhances Engraftment of Hematopoietic Donor-derived Cells in the Brain Compared With Irradiation
Authors: Fiona L Wilkinson, Ana Sergijenko, Kia J Langford-Smith, Marcela Malinowska, Rob F Wynn, Brian W Bigger
Journal: Molecular Therapy (2013)

Hematopoietic stem cell gene therapy for neurological disorders relies on transmigration of donor-derived monocytes to the brain, where they can engraft as microglia and deliver therapeutic proteins. Many mouse studies use whole-body irradiation to investigate brain transmigration pathways, but chemotherapy is generally used clinically. The current evidence for transmigration to the brain after chemotherapy is conflicting. We compared hematopoietic donor cell brain engraftment after bone marrow (BM) transplants in busulfan- or irradiation-conditioned mice. Significantly more donor-derived microglial cells engrafted posttransplant in busulfan-conditioned brain compared with the irradiated, in both the short and long term. Although total Iba-1+ microglial content was increased in irradiated brain in the short term, it was similar between groups over long-term engraftment. MCP-1, a key regulator of monocyte transmigration, showed long-term elevation in busulfan-conditioned brain, whereas irradiated brains showed long-term elevation of the proinflammatory chemokine interleukin 1α (IL-1α), with increased in situ proliferation of resident microglia, and significant increases in the relative number of amoeboid activated microglia in the brain. This has implications for the choice of conditioning regimen to promote hematopoietic cell brain engraftment and the relevance of irradiation in mouse models of transplantation. Hematopoietic stem cell gene therapy for neurological disorders relies on transmigration of donor-derived monocytes to the brain, where they can engraft as microglia and deliver therapeutic proteins. Many mouse studies use whole-body irradiation to investigate brain transmigration pathways, but chemotherapy is generally used clinically. The current evidence for transmigration to the brain after chemotherapy is conflicting. We compared hematopoietic donor cell brain engraftment after bone marrow (BM) transplants in busulfan- or irradiation-conditioned mice. Significantly more donor-derived microglial cells engrafted posttransplant in busulfan-conditioned brain compared with the irradiated, in both the short and long term. Although total Iba-1+ microglial content was increased in irradiated brain in the short term, it was similar between groups over long-term engraftment. MCP-1, a key regulator of monocyte transmigration, showed long-term elevation in busulfan-conditioned brain, whereas irradiated brains showed long-term elevation of the proinflammatory chemokine interleukin 1α (IL-1α), with increased in situ proliferation of resident microglia, and significant increases in the relative number of amoeboid activated microglia in the brain. This has implications for the choice of conditioning regimen to promote hematopoietic cell brain engraftment and the relevance of irradiation in mouse models of transplantation.
Uraemia and Cardiac Tamponade
Authors: S. Marketos
Journal: BMJ (1964)

MEDIALOURNL 447 suggests that the sooner it gets into the care of its adoptive parents the better.There is another truth that mothers could be told which might help to relieve their guilt.It is that their babies are in great demand, and that by surrendering their rights at birth they are performing a valuable public service and bringing happiness to childless couples.-Iam, etc., Southsea, Hants.
Advertisements for doctors with particular religious beliefs
Authors: J. A Hall
Journal: BMJ (1982)

<h3>Abstract</h3> Learning-related attention is one of the most important factors influencing learning. While technologies have enabled the automatic detection of students’ attention levels, the detected states might fail to be learning-related if students did not attend learning tasks (e.g., the attention level of a student who reads comics secretly during classroom learning). This phenomenon poses challenges to the practical application, especially in the primary school stage, which is crucial for students to set up learning attitudes/strategies. Inspired by the emerging inter-person perspective in neuroscience, we proposed an inter-brain attention coupling method to detect learning-related attention. Our method is based on the premise that learning-related attention should follow the structures of course contents, which is reflected in the attention dynamics shared across students. We hypothesized that one’s level of learning-related attention could be detected in the inter-brain attention coupling, which is defined as the degree to which an individual student’s attention dynamics match the attention dynamics averaged across classmates. To test this idea, wearable EEG devices were used to monitor students’ attention levels in a class of primary school students during classroom learning. We found that one’s inter-brain attention coupling was positively correlated with academic performance: higher performances are associated with higher coupling to the class-average attention dynamics. No significant correlation was found between students’ attention levels averaged within the individual and their academic performances. These results demonstrated the value of inter-brain attention coupling in assessing primary school students’ learning process. We argued that inter-person coupling analysis could be useful in monitoring learning-related attention in real-world educational contexts. <h3>Highlights</h3> Wearable EEG devices were used to monitor students’ attention levels in a class of primary school students during classroom learning. A better coupling for one’s attention dynamics to the class-average attention dynamics was associated with a better academic performance. One’s inter-brain attention coupling to class-average attention dynamics during lectures outperformed as an indicator of the learning process compared with the value of attention levels. The present finding suggests that students’ learning-related attention dynamics can be detected from an inter-person perspective, which will be useful for ‘wild’ educational applications. <h3>Graphic Abstract</h3>
Multiple pulmonary nodules: An unusual presentation of fludarabine pulmonary toxicity: Case report and review of literature
Authors: Sandeep Garg, Manisha S. Garg, Neil Basmaji
Journal: American Journal of Hematology (2002)

Abstract Fludarabine monophosphate, a purine analogue is used in the treatment of lymphoid malignancies. A 73‐year‐old woman presented with fever and cough 2 weeks after completing the third cycle of fludarabine for chronic lymphocytic leukemia (CLL). Chest roentgenogram showed multiple pulmonary nodules. Pulmonary histopathology demonstrated a mononuclear interstitial infiltrate without evidence of malignant, infectious, granulomatous, or vascular causes. Her symptoms and pulmonary nodules resolved following treatment with corticosteroids. To our knowledge, four cases of interstitial pneumonitis associated with fludarabine have been reported in medical literature. Fludarabine induced lung toxicity must be considered in all patients who develop unexplained lung disease while receiving fludarabine. It is reversible with discontinuation of drug and administration of corticosteroids. This case extends the spectrum of fludarabine pulmonary toxicity to include pulmonary nodules. Am. J. Hematol. 70:241–245, 2002. © 2002 Wiley‐Liss, Inc.
Drug industry is considering more use of differential pricing, conference hears
Authors: E. Sukkar
Journal: BMJ (2011)

The drug industry is indicating that it is more willing to participate in differential pricing to improve access to its products.

Severin Schwan, chief executive officer of Roche, the world’s fifth largest drug company, told a drug and biotechnology industry conference organised by the Financial Times and held in London on 5-6 December that one of the big trends he expects to occur in the future is the use of differentiated rather than uniform pricing.

Pricing can be differentiated according to countries’ needs and ability to pay and also, more challengingly, between patients of different socioeconomic status in the same country.

The industry has always been a bit nervous about differential pricing, and the practice is not widespread. This is mainly because companies are worried that more lowly priced products will flow back to high income countries, the source of most companies’ profits. The industry is also concerned about the practice of external …
306 RELATION OF INSULIN RESISTANCE AND HEPATIC STEATOSIS WITH ADVANCED HEPATIC FIBROSIS IN PATIENTS WITH GENOTYPE 1 OR 2/3 CHRONIC HEPATITIS C
Authors: A. Thompson, M. Grigorescu, R. Flisiak, A. Horban, M. Buti, V. Rehak, K. Han, R. Safadi, M. Cho, M. Torbenson, G. Subramanian, J. McHutchison
Journal: Journal of Hepatology (2010)
A Prospective, Observational Study of Postmenopausal Hormone Therapy and Primary Prevention of Cardiovascular Disease
Authors: Francine Grodstein
Journal: Annals of Internal Medicine (2000)

Background: Most primary prevention studies have found that long-term users of postmenopausal hormone therapy are at lower risk for coronary events, but numerous questions remain. An adverse influence of hormone therapy on cardiovascular risk has been suggested during the initial year of use; however, few data are available on short-term hormone therapy. In addition, the cardiovascular effects of daily doses of oral conjugated estrogen lower than 0.625 mg are unknown, and few studies have examined estrogen plus progestin in this regard. Objective: To investigate duration, dose, and type of postmenopausal hormone therapy and primary prevention of cardiovascular disease. Design: Prospective, observational cohort study. Setting: Nurses' Health Study, with follow-up from 1976 to 1996. Patients: 70 533 postmenopausal women, in whom 1258 major coronary events (nonfatal myocardial infarction or fatal coronary disease) and 767 strokes were identified. Measurements: Details of postmenopausal hormone use were ascertained by using biennial questionnaires. Cardiovascular disease was established by using a questionnaire and was confirmed by medical record review. Logistic regression models were used to calculate relative risks and 95% CIs, adjusted for confounders. Results: When all cardiovascular risk factors were considered, the risk for major coronary events was lower among current users of hormone therapy, including short-term users, compared with never-users (relative risk, 0.61 [95% CI, 0.52 to 0.71]). Among women taking oral conjugated estrogen, the risk for coronary events was similarly reduced in those currently taking 0.625 mg daily (relative risk, 0.54 [CI, 0.44 to 0.67]) and those taking 0.3 mg daily (relative risk, 0.58 [CI, 0.37 to 0.92]) compared with never-users. However, the risk for stroke was statistically significantly increased among women taking 0.625 mg or more of oral conjugated estrogen daily (relative risk, 1.35 [CI, 1.08 to 1.68] for 0.625 mg/d and 1.63 [CI, 1.18 to 2.26] for ≥ 1.25 mg/d) and those taking estrogen plus progestin (relative risk, 1.45 [CI, 1.10 to 1.92]). Overall, little relation was observed between combination hormone therapy and risk for cardiovascular disease (major coronary heart disease plus stroke) (relative risk, 0.91 [CI, 0.75 to 1.11]). Conclusions: Postmenopausal hormone use appears to decrease risk for major coronary events in women without previous heart disease. Furthermore, 0.3 mg of oral conjugated estrogen daily is associated with a reduction similar to that seen with the standard dose of 0.625 mg. However, estrogen at daily doses of 0.625 mg or greater and in combination with progestin may increase risk for stroke.
Acute Effects of Elevation of Coronary Sinus Pressure
Authors: RICHARD W. ECKSTEIN, J. CARL HORNBERGER, TOYOMI SANO
Journal: Circulation (1953)

The acute physiologic effects of the aorta to coronary sinus anastomosis of Beck have been studied. The evidence presented shows that arterialization of the coronary sinus results in a small retrograde flow from the sinus through capillaries into the occluded artery and that such retrograde flow supplies from 14 to 25 per cent of the normal myocardial oxygen requirement. It is suggested that this is insufficient to maintain normal myocardial contraction, but probably prevents ventricular fibrillation. However, when the sinus is arterialized in the presence of normal or reduced coronary flow electrocardiographic and coronary inflow data show that there is myocardial anoxia. This is probably due to the restriction in capillary outflow and results in an expansion of the coronary vascular bed.
Regulatory T-Cell Impairment in Cystic Fibrosis Patients with Chronic <i>Pseudomonas</i> Infection
Authors: Andreas Hector, Heike Schäfer, Simone Pöschel, Alexandra Fischer, Benedikt Fritzsching, Anjali Ralhan, Melanie Carevic, Hasan Öz, Sabine Zundel, Michael Hogardt, Martina Bakele, Nikolaus Rieber, Joachim Riethmueller, Ute Graepler-Mainka, Mirjam Stahl, Annika Bender, Julia-Stefanie Frick, Marcus Mall, Dominik Hartl
Journal: American Journal of Respiratory and Critical Care Medicine (2015)

Patients with cystic fibrosis (CF) lung disease have chronic airway inflammation driven by disrupted balance of T-cell (Th17 and Th2) responses. Regulatory T cells (Tregs) dampen T-cell activation, but their role in CF is incompletely understood.To characterize numbers, function, and clinical impact of Tregs in CF lung disease.Tregs were quantified in peripheral blood and airway samples from patients with CF and from lung disease control patients without CF and healthy control subjects. The role of Pseudomonas aeruginosa and CF transmembrane conductance regulator (CFTR) in Treg regulation was analyzed by using in vitro and murine in vivo models.Tregs were decreased in peripheral blood and airways of patients with CF compared with healthy controls or lung disease patients without CF and correlated positively with lung function parameters. Patients with CF with chronic P. aeruginosa infection had lower Tregs compared with patients with CF without P. aeruginosa infection. Genetic knockout, pharmacological inhibition, and P. aeruginosa infection studies showed that both P. aeruginosa and CFTR contributed to Treg dysregulation in CF. Functionally, Tregs from patients with CF or from Cftr(-/-) mice were impaired in suppressing conventional T cells, an effect that was enhanced by P. aeruginosa infection. The loss of Tregs in CF affected memory, but not naive Tregs, and manifested gradually with disease progression.Patients with CF who have chronic P. aeruginosa infection show an age-dependent, quantitative, and qualitative impairment of Tregs. Modulation of Tregs represents a novel strategy to rebalance T-cell responses, dampen inflammation, and ultimately improve outcomes for patients with infective CF lung disease.
Laminectomy for Spinal Injury Criticized
Authors: Harry Hahn
Journal: JAMA (1970)

<h3>To the Editor.—</h3> I have just read the article, "Routine Laminectomy for Spinal Injury Criticized," in the MEDICAL NEWS section ofThe Journal(<b>211</b>:913, 1970). I would like to say, "Hear! Hear!," and hope to see more articles of this type in the literature. There is probably no injury that more severely disrupts normal body physiology than a cervical cord injury and the loss of spine stability. Only one more neurological segment due laminectomy can make a world of difference in the rehabilitation and functioning of the disabled individual. It appears to me that many laminectomies are done, not on firm clinical indications, but rather due to an aspect of human nature, ie, many times it is harder to do nothing, than it is to do something. I would like to call your readers' attention to "The Value of Postural Reduction in the Initial Management of Closed Injuries of