tbuckley/cabot-search huggingface dataset:
Physicians’ Diagnostic Accuracy, Confidence, and Resource Requests
Authors: Ashley N. D. Meyer, Velma L. Payne, Derek W. Meeks, Radha Rao, Hardeep Singh
Journal: JAMA Internal Medicine (2013)

IMPORTANCELittle is known about the relationship between physicians' diagnostic accuracy and their confidence in that accuracy.OBJECTIVE To evaluate how physicians' diagnostic calibration, defined as the relationship between diagnostic accuracy and confidence in that accuracy, changes with evolution of the diagnostic process and with increasing diagnostic difficulty of clinical case vignettes. DESIGN, SETTING, AND PARTICIPANTSWe recruited general internists from an online physician community and asked them to diagnose 4 previously validated case vignettes of variable difficulty (2 easier; 2 more difficult).Cases were presented in a web-based format and divided into 4 sequential phases simulating diagnosis evolution: history, physical examination, general diagnostic testing data, and definitive diagnostic testing.After each phase, physicians recorded 1 to 3 differential diagnoses and corresponding judgments of confidence.Before being presented with definitive diagnostic data, physicians were asked to identify additional resources they would require to diagnose each case (ie, additional tests, second opinions, curbside consultations, referrals, and reference materials).MAIN OUTCOMES AND MEASURES Diagnostic accuracy (scored as 0 or 1), confidence in diagnostic accuracy (on a scale of 0-10), diagnostic calibration, and whether additional resources were requested (no or yes).RESULTS A total of 118 physicians with broad geographical representation within the United States correctly diagnosed 55.3% of easier and 5.8% of more difficult cases (P < .001).Despite a large difference in diagnostic accuracy between easier and more difficult cases, the difference in confidence was relatively small (7.2 vs 6.4 out of 10, for easier and more difficult cases, respectively) (P < .001)and likely clinically insignificant.Overall, diagnostic calibration was worse for more difficult cases (P < .001)and characterized by overconfidence in accuracy.Higher confidence was related to decreased requests for additional diagnostic tests (P = .01);higher case difficulty was related to more requests for additional reference materials (P = .01).CONCLUSIONS AND RELEVANCE Our study suggests that physicians' level of confidence may be relatively insensitive to both diagnostic accuracy and case difficulty.This mismatch might prevent physicians from reexamining difficult cases where their diagnosis may be incorrect.
Ian Campbell Roddie
Authors: P. Froggatt, M. Roddie, W. Wallace
Journal: BMJ (2011)

Ian Campbell Roddie was an innovative physiologist whose classic work on peripheral vascular dynamics and lymphatic circulation is still widely quoted. A lucid and inspirational teacher, he was also a deep thinker on medical education, and his pioneering work on instruction and assessment methods stimulated timely debate and remains relevant. Not least, he was an efficient enabling administrator and a decisive executive.

Ian Roddie was born the third of four medical sons of a local Methodist minister. He entered Queen’s from Methodist College, Belfast, in 1946 graduating MB, BCh, BAO in 1953, having previously taken a BSc in physiology (1950, first class honours). He won the Malcolm exhibition in 1951 and, in 1953, the McQuitty scholarship at the Royal Victoria Hospital, Belfast, the major teaching hospital associated with Queen’s. After house appointments at the Royal Victoria he joined Professor David Greenfield’s research team at Queen’s—working with J T Shepherd (later to be chairman of the Mayo Foundation), R F Whelan (later to be vice chancellor of the Universities of Western Australia and then of Liverpool), and W E Glover (later to be dean of the faculty of medicine at the University of New South Wales)—researching the nervous control of peripheral blood vessels, which Greenfield and his predecessor in the Dunville chair, Henry Barcroft, had pioneered. This led to many publications, an MD (with gold medal) in 1957, a Harkness Commonwealth Fund fellowship to the University of Washington in Seattle (1960-1), and a DSc (QUB, 1962) on his return. When he succeeded Greenfield in 1964 he was leading major research into the effect of mental stress and thermoregulation on the peripheral circulation, …
2014 Presidential Address: Stop Diabetes—It Is Up to Us
Authors: Elizabeth R. Seaquist
Journal: Diabetes Care (2015)

This address was delivered by Elizabeth R. Seaquist, MD, President, Medicine & Science, of the American Diabetes Association (ADA) at the Association's 74th Scientific Sessions in San Francisco, CA, on 15 June 2014. Dr. Seaquist is a professor of medicine at the University of Minnesota in Minneapolis, where she holds the Pennock Family Chair in Diabetes Research. She has been an ADA volunteer since 1987 and has served on several national committees and chaired the Association's workgroup on Hypoglycemia in Diabetes. At the local level, she served a 2-year term as cochair of the ADA EXPO in Minneapolis. Dr. Seaquist is a clinical investigator interested in the complications of diabetes. Her research focuses on the effect of diabetes on brain metabolism structure and function. She directs the University of Minnesota site for the Action to Control Cardiovascular Risk in Diabetes (ACCORD) and Glycemia Reduction Approaches in Diabetes: A Comparative Effectiveness Study(GRADE) trials and has an active clinical practice. She was the 2009 recipient of the ADA's Distinguished Clinical Scientist Award. Dr. Seaquist holds a Bachelor of Arts degree from Vassar College in Poughkeepsie, NY, and a doctorate in medicine from the University of Minnesota. She is board certified in internal medicine and endocrinology, diabetes, and metabolism. The ADA and Diabetes Care thank Dr. Seaquist for her outstanding leadership and service to the Association.
INCREASE IN THE INCIDENCE OF ACUTE CORONARY SYNDROME AFTER THE 2011 EAST JAPAN NATURAL DISASTER: CONCORDANCE WITH SEQUENTIAL QUAKE SHOCKS
Authors: Masanobu Niiyama, Fumitaka Tanaka, Kenyu Sato, Toshiyuki Onoda, Tomohiro Takahashi, Toshie Segawa, Miho Honma, Motoyuki Nakamura
Journal: Journal of the American College of Cardiology (2013)
Interindividual Variability in Modeling Exposure and Toxicokinetics: A Case Study on Cadmium.
Authors: W Slob, E Krajnc
Journal: Environmental Health Perspectives (1994)

This case study on cadmium illustrates a methodological framework for modeling the relation between external and internal dose in which interindividual variability is an integral component. The interindividual variability in intake of cadmium together with the variability in organ weights cannot explain the interindividual variability in internal doses. Therefore, variation in physiology was taken into account as well by assuming that some of the parameters of the toxicokinetic model are stochastic. This "second-order" modeling approach enables the prediction of internal dose distributions relating to the population, as opposed to "first-order" modeling, in which only the internal dose of the average individual is predicted. In the case of cadmium, where the critical internal concentration (in the kidney) is relatively well known, the fraction of the population at risk can be derived immediately. The use of this modeling framework to estimate risks for specific risk groups, defined by (combinations of) specific risk factors, is illustrated.
Hepatitis C: Watch for the Many or Treat for the Few?
Authors: Stewart Rogers
Journal: JAMA (1996)

<h3>To the Editor.</h3> —In the Clinical Crossroads article on asymptomatic hepatitis C infection,<sup>1</sup>there seems to be a disjunction between the initial statistics on this epidemic disorder and the main thrust of the management advice. Dr Sorrell states that 3.5 million Americans have chronic hepatitis C while 8000 to 10 000 die of it annually. Even adding in the 1000 annual liver transplants attributed to hepatitis C, the ultimate bad outcome rate is 11000 a year. Even if we assume that the new ability to test blood donations will prevent further accretion to this vast reservoir of cases, in 30 years only 9% of the 3.5 million will develop end-stage disease or hepatoma. This is corroborated by the article by Seeff et al,<sup>2</sup>which Dr Sorrell cites and then seems to ignore, that shows no effect of non-A, non-B hepatitis on 18-year total mortality and only the slightest
Premiums for employer sponsored insurance rise 4-5% in the US
Authors: M. McCarthy
Journal: BMJ (2013)

Annual premiums for employer sponsored health insurance in the United States rose 4% for family coverage and 5% for individuals last year, a survey has found. Family cover now costs an average of $16 351 (£10 483; €12 265) and individual cover $5884.1

Although the increases outstripped the rate of general inflation (1.1%) and the increase of wages (1.8%), the rise in premiums was much lower than it has been over the past decade, which saw family premiums more than double.

The annual survey was conducted by the Kaiser Family Foundation and the Health Research and Educational Trust, a research group affiliated with the American Hospital Association.

The researchers found that premiums increased at modest levels, consistent with the last several years, and that coverage and offer rates did not change …
Failure of partial hypophysectomy as definitive treatment in cushing’s disease owing to nodular corticotrope hyperpiasia; report of four cases
Authors: Luiz R. Salgado, Berenice B. MendonÇa, Jayme Goldman, Mauro Semer, Mirta Knoepfelmacher, Ana M. Tsanaclis, Bernardo L Wajchenberg, Bernardo Liberman
Journal: Endocrine Pathology (1995)
Duodenal involvement in Gardner's syndrome
Authors: R. N. Melmed, I. A. D. Bouchier
Journal: Gut (1972)

It is suggested that duodenal polyps are more frequent in Gardner9s syndrome than previously recognized. The polyps have a particular tendency to undergo malignant change. Two patients with Gardner9s syndrome are reported in whom duodenal polyps were associated in one patient with periampullary cancer and in the other with a possible adenocarcinoma of the duodenum.
Cryptic or mystic? Glacial tree refugia in northern Europe
Authors: P.C. Tzedakis, B.C. Emerson, G.M. Hewitt
Journal: Trends in Ecology & Evolution (2013)

Here, we examine the evidence for tree refugia in northern Europe during the Late Pleniglacial (LPG) interval of maximum tree-range contraction. Our review highlights the often equivocal nature of genetic data and a tendency to overestimate potential tree distributions due to warm climate-model bias, and also reveals a convergence of macrofossil and pollen evidence. What emerges is the absence of temperate trees north of 45°N and a west-east (W-E) asymmetry in boreal tree distribution, with a treeless Western Europe north of 46°N, while restricted boreal populations persisted in Eastern Europe up to 49°N, and higher latitudes east of the Fennoscandian ice-sheet. These results have implications for current thinking on European genetic diversity patterns, species migration capacity, and conservation strategies.
Mr. Ernest Hart Replies to Dr. Hammond.
Authors: Ernest Hart
Journal: JAMA (1893)

<h3>To the Editor:</h3> —My respect for and my sympathy with the medical profession in America, and my knowledge of their sentiments, forbid me to regard Dr. William A. Hammond as their representative in the defense which he puts forward in the columns of the<i>New York Medical Journal</i>, Sept. 16, of the practices of publicity hunting, by newspaper interviews, newspaper portraits and of the use of and traffic in secret preparations, etc. I have in the course of recent travel received personally from many hundreds of prominent and representative physicians in Milwaukee, Washington, Boston, Philadelphia, Chicago, Cincinnati, Detroit, and from all parts of the United States, their cordial congratulations on the tone and substance of the addresses which I had the honor to deliver at Milwaukee and Washington. I have been assured on all hands of the entire sympathy of the great body of the profession in the views therein
Asymptomatic microscopic haematuria.
Authors: N Bullock
Journal: BMJ (1986)

escaped the committee-namely, the appointment ofmedical epidemiologists, appropriately trained and with adequate support staff, to take local responsibility for the ascertainment, prevention, and control of all disease whether infec- tious or not.This task is important enough for them not to be encumbered by administrative or other duties.The timely setting up by the Secretary of State of an inquiry into the future development of the public health functions under the chairmanship of the Chief Medical Officer, Dr Donald Acheson, will no doubt consider this need-and, we hope, begin a revival of British public health.
Protection of Man from Natural Infection with Influenza A2 Hong Kong Virus by Amantadine: A Controlled Field Trial
Authors: N. Oker-Blom, T. Hovi, P. Leinikki, T. Palosuo, R. Pettersson, J. Suni
Journal: BMJ (1970)

Prophylactic administration of amantadine in doses of 100 mg. twice a day offered statistically significant protection against influenza A2 infection in a double-blind field trial involving 391 medical student volunteers during the influenza A2 Hong Kong epidemic in Helsinki in the winter of 1969. Serologically verified influenza, as measured by complement fixation and/or haemagglutination inhibition, occurred in 27 out of 192 students in the amantadine group against 57 out of 199 in the placebo group, giving a protection rate of 52%.
Varicose Veins, Deep Vein Thrombosis, and Haemorrhoids: Epidemiology and Suggested Aetiology
Authors: D. P. Burkitt
Journal: BMJ (1972)

Current concepts on the aetiology of varicose veins, deep vein thrombosis, and haemorrhoids have been examined and, in the light of epidemiological evidence, found wanting.It is suggested that the fundamental cause of these disorders is faecal arrest which is the result of a low-residue diet.
Successful Transition From Insulin to Sulfonylurea Therapy in a Patient With Monogenic Neonatal Diabetes Owing to a KCNJ11 P333L Mutation. Diabetes Care 2013;36:e201
Authors: K. Q. Philla, A. J. Bauer, K. S. Vogt, S. A. W. Greeley
Journal: Diabetes Care (2014)

In the print version of the article listed above, the abbreviation of phenylalanine (Phe) as P is not correct. The “P333L” mutation should have read “F333L.” The online version reflects these changes.
Abstract C26: Molecular determinants of the intravasation step in cancer metastasis
Authors: Elena I. Deryugina, James P. Quigley
Journal: Cancer Research (2013)

Abstract Intravasation, the directional entry of primary tumor cells into host vasculature, remains the most understudied step in the metastatic cascade, likely due to deficiency in models recapitulating the intravasation process and allowing for molecular probing and intervention in vivo. By employing chick embryo models of spontaneous metastasis, where human tumor cells form microtumors and disseminate into secondary tissues strictly via an angiogenic vasculature, we have identified several rate-limiting processes and critical molecules of tumor and host origin, which functionally contribute to intravasation. We have demonstrated that the induction of an intravasation-sustaining tumor microenvironment involves tumor-produced cytokines, including IL-8 that triggers the influx of neutrophils into developing primary tumors. These inflammatory neutrophils deliver a potent pro-angiogenic protease, TIMP-1-free MMP-9, which releases stroma-bound angiogenic factors such as FGF-2 and VEGF. In addition, our recent findings indicate that M2-polarized macrophages also produce TIMP-1-deficient MMP-9, which explains the high angiogenic potential of this sub-type of inflammatory cells. Whereas host inflammatory cell MMP-9 promotes tumor angiogenesis, one of the tumor-produced MMPs, namely MMP-1, appears to regulate the microarchitecture of intratumoral vasculature. We have demonstrated that carcinoma cell MMP-1 facilitates tumor cell intravasation by specific induction of vascular permeability via activation of PAR1 expressed on the angiogenic endothelial cells. Finally, we show that intimate interactions between tumor cells and host endothelial cells result in de novo generation of plasmin that cleaves a transmembrane molecule, CDCP1, regulating tumor cell survival and motility signaling, which allows for successful intravasation. Together, our findings illuminate how different proteolytic enzymes, implicated mostly in path-clearing matrix proteolysis and tumor invasion, also orchestrate localized protein modifications and regulate cellular processes leading to, and following the intratumoral intravasation events. Citation Format: Elena I. Deryugina, James P. Quigley. Molecular determinants of the intravasation step in cancer metastasis. [abstract]. In: Proceedings of the AACR Special Conference on Tumor Invasion and Metastasis; Jan 20-23, 2013; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2013;73(3 Suppl):Abstract nr C26.
Suicide rates in young men in England and Wales in the 21st century: time trend study
Authors: Lucy Biddle, Anita Brock, Sara T Brookes, David Gunnell
Journal: BMJ (2008)

To explore trends in suicide in young people to investigate the recent observation that after year on year rises in the 1970s, 1980s, and early 1990s, rates in young men are now declining.Time trend analysis.England and Wales, 1968-2005. Population Men and women aged 15-34 years.Since the 1990s, rates of suicide in young men have declined steadily and by 2005 they were at their lowest level for almost 30 years. This decline is partly because of a reduction in poisoning with car exhaust gas as an increased number of cars have catalytic converters; but there have been declines in suicides from all common methods, including hanging, suggesting a more pervasive effect. Other risk factors for suicide, such as unemployment and divorce, have also decreased. Possible recent reductions in alcohol use among young men and increases in prescribing of antidepressants do not seem to be temporally related to the decline in suicide.Suicide rates in young men have declined markedly in the past 10 years in England and Wales. Reductions in key risk factors for suicide, such as unemployment, might be contributing to lower rates.
Thymic Stromal Lymphopoietin-Mediated Extramedullary Hematopoiesis Promotes Allergic Inflammation
Authors: Mark C. Siracusa, Steven A. Saenz, Elia D. Tait Wojno, Brian S. Kim, Lisa C. Osborne, Carly G. Ziegler, Alain J. Benitez, Kathryn R. Ruymann, Donna L. Farber, Patrick M. Sleiman, Hakon Hakonarson, Antonella Cianferoni, Mei-Lun Wang, Jonathan M. Spergel, Michael R. Comeau, David Artis
Journal: Immunity (2013)
Dyslexia as Cause of Psychiatric Disorder in Adults
Authors: W. A. Saunders, M. G. Barker
Journal: BMJ (1972)

A few patients may be of normal intelligence but have difficulties in reading, writing, and spelling, which are the main precipitants of a psychiatric disorder. In seven patients this illiteracy emerged only after intensive examination, as they had hidden it from employers, friends, and children. Characteristically these patients are often very sensitive about this disability and marital friction is common. They are also often noticeably resistant to remedial help.
Local delivery of an antithrombin inhibits platelet-dependent thrombosis.
Authors: N A Scott, G L Nunes, S B King, L A Harker, S R Hanson
Journal: Circulation (1994)

BACKGROUND Platelet-dependent thrombosis can be effectively inhibited by intravenous administration of direct thrombin antagonists. However, an increased propensity for abnormal bleeding has been associated with systemic administration of these agents. The goal of this study was to determine whether local delivery of a potent thrombin inhibitor, D-Phe-L-Pro-L-Arg chloromethyl ketone (PPACK), could inhibit platelet-dependent thrombosis without altering systemic hemostatic function. METHODS AND RESULTS Thrombus formation was measured by quantitative imaging of 111In-labeled platelet deposition on segments of thrombogenic vascular graft interposed in arteriovenous shunts in a porcine model. Intravenous administration of PPACK inhibited platelet deposition at a dose of 12.5 micrograms/kg per minute, which was associated with significant prolongations of both template bleeding times and activated partial thromboplastin times. By contrast, local infusion of PPACK at a dose of 0.02 micrograms/kg per minute (ie, a 600-fold smaller dose) into the fluid boundary layer at the interface between flowing blood and the thrombogenic segment produced equivalent inhibition of platelet deposition without prolonging either the bleeding time or the activated partial thromboplastin time. In addition, static exposure of a mural thrombus to solutions of PPACK at concentrations &gt; or = 2.5 mg/mL for 15 minutes produced sustained inhibition of platelet-dependent thrombosis with no change in hemostatic measurements. CONCLUSIONS These results indicate that local delivery of the direct antithrombin PPACK, by either boundary layer infusion or static application techniques, effectively inhibits platelet-dependent thrombosis at doses that are several orders of magnitude less than the systemic dose required for an equivalent antithrombotic effect. In contrast to the systemic administration of PPACK, local delivery produced maximal inhibition of thrombosis without alterations in hemostasis.
Acute Metabolic Influences on the Natriuretic Peptide System in Humans
Authors: Pankaj Arora, Connie Wu, Tariq Hamid, Garima Arora, Obiajulu Agha, Kaitlin Allen, Robert E.T. Tainsh, Dongjian Hu, Romy A. Ryan, Ibrahim J. Domian, Emmanuel S. Buys, Donald B. Bloch, Sumanth D. Prabhu, Kenneth D. Bloch, Christopher Newton-Cheh, Thomas J. Wang
Journal: Journal of the American College of Cardiology (2016)
International cross-cultural field validation of an European Organization for Research and Treatment of Cancer questionnaire module for patients with primary liver cancer, the European Organization for Research and Treatment of Cancer quality-of-life ques
Authors: Wei-Chu Chie, Jane M. Blazeby, Chin-Fu Hsiao, Herng-Chia Chiu, Ronnie T. Poon, Naoko Mikoshiba, Gillian Al-Kadhimi, Nigel Heaton, Jozer Calara, Peter Collins, Katharine Caddick, Anna Costantini, Valerie Vilgrain, Ludovic Trinquart, Chieh Chiang
Journal: Hepatology (2011)

This international field validation study examined the psychometric properties and clinical validity of the European Organization for Research and Treatment of Cancer (EORTC) questionnaire module for hepatocellular carcinoma (HCC), the EORTC quality-of-life questionnaire (QLQ)-HCC18. The EORTC QLQ-HCC18 was administered with the core questionnaire, the EORTC QLQ-C30, to 272 patients from seven centers in 6 countries. Patient acceptability of the module was examined with a debriefing questionnaire, and psychometric and clinical properties were assessed. Multitrait scaling analyses confirmed the hypothesized scale structure without any scaling error, and the fatigue scale demonstrated satisfactory internal consistency. The test-retest reliability scores were high for all scales, except abdominal swelling and sexual interest. The correlations between all scales of the QLQ-HCC18 and the QLQ-C30 were low or moderate, and many scales could distinguish patients with different clinical conditions. The module demonstrated responsiveness to clinical change in pain before and after surgery and some borderline change in patients undergoing systemic treatment.The EORTC QLQ-HCC18 can be used as a supplementary module for the EORTC QLQ-C30 in clinical trials for patients with HCC.
Incidence and predictors of hepatocellular carcinoma in Caucasian chronic hepatitis B patients receiving entecavir or tenofovir
Authors: George V. Papatheodoridis, George N. Dalekos, Cihan Yurdaydin, Maria Buti, John Goulis, Pauline Arends, Vana Sypsa, Spilios Manolakopoulos, Giampaolo Mangia, Nikolaos Gatselis, Onur Keskın, Savvoula Savvidou, Bettina E. Hansen, Christos Papaioannou, Kostantinos Galanis, Ramazan Idilman, Massimo Colombo, Rafael Esteban, Harry L.A. Janssen, Pietro Lampertico
Journal: Journal of Hepatology (2014)