tbuckley/cabot-search huggingface dataset:
Effectiveness of a Selective, Personality-Targeted Prevention Program for Adolescent Alcohol Use and Misuse
Authors: Patricia J. Conrod, Maeve O’Leary-Barrett, Nicola Newton, Lauren Topper, Natalie Castellanos-Ryan, Clare Mackie, Alain Girard
Journal: JAMA Psychiatry (2013)

Selective school-based alcohol prevention programs targeting youth with personality risk factors for addiction and mental health problems have been found to reduce substance use and misuse in those with elevated personality profiles.To report 24-month outcomes of the Teacher-Delivered Personality-Targeted Interventions for Substance Misuse Trial (Adventure trial) in which school staff were trained to provide interventions to students with 1 of 4 high-risk (HR) profiles: anxiety sensitivity, hopelessness, impulsivity, and sensation seeking and to examine the indirect herd effects of this program on the broader low-risk (LR) population of students who were not selected for intervention.Cluster randomized controlled trial.Secondary schools in London, United Kingdom.A total of 1210 HR and 1433 LR students in the ninth grade (mean [SD] age, 13.7 [0.33] years).Schools were randomized to provide brief personality-targeted interventions to HR youth or treatment as usual (statutory drug education in class).Participants were assessed for drinking, binge drinking, and problem drinking before randomization and at 6-monthly intervals for 2 years.Two-part latent growth models indicated long-term effects of the intervention on drinking rates (β = -0.320, SE = 0.145, P = .03) and binge drinking rates (β = -0.400, SE = 0.179, P = .03) and growth in binge drinking (β = -0.716, SE = 0.274, P = .009) and problem drinking (β = -0.452, SE = 0.193, P = .02) for HR youth. The HR youth were also found to benefit from the interventions during the 24-month follow-up on drinking quantity (β = -0.098, SE = 0.047, P = .04), growth in drinking quantity (β = -0.176, SE = 0.073, P = .02), and growth in binge drinking frequency (β = -0.183, SE = 0.092, P = .047). Some herd effects in LR youth were observed, specifically on drinking rates (β = -0.259, SE = 0.132, P = .049) and growth of binge drinking (β = -0.244, SE = 0.073, P = .001), during the 24-month follow-up.Findings further support the personality-targeted approach to alcohol prevention and its effectiveness when provided by trained school staff. Particularly novel are the findings of some mild herd effects that result from this selective prevention program.clinicaltrials.gov Identifier: NCT00776685.
The Effects of Nuclear Weapons
Authors: Marshall Brucer
Journal: JAMA (1962)

<b>The Atomic Bomb Casualty Commission; The First Fourteen Years</b>. By R. K. Cannan. News Report XII (no. 1): 1-7 Jan.-Feb., 1962. National Academy of Sciences, National Research Council, 2101 Constitution Ave., N.W., Washington 25, D.C. This is a peculiar book review because it reviews an encyclopedic government report and an article summarizing 2,409 articles and 14 years of hard work. When<i>The Effects of Atomic Weapons</i>was first issued in 1957, it was based upon 1950 data on 1945 atom bombs. It contained everything known about "big" explosions and guessed at the rest. The decision to revise was made during the weapons-test moratorium, and was based upon the acquisition of facts rather than upon the necessity for guesses. Also, the word "big" had shifted from kilotons to megatons. Generally, the book is written nontechnically, but gives a highly technical description of nuclear explosions. The problems of air blast, thermal irradiation,
MATERNAL MORTALITY IN ROCHDALE: AN ACHIEVEMENT IN A BLACK AREA
Authors: W. H. F. Oxley, M. H. Phillips, J. Young
Journal: BMJ (1935)

Any apparatus designed to wash out bo-wel contents by irrigation will inevitably tend-the more so the more effective the apparatus-to lead to constipation, inasmuch as (1) the normal protective residual debris is thereby washed away, and (2) the natural function of defaccationl is su)p)lanted by artificial means.The glass contrivance shown in the accompanying figure, which differs from those commonly used in irrigationi only in that the vertical limb is curved instea(l of straight, enables the operator to watch the effects of w%!hat he is doinlg, as the tide alternately ebbs and flows before him.By this means he is able to form some idea of the activity and general .. .....
ATRIAL FIBRILLATION IN ASYMPTOMATIC AORTIC STENOSIS: A SIMVASTATIN EZETIMIBE IN AORTIC STENOSIS SUBSTUDY
Authors: Anders M. Greve, Eva Gerdts, Kurt Boman, Christa Gohlke-Baerwolf, Anne B. Rossebø, Lars Køber, Ronnie Willenheimer, Kristian Wachtell
Journal: Journal of the American College of Cardiology (2011)
Diminished Forearm Arteriolar Dilator Capacity Produced by Mineralocorticoid-Induced Salt Retention in Man
Authors: ROBERT ZELIS, DEAN T. MASON
Journal: Circulation (1970)

The mechanism of the increased stiffness of peripheral vessels in patients with congestive heart failure (CHF) is unknown. It was considered that an increased sodium (Na + ) content of peripheral vessels, shown in experimental CHF, might lead to diminished arteriolar dilator capacity. Thus, Na + retention was induced in six normal volunteers by the daily oral administration of 0.2 mg of fludrocortisone acetate (F) and 10 g NaCl for 1 week. This induced a weight increase of 3.1 lb and increased serum Na + and decreased serum potassium concentrations ( P &lt; 0.02). The peak reactive hyperemia blood flow (RHBF) was measured plethysmographically in the forearm before and after treatment. Upon restoration of the circulation after 1, 5, and 10 min of ischemia the peak RHBF was 21.8, 33.1, and 34.9 ml/min/100 ml before administration of F and NaCl but was reduced to 19.6 ( P &gt; 0.2), 28.6 ( P &lt; 0.02), and 24.4 ( P &lt; 0.02) ml/min/100 ml by treatment. Thus, steroid-induced salt retention leads to diminished vascular compliance. Furthermore, it is suggested that increased vascular Na + content is causally related to the vascular stiffness abnormality characterostic of CHF.
The evolutionary route to self-deception: Why offensive versus defensive strategy might be a false alternative
Authors: Ulrich Frey, Eckart Voland
Journal: Behavioral and Brain Sciences (2011)

Abstract Self-deception may be the result of social manipulation and conflict management of social in-groups. Although self-deception certainly has offensive and defensive aspects, a full evolutionary understanding of this phenomenon is not possible until strategies of other parties are included into a model of self-perception and self-representation.
A patient with chest pain and electrocardiographic changes
Authors: J. K. Sarfo-Annin, P. J. Stafford
Journal: BMJ (2013)

A 33 year old white man was admitted to the local coronary care unit with chest pain. Two hours earlier he had developed epigastric pain, which evolved into central chest pain. There had been one episode of vomiting with dizziness, dyspnoea, sweating, and distal paraesthesiae. The pain had resolved by the time he was admitted to the unit.

Physical examination was normal; fig 1⇓ shows the 12 lead electrocardiograph. Transthoracic echocardiography showed normal left ventricular systolic function, with no regional wall motion abnormalities, and normal valve function.



Fig 1 Twelve lead electrocardiograph on admission



Later that day he became nauseated, diaphoretic, and visibly pale. He also had blurred vision, muffled hearing, and tingling in both hands. Chest pain was not present. His systolic blood pressure had dropped to 89 mm Hg and bedside cardiac monitoring showed a pause of three to four seconds with no P wave activity, with a return of spontaneous QRS complexes. Subsequent physical examination was normal.

He later mentioned that his daughter currently had gastroenteritis and that he had been experiencing flu-like symptoms. He had a history of syncope with phlebotomy, but no other vasovagal-type events. His sister had been diagnosed with epilepsy with multiple seizures that were resistant to drugs.



### 1 What condition do the history and admission electrocardiograph suggest, and what is the immediate management?

#### Short answer

The electrocardiograph shows a “coved” type 1 Brugada pattern, which together with the patient’s history is suggestive of Brugada syndrome. Cardiac differential diagnoses include acute coronary syndromes and pericarditis in light of the syncope and fever. Chest pain could also originate from the respiratory system (for example, pulmonary embolus) or gastrointestinal tract …
Saved by tuberculosis
Authors: T. Dalrymple
Journal: BMJ (2011)

It is a startling thought that the population of Renaissance Florence was smaller than that of present day Croydon. I may be mistaken, of course, but I doubt whether tourists, in half a millennium’s time, will flock to Croydon in such numbers that it will be difficult to find accommodation there.

In like fashion, small islands are surprisingly productive of literature. Perhaps this is because they are like culture flasks of human nature. Passions run high in small communities, and where little happens small events are examined with minute attention.

George Mackay Brown (1921–1996) was born in the Orkney Islands and, except for a few years of belated studies in Edinburgh, spent his whole life there. It is said …
How Many Physicians? How Much Does It Matter?
Authors: Thomas C. Ricketts
Journal: JAMA (2009)

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 HomeNew OnlineCurrent IssueFor Authors 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) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More 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 journal
On Lymphokines, Cytokines, and Breakthroughs
Authors: Charles G. Moertel
Journal: JAMA (1986)

Advanced cancer will take the lives of almost half a million Americans this year. Certainly, any claim of therapeutic accomplishment in this area will attract major public interest. In recent times, this interest has been focused on the lymphokines and cytokines, natural substances that man produces as a defense against the diseases that may afflict him. Through ingenious recombinant DNA technologies, these substances can be produced in quantities sufficiently large to permit therapeutic application. Numbered among these are the interferons, tumor necrosis factor, and the interleukins. In this issue ofThe Journal, a group of investigators present a second report<sup>1</sup>of their work with high doses of interleukin 2 (IL-2) used either alone or, as first reported,<sup>2</sup>in combination with lymphokine-activated killer (LAK) cells. Following their first publication, these authors described their work as a "breakthrough"; since this claim bore the imprimatur of the National Cancer Institute, it
Oscillatory Shear Stress Stimulates Adhesion Molecule Expression in Cultured Human Endothelium
Authors: David C. Chappell, Signe E. Varner, Robert M. Nerem, Russell M. Medford, R. Wayne Alexander
Journal: Circulation Research (1998)

Abstract —Low and oscillatory shear stresses are major features of the hemodynamic environment of sites opposite arterial flow dividers that are predisposed to atherosclerosis. Atherosclerosis is a focal inflammatory disease characterized initially by the recruitment of mononuclear cells into the arterial wall. The specific characteristics of the hemodynamic environment that facilitate the generation of arterial inflammatory responses in the presence of, for example, hyperlipidemia are unknown. We show here that prolonged oscillatory shear stress induces expression of endothelial cell leukocyte adhesion molecules, which are centrally important in mediating leukocyte localization into the arterial wall. Vascular cell adhesion molecule-1 was upregulated an average 9-fold relative to endothelial monolayers in static culture. Intercellular adhesion molecule-1 and E-selectin exhibited 11-fold and 7.5-fold increases, respectively. Upregulation of these adhesion molecules was associated with enhanced monocyte adherence. Cytokine stimulation of surface vascular cell adhesion molecule-1 was maximally induced after 6 and 8 hours of cytokine incubation. Oscillatory shear stress for these time periods elicited respective vascular cell adhesion molecule-1 levels of 16% and 30% relative to those observed for cytokine stimulation. Surface intercellular adhesion molecule-1 induction by cytokine stimulation for 24 hours was found to be approximately five times the level detected after 24 hours of oscillatory shear stress. Experiments performed in the presence of the antioxidant N -acetylcysteine demonstrated that the expression of vascular cell adhesion molecule-1 could be almost totally abolished, whereas that of intercellular adhesion molecule-1 was typically reduced by ≈70%. These results imply that oscillatory shear stress per se is sufficient to stimulate mononuclear leukocyte adhesion and, presumptively, migration into the arterial wall. These results further indicate that atherosclerotic lesion initiation is likely related, at least in part, to unique signals generated by oscillatory shear stress and that the mechanism of upregulation is, to some extent, redox sensitive.
The frequency of phospholipase A<sub>2</sub> binding of basophilic granulocytes does not decrease during bee‐venom‐specific immunotherapy
Authors: J Irsch, A Löhndorf, A Radbruch, C König, T Krieg, N Hunzelmann, H Tesch, H Merk, A Radbruch
Journal: Allergy (1999)

The major allergenic component of bee venom is phospholipase A2 (PLA2).In this study, PLA2 was used to analyze and enrich PLA2-binding cells from peripheral blood by high gradient magnetic cell sorting.In normal donors, the frequency of allergen (PLA2)-binding cells among peripheral blood mononuclear cells (PBMC) as determined by flow cytometry is below 0.1%, whereas in bee-venom-allergic patients, PLA2-binding cells are readily detectable at frequencies of up to 2.3%. In severely bee-venom-allergic patients, many basophilic granulocytes are present, as defined by anti-CD9, CD25, and CD38 mAb, comprising up to 95% of the PLA2-binding cells. From blood of allergic and normal donors, about equal absolute numbers of allergen-binding CD19/21-positive B cells can be enriched. Severe anaphylactic reactions (Mueller grade IV) and failure of or adverse reactions during immunotherapy are associated with high numbers of circulating allergen-binding basophils. Interestingly, in the patients studied, the number of PLA2-binding basophilic granulocytes did not markedly change during rush immunotherapy and up to 6 months of maintenance immunotherapy.The specific and reproducible enrichment of PLA2-binding cells provides a new tool for the analysis and monitoring of effector cells in bee-venom-allergic patients with immediate-type hypersensitivity.
T‐lymphocyte subpopulation changes during hemolysis in glucose‐6‐phosphate dehydrogenase (G6PD)‐deficient children
Authors: G. Schilirò, C. Minniti, A. Sciotto, A. Bellino, A. Russo
Journal: American Journal of Hematology (1986)

Abstract Lymphocyte subpopulations were studied by means of sheep red blood cell (SRC)‐rosetting technique and OKT11, OKT3, OKT4, and OKT8 monoclonal antibodies in ten Sicilian glucose‐6‐phosphate dehydrogenase‐deficient children during the hemolytic crisis due to fava bean ingestion. The number of SRC‐rosetting lymphocytes was significantly reduced, while the number of OKT3‐positive cells was normal. An inversion of the OKT4/OKT8 ratio was observed, due to a decrease of OKT4‐positive cells and an increase of OKT8‐positive cells. All these abnormalities reverted to normal in the four children studied after recovery.
Doctors in the House
Authors: J. Warden
Journal: BMJ (1987)

This weekend 31 overtired doctors are having their first rest days for perhaps three or four weeks.Another example of medical under- staffing and overwork?No, these 31 doctors were candidates in the 1987 general election, and they represent not only a possible record total but equally a continuing trend in the politics of medicine.If in successive elections more doctors are prepared to become parliamentary candidates, with all the implications for career change that arise, it must say something about the troubled politics of health and a growing concern among the present generation of practitioners to get closer to the levers of power.Until now, however, more doctor candidates has not meant more medical MPs.The success rate has actually fallen over the past 20 years.From 10 doctors elected in 1964 the complement fell to only five in the last parliament.This column predates last Thursday's poll so the 1987 outcome must await later analysis.But one trend is already clear.Doctors are strongly attracted to the SDP/Liberal Alliance.Of the 31 who were candidates 13 stood for the Alliance parties, compared with six as Conservatives and six Labour.Another six stood for minor parties (including three in Northern Ireland).This indicates a marked shift of medical preference away from the Labour party, which in 1964 was able to field 12 medically qualified candidates, ofwhom seven were elected.That doctors seem most comfortable with the Alliance is put down variously to their independence ofmind, that it has a doctor as joint leader, and the claim of the Alliance to be a "healing force" in society.But they also chose the hard way to get elected.There is the wider question, however, of why a doctor should want to become a member of parliament at all.For barristers it is understandable that they should aspire to become legislators, but in terms of public esteem doctors rank high and politicians low.On an MP's salary of under £20 000 there will probably be a financial loss.Career prospects are uncertain, continued practice is difficult, and
Causes and Consequences of Heart Failure After Prophylactic Implantation of a Defibrillator in the Multicenter Automatic Defibrillator Implantation Trial II
Authors: Ilan Goldenberg, Arthur J. Moss, W. Jackson Hall, Scott McNitt, Wojciech Zareba, Mark L. Andrews, David S. Cannom
Journal: Circulation (2006)

Implantable cardioverter-defibrillator (ICD) therapy may be associated with an increased risk for heart failure (HF). The present study evaluated the frequency, causes, and consequences of HF after ICD implantation.We performed a retrospective analysis of the clinical factors and outcomes associated with postenrollment HF events in 1218 patients enrolled in the Multicenter Automatic Defibrillator Implantation Trial II. The adjusted hazard ratios (HRs) of ICD:conventional therapy for first and recurrent HF events were 1.39 (P=0.02) and 1.58 (P<0.001), respectively. The risk was increased among patients who received single-chamber or dual-chamber ICDs. Development of HF was associated with an increased mortality risk (HR, 3.80; P<0.001). Among patients who received a single-chamber ICD, there was a similar survival benefit before and after the development of HF (HR, 0.59 and 0.61, respectively; P=0.92 for difference), whereas among patients with dual-chamber devices, there was a significant reduction in survival benefit after HF (HR, 0.26 and 0.83, respectively; P=0.01 for difference). Within the defibrillator arm of the trial, patients who received life-prolonging therapy from the ICD had an increased risk for first and recurrent HF events (HR, 1.90; P=0.01 and 1.74; P<0.001, respectively).Patients with chronic ischemic heart disease who are treated with either single-chamber or dual-chamber ICDs have improved survival but an increased risk of HF. The present data suggest that ICD therapy transforms sudden death risk to a subsequent HF risk. These findings should direct more attention to the prevention of HF in patients who receive an ICD.
Mouth pressure in response to magnetic stimulation of the phrenic nerves.
Authors: C H Hamnegaard, S Wragg, D Kyroussis, G Mills, B Bake, M Green, J Moxham
Journal: Thorax (1995)

BACKGROUND--Diaphragm strength can be assessed by the measurement of gastric (TW PGA), oesophageal (TW POES), and transdiaphragmatic (TW PDI) pressure in response to phrenic nerve stimulation. However, this requires the passage of two balloon catheters. A less invasive method of assessing diaphragm contractility during stimulation of the phrenic nerves would be of clinical value. A study was undertaken to determine whether pressure measured at the mouth (TW PM) during magnetic stimulation of the phrenic nerves accurately reflects TW POES, and to investigate the relations between TW PM and TW PDI; and also to see whether glottic closure and twitch potentiation can be avoided during these measurements. METHODS--Eight normal subjects and eight patients with suspected respiratory muscle weakness without lung disease were studied. To prevent glottic closure magnetic stimulation of the phrenic nerves was performed at functional residual capacity during a gentle expiratory effort against an occluded airway incorporating a small leak. TW PDI, TW POES, and TW PM were recorded. Care was taken to avoid potentiation of the diaphragm. RESULTS--In normal subjects mean TW PM was 13.7 cm H2O (range 11.3-16.1) and TW POES was 13.3 cm H2O (range 10.4-15.9) with a mean (SD) difference of 0.4 (0.81) cm H2O. In patients mean TW PM was 9.1 cm H2O (range 0.5-18.2) and TW POES was 9.3 (range 0.7-18.7) with a mean (SD) difference of -0.2 (0.84) cm H2O. The relation between TW PM and TW PDI was less close but was well described by a linear function. In patients with diaphragm weakness (low sniff PDI) TW PM was &lt; 10 cm H2O. CONCLUSIONS--TW PM reliably reflects TW POES and can be used to predict TW PDI in normal subjects and patients without lung disease. TW PM may therefore be a promising non-invasive, non-volitional technique for the assessment of diaphragm strength.
Potential Effects of the "Premium-Support" Proposal on the Security of Medicare
Authors: Barbara Markham Smith
Journal: JAMA (1999)

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 HomeNew OnlineCurrent IssueFor Authors 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) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More 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 journal