tbuckley/cabot-search huggingface dataset:
Analyzing Computer-based Decision Support Systems
Authors: Clement J. McDonald, Siu L. Hui, Xiao-Hua Zhou
Journal: Annals of Internal Medicine (1994)

Letters15 September 1994Analyzing Computer-based Decision Support SystemsClement J. McDonald, Siu L. Hui, and Xiao-Hua ZhouClement J. McDonaldIndiana University School of Medicine, Regenstrief Institute of Health Care, Indianapolis, IN 46202Search for more papers by this author, Siu L. HuiIndiana University School of Medicine, Regenstrief Institute of Health Care, Indianapolis, IN 46202Search for more papers by this author, and Xiao-Hua ZhouIndiana University School of Medicine, Regenstrief Institute of Health Care, Indianapolis, IN 46202Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-121-6-199409150-00017 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:The careful analysis of computer-based decision making by Johnson and colleagues [1] is an important contribution. Although we agree with most of their conclusions, we disagree strongly with two of their criteria for methodologic adequacy.First, they imply by their scoring system that randomization by practice or institution (rather than by patient or physician) is always preferred. Randomization in clinical trials is designed to control bias. Studies of computer-based decision support systems typically require hierarchical, clustered designs with the intervention applied to the physician (computer reminders) and the outcomes measured in patients (for example, delivery of preventive ...References1. Johnson ME, Langton KB, Haynes RB, Mathieu A. Effects of computer-based clinical decision support systems on clinician performance and patient outcomes. Ann Intern Med. 1994; 120:135-42. Google Scholar2. McDonald CJ, Wilson GA, McCabe GP. Physician response to computer reminders. JAMA. 1980; 244:1579-81. Google Scholar3. Liang KY, Zeger SL. Longitudinal data analysis using generalized linear models. Biometrika. 1986; 73:13-22. Google Scholar4. Bryk AS, Raudenbush SW. Hierarchical Linear Models. Newbury Park, California: Sage Publication; 1992. Google Scholar5. Shapiro S. Evidence on screening for breast cancer from randomized trials. Cancer. 1977; 39:2772-82. Google Scholar Author, Article, and Disclosure InformationAffiliations: Indiana University School of Medicine, Regenstrief Institute of Health Care, Indianapolis, IN 46202 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByDesigning, Conducting, and Reporting Clinical Decision Support Studies: Recommendations and Call to ActionKensaku Kawamoto, MD, PhD, MHS and Clement J. McDonald, MD 15 September 1994Volume 121, Issue 6Page: 469KeywordsBlood pressureClinical trialsComputersComputing systemsDecision analysisDecision makingPreventive medicine Issue Published: 15 September 1994 CopyrightCopyright © 1994 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...
Osteochondroma of the Coronoid Process of the Mandible
Authors: Morris H. Levine, James Chessen, William D. McCarthy
Journal: New England Journal of Medicine (1957)

THE occurrence of osteochondroma of the coronoid process of the mandible is rare. A search of the literature reveals only 4 previously reported cases. Addition of another, with a brief discussion of the outstanding features of this condition, therefore seems desirable.Case ReportA 73-year-old female noted that a "lump" had developed on the left side of her face after exposure to cold air more than 30 years before admission on November 22, 1954. This "lump" appeared to increase in size as the years passed. There was progressively increased limitation of jaw motion, which her previous physicians attributed to temporomandibular . . .
Treatment of Shock: Principles and Practice
Authors: Robert W. Hopkins
Journal: JAMA (1975)

This small volume consists principally of a series of essays by a number of well-known investigators in the field of shock. These include Drs. Schumer, Nyhus, and others at the Abraham Lincoln School of Medicine of the University of Illinois, Max Weil and Herbert Shubin of the University of Southern California School of Medicine, Benjamin Rush of the College of Medicine and Dentistry of New Jersey, Robert Wilson of Wayne State University School of Medicine, Robert Hardaway of the William Beaumont General Hospital, John Siegel of State University of New York at Buffalo, and William Stahl of New York University. The essays are of considerable interest in that they reflect the respective authors' thinking about major problems in circulatory shock. These include monitoring, volume replacement, vasoactive drugs, metabolic disorders, infection, and respiratory, cardiac, and renal problems. References provided at the end of each chapter provide an opportunity for the reader
[151] BLOODLESS CADAVERIC LIVER TRANSPLANTATION: EXPERIENCE WITH JEHOVAH'S WITNESS RECIPIENTS
Authors: O. Detry, A. De Roover, C. Coimbra, J.O. Monnard, M.F. Hans, M.H. Delbouille, A. Kaba, J. Joris, J.P. Squifflet, J. Delwaide, M. Meurisse, P. Honore
Journal: Journal of Hepatology (2007)
Breast Cancer in Europe
Authors: Rebecca Voelker
Journal: JAMA (2000)

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
Strokes should be taken as seriously as heart attacks, MPs say
Authors: Adrian O'Dowd
Journal: BMJ (2006)

All strokes should be treated as a medical emergency and taken as seriously as a heart attack, concludes a parliamentary report that says hundreds of stroke patients die needlessly every year.

MPs on the House of Commons Committee of Public Accounts have stressed how important it is that stroke be treated in the same way as heart disease and cancer for lives to be saved and the risk of disability reduced.

The committee, publishing its report into stroke care in England last week, said stroke was one of the top three causes …
835-3 Beta-blocker dose does not influence the beneficial effects of carvedilol compared to metroprolol in the patients with heart failure: Results from the carvedilol or Metoprolol European Trial (COMET)
Authors: Marco Metra, Philip A Poole-Wilson, John G Cleland, Andrea Di Lenarda, Peter Hanrath, Michel Komajda, Jacobus Lubsen, Beatrix Lutiger, Willem J Remme, Armin Scherhag, Andrew Charlesworth, Christian Torp-Pedersen
Journal: Journal of the American College of Cardiology (2004)
Che Guevara: The Antihero
Authors: Lidio O. Mora, B. A. G. Santamarina
Journal: New England Journal of Medicine (1969)

IT has been stated many times that today's youth does not indulge in what once was called hero worship. Some explain this phenomenon mainly by youth's tendency to reject authority, its lack of need to look up to anything or anybody; whereas others say life simply does not produce heroes anymore — ours is the time of the antihero.When we look at the daily pictures of the news media showing the various student riots and demonstrations in all parts of the globe, we cannot help noticing, in the conglomeration of placards, the frequent recurrence of one face, the face . . .
Double-Stranded RNA of Intestinal Commensal but Not Pathogenic Bacteria Triggers Production of Protective Interferon-β
Authors: Tadaomi Kawashima, Akemi Kosaka, Huimin Yan, Zijin Guo, Ryosuke Uchiyama, Ryutaro Fukui, Daisuke Kaneko, Yutaro Kumagai, Dong-Ju You, Joaquim Carreras, Satoshi Uematsu, Myoung Ho Jang, Osamu Takeuchi, Tsuneyasu Kaisho, Shizuo Akira, Kensuke Miyake, Hiroko Tsutsui, Takashi Saito, Ikuko Nishimura, Noriko M. Tsuji
Journal: Immunity (2013)
Clinical and prognostic relevance of serum S‐100β protein in malignant melanoma
Authors: None Schultz, None Diepgen, None Von Den Driesch
Journal: British Journal of Dermatology (1998)

To assess the clinical and prognostic relevance of serum S‐100β in malignant melanoma serum levels of S‐100β protein were measured in 84 patients with malignant melanoma. Using a cut‐off value of 0.3 μg/L the sensitivity was 0% (none of 36) in patients with stage II, 31% (four of 13) in patients with stage III and 69% (24 of 35) in patients with stage IV. In the reference group serum S‐100β was below 0.3 μg/L in all cases (specificity = 100%). A significant correlation existed between serum S‐100β values and clinical staging as well as survival. In patients with distant metastases the serum concentration of S‐100β protein correlated well with the number of affected organs. Serial measurement in these patients revealed that tumour progression was accompanied by rising S‐100β values whereas declining values could only be revealed in one patient with a dramatic clinical response to therapy. Our results suggest that serum S‐100β determination is a useful marker for the evaluation of prognosis in patients with metastatic malignant melanoma and should be included in the clinical staging.
The Hospital — A Look Ahead
Authors: George R. Minot
Journal: New England Journal of Medicine (1947)

CLINICAL investigation has been conducted in the Massachusetts General Hospital with ever-increasing frequency and significance. In the future the hospital will continue to be a leader in such work, which will be developed more than ever before. From research of today come new forms of treatment tomorrow. It is treatment that patients are particularly concerned about. The physician, by investigative means, learns much about the etiology and diagnosis of disease, and investigative studies give information of a wide sort to the physician and the scientist.This type of work is often done in conjunction with medical schools, but the work . . .
Impact of face-washing on trachoma in Kongwa, Tanzania
Authors: S. West, B. Muñoz, M. Lynch, A. Kayongoya, Z. Chilangwa, B.B.O. Mmbaga, H.R. Taylor
Journal: The Lancet (1995)

Observational studies have suggested that the prevalence of trachoma is lower in children with clean faces than in those with ocular or nasal discharge or flies on the face. We carried out a community-based randomised trial in three pairs of villages to assess the impact on trachoma of a face-washing intervention programme following a mass topical antibiotic treatment campaign. Six villages in Kongwa, Tanzania, were randomly assigned mass treatment plus the face-washing programme or treatment only. 1417 children aged 1-7 years in these villages were randomly selected and followed up for trachoma status and observations of facial cleanliness at baseline and 2, 6, and 12 months. At 12 months, children in the intervention villages were 60% more likely to have had clean faces at two or more follow-up visits than children in the control villages. The odds of having severe trachoma in the intervention villages were 0.62 (95% Cl 0.40-0.97) compared with control villages. A clean face at two or more follow-up visits was protective for any trachoma (odds ratio 0.58 [0.47-0.72]) and severe trachoma (0.35 [0.21-0.59]). This community-based participatory approach to face-washing intervention had variable penetration rates in the villages and was labour intensive. However, we found that, combined with topical treatment, community-based strategies for improving hygiene in children in trachoma-endemic villages can reduce the prevalence of trachoma.
Gene Patenting — Is the Pendulum Swinging Back?
Authors: Aaron S. Kesselheim, Michelle M. Mello
Journal: New England Journal of Medicine (2010)

Are human genes and the process of comparing DNA sequences patentable? These questions were raised by a group of researchers, pathologists, patients with cancer, and medical professional organizations challenging some of Myriad Genetics' patents covering the BRCA1 and BRCA2 genes and their use in screening for elevated risks of breast and ovarian cancer. On March 29, in a startling decision, a federal district court judge invalidated many of Myriad's patent claims,1 reigniting a long-simmering debate about the patentability of genes.The Patent Act permits exclusive control for a limited time (currently 20 years) of any “process, machine, manufacture, or composition . . .
Atrogin-1 deficiency promotes cardiomyopathy and premature death via impaired autophagy
Authors: Tania Zaglia, Giulia Milan, Aaron Ruhs, Mauro Franzoso, Enrico Bertaggia, Nicola Pianca, Andrea Carpi, Pierluigi Carullo, Paola Pesce, David Sacerdoti, Cristiano Sarais, Daniele Catalucci, Marcus Krüger, Marco Mongillo, Marco Sandri
Journal: Journal of Clinical Investigation (2014)

Cardiomyocyte proteostasis is mediated by the ubiquitin/proteasome system (UPS) and autophagy/lysosome system and is fundamental for cardiac adaptation to both physiologic (e.g., exercise) and pathologic (e.g., pressure overload) stresses. Both the UPS and autophagy/lysosome system exhibit reduced efficiency as a consequence of aging, and dysfunction in these systems is associated with cardiomyopathies. The muscle-specific ubiquitin ligase atrogin-1 targets signaling proteins involved in cardiac hypertrophy for degradation. Here, using atrogin-1 KO mice in combination with in vivo pulsed stable isotope labeling of amino acids in cell culture proteomics and biochemical and cellular analyses, we identified charged multivesicular body protein 2B (CHMP2B), which is part of an endosomal sorting complex (ESCRT) required for autophagy, as a target of atrogin-1–mediated degradation. Mice lacking atrogin-1 failed to degrade CHMP2B, resulting in autophagy impairment, intracellular protein aggregate accumulation, unfolded protein response activation, and subsequent cardiomyocyte apoptosis, all of which increased progressively with age. Cellular proteostasis alterations resulted in cardiomyopathy characterized by myocardial remodeling with interstitial fibrosis, with reduced diastolic function and arrhythmias. CHMP2B downregulation in atrogin-1 KO mice restored autophagy and decreased proteotoxicity, thereby preventing cell death. These data indicate that atrogin-1 promotes cardiomyocyte health through mediating the interplay between UPS and autophagy/lysosome system and its alteration promotes development of cardiomyopathies.
Toll-like receptor 2 ligands promote chronic atopic dermatitis through IL-4–mediated suppression of IL-10
Authors: Susanne Kaesler, Thomas Volz, Yuliya Skabytska, Martin Köberle, Ulrike Hein, Ko-Ming Chen, Emmanuella Guenova, Florian Wölbing, Martin Röcken, Tilo Biedermann
Journal: Journal of Allergy and Clinical Immunology (2014)
GMC takes racial discrimination seriously
Authors: L. Beecham
Journal: BMJ (1997)

The General Medical Council (GMC) is determined to give a lead to the medical profession in fighting racial bias and has already made several changes in the way that it handles complaints and other information it receives about doctors.

Earlier this year the council accepted in full the recommendations of its racial equality group, and last week the council received a report on the progress that had been made. The group had commissioned the Policy …
English NHS waiting times: what next?
Authors: Anthony J Harrison, John Appleby
Journal: Journal of the Royal Society of Medicine (2009)

The introduction of the 18-week maximum waiting time target in the English NHS in 2004 represented a major step towards a rational approach to waiting times. Imposing an ‘end-to-end’ target – as had previously been defined only for cancer – meant that patients' actual experience of waiting, from referral by their GP via outpatients and diagnostics, through inpatient waiting and treatment in hospital, was fully taken into account.

In 2006 Lewis and Appleby asked whether the 18-week target would be achieved by the end of 2008.1 Their answer was optimistic, and now, nearly two years later, it appears that the NHS as a whole will meet the target.2 This has been a substantial achievement for a healthcare service in which many believed waiting was not just a necessary rationing mechanism, but an inevitability.3 The question Lewis and Appleby posed was should and could waiting times be reduced even further? In this article we expand on the options noted by Lewis and Appleby for making further reductions.
Inhibition of extracellular nucleotides hydrolysis intensifies the allergic bronchospasm. A novel protective role of ectonucleotidases
Authors: J. Chávez, M. H. Vargas, D. C. Rebollar‐Ayala, V. Díaz‐Hernández, J. E. Cruz‐Valderrama, E. Flores‐Soto, M. Flores‐García, N. N. Jiménez‐Vargas, C. Barajas‐López, L. M. Montaño
Journal: Allergy (2013)

Abstract Background Nucleotides released to the extracellular space stimulate purinergic receptors, and their effects are modulated by ectonucleotidases. The role of ATP in the allergic bronchospasm has been scantly studied. Methods We used several techniques (plethysmography, organ baths, confocal microscopy, RT ‐ PCR , ATP measurement) to explore the role of nucleotides and ectonucleotidases in the allergic bronchospasm in guinea pigs. Results While allergenic challenge with a low‐dose ovalbumin (OVA) only produced a small bronchospasm (~2‐fold the basal lung resistance), previous inhibition of ectonucleotidases by ARL‐67156 greatly intensified this response (~11‐fold the basal lung resistance, with 44% mortality). Bronchoalveolar lavage fluid obtained during this bronchospasm contained increased ATP concentration. This potentiation was abolished by antagonism of purinergic receptors (suramin+RB2) or TXA 2 receptor (SQ29548), or by intratracheal apyrase. In tracheal rings and lung parenchyma strips, OVA caused a concentration‐dependent contraction. Suramin+RB2 or levamisole produced a significant rightward displacement of this response, and ARL‐67156 did not modify it. Platelets stimulated with OVA released ATP. Confocal images of nonsensitized tracheas showed slight fluorescence for P2Y 6 receptors in epithelium and none for P2Y 4 . Sensitized animals showed strong fluorescence to both receptors and to alkaline phosphatase in the airway epithelium. This correlated with a large increment in mRNA for P2Y 4 and P2Y 6 receptors in sensitized animals. Conclusions Nucleotides greatly potentiate the allergic bronchospasm when ectonucleotidases activity is diminished, and this effect is probably favored by the upregulation of P2Y 4 and P2Y 6 receptors in airway epithelium during sensitization. These results prompt for further research on these mechanisms in human asthma.
ARTERIO-VENOUS ANEURYSM OF FEMORAL ARTERY SUCCESSFULLY TREATED BY OPERATION
Authors: G. G. Gillon
Journal: BMJ (1915)

IMEDICAL JoURWAS& I043Now place nine small test tubes in a row on anotlher plasticene tray.Witlh a teat and test pipette fill in the left tube with 3 volumes of saline and 1 volume of appro- priately diluted normal serum containing two units of complement.The rematining eiglht tubes are filled in with 2 volumes of the dilutions of extract, in order from left to right, 1 volume of saline, and 1 volumne of complement.All ingredients must be filled into tube 2, then tube 3, and so on.IncuLbate in water-bath for twenty minutes, add 2 volumes of 5 per cent.sensitized corpuscle suspension, mix, and incubate a further twenty minutes.Thie left-hand tube is a control, and should show com- plete haemolysis.The rest are examined from left to right until the tube is found giving complete inhibition of haemolysis-that is, a precipitate of corpuscles and a colourless supernatant fluid.One-third of the strength of extract in this tube is the strength to be used for the tests-for example, if 25 per cent.extract completely inllibits haemolysis, 8 per cent. is the strength to use in the tests.This 8 per cent.dilution is made fresh for each batch of tests from the stock unliluted extract.C. The Actutal Test.Tlhe materials required having been prepared and standardized, the following procedure is convenient: 1. Prepare the 5 per cent.sensitized suspension of sheep's corpuscles.2. Titrate complement and incubate.3. Dilute extract to required strength for use. 4. Examine result of complement titration and dilute so that eaclh voluime cointains 2 units of complement.Place in a plasticene tray three rows of two small test- tubes for conitrols, and one row for eaclh patient's blood to be tested.Put an extra tube to each row to dilute serums in, and as each serum is tested dilute it 2 volumes to 3 volumes of saline (2-5 dilutiob).Between fillinig in each row the pipette must be rinsed witlh distilled water and dried in a cool Bunsen flamne and allowed to cool.The tubes are filled in as slhown in Table I.TABLE I. Leit Tube.Bight Tube.1st pair: No serum.4 vols.saline. 2 vols.saline 2 vols.extract 2nid pair: Normal 2 vols.saline 2 vols.extract serulm; negative 1 vol.heated serum 1 vol.heated serum control.(2-5 dilution) (2--5 dilution)
DEMONSTRATION OF INTERCELLULAR IMMUNOFLUORESCENCE AND EPIDERMAL HYSTERESIS IN BULLOUS FIXED DRUG ERUPTION DUE TO PHENOLPHTHALEIN
Authors: WALTER B. SHELLEY, OTTO L. A. SCHLAPPNER, HAROLD B. HEISS
Journal: British Journal of Dermatology (1972)

Summary.— We have reported a case of severe bullous erythema multiforme type of fixed drug eruption in which (1) multiple drugs were erroneously first indicated as the cause; (2) a false positive bullous patch test was obtained and discovered to be an intracorneal artefact, reflecting a new phenomenon, epidermal hysteresis; (3) a relationship to auto-sensitization and pemphigus was discerned by the demonstration of direct intercellular immunofluorescence in the lower epidermis of the affected fixed sites only; (4) phenolphthalein was finally proven to be the specific cause by double-blind oral challenge.
Biostatistical analysis of the micronucleus mutagenicity assay based on the assumption of a mixing distribution.
Authors: L Hothorn
Journal: Environmental Health Perspectives (1994)

The in vivo micronucleus assay can be analyzed by comparing the number of micronuclei (MN) of several dose groups with those of a control group. In several publications, difficulties arose in estimating a suitable distribution for MN, even in the untreated historical control groups. Mitchell et al. described the presence of a subpopulation of more susceptible responders. Based on this assumption of such a subpopulation, score tests were used for the mixing distribution of responders and nonresponders (behavior same as in untreated control animals) within the dose groups. The power behavior of these tests was characterized with a simulation study. The advantage of score tests can be shown, even in the practical and important guideline case of only five animals per group.