tbuckley/cabot-search huggingface dataset:
A full blooded market system: at what cost to the NHS?
Authors: I. Kirkpatrick, C. McCabe
Journal: BMJ (2011)

The current plans to reform the NHS have, with some justification, been described as the biggest shake up of the service since its creation. Abolishing primary care trusts and transferring responsibility for 65% of the budget to clinical commissioning groups (or so called senates) represents a bold move. Ultimately this promises to transform the architecture of the NHS into a more diverse and market based system. The move away from the standard state monopoly of the current NHS, it is claimed, will also deliver substantial cost savings, cut red tape, and empower clinicians (read doctors) to run the service. Over the next five years the changes are predicted to save £5.1bn (€5.7bn; $8.2bn), including £3.9bn from commissioning.1

Perhaps not surprisingly these claims are hotly contested. Critics point to the very substantial costs of transition and to massive disruption of services. The think tank Civitas, for example, predicts an absolute drop in performance of “quality of service” and “use of resources” lasting at least one year in primary care trusts that are merged.2 Following the so called listening exercise in April even the government now acknowledges that the original 2013 deadline for the completion of the reforms should be relaxed.3

Others have raised even more fundamental questions about the unintended consequences of an open market for health. Kieran Walshe, professor of health policy and management at Manchester Business School, described the reforms as “a huge distraction from the real mission of the …
Survival with full neurologic recovery and no cerebral pathology after prolonged cardiopulmonary resuscitation with vasopressin in pigs
Authors: Volker Wenzel, Karl H. Lindner, Anette C. Krismer, Wolfgang G. Voelckel, Michael F. Schocke, Wolfgang Hund, Markus Witkiewicz, Egfried A. Miller, Günter Klima, Jörg Wissel, Werner Lingnau, Franz T. Aichner
Journal: Journal of the American College of Cardiology (2000)
Review of health-related quality of life data in multiple myeloma patients treated with novel agents
Authors: P Sonneveld, S G Verelst, P Lewis, V Gray-Schopfer, A Hutchings, A Nixon, M T Petrucci
Journal: Leukemia (2013)

In multiple myeloma (MM), health-related quality of life (HRQoL) data is becoming increasingly important, owing to improved survival outcomes and the impact of treatment-related toxicity on HRQoL. Researchers are more frequently including HRQoL assessments in clinical trials, but analysis and reporting of this data has not been consistent. A systematic literature review assessed the effect of novel agents (thalidomide, bortezomib and lenalidomide) on HRQoL in MM patients, and evaluated the subsequent reporting of these HRQoL results. A relatively small body of literature addresses HRQoL data in MM patients treated with novel MM therapeutic agents: 9 manuscripts and 15 conference proceedings. The literature demonstrates the complementary value of HRQoL when assessing clinical response, progression, overall survival and toxicity. However, weaknesses and inconsistencies in analysis and presentation of HRQoL data were observed, often complicating interpretation of the impact of treatment on HRQoL in MM. Further evaluation of HRQoL in MM patients treated with novel agents is required in larger cohorts, and ideally in head-to-head comparative studies. Additionally, the development of standardised MM-specific best practice guidelines in HRQoL data collection and analysis is recommended. These would ensure that future data are more useful in guiding predictive models and clinical decisions.
Expression of T6 antigen on the epidermal keratinocytes in various dermatoses
Authors: M. Drijkoningen, C. Wolf-Peeters, V. Desmet
Journal: British Journal of Dermatology (1986)

Journal Article Expression of T6 antigen on the epidermal keratinocytes in various dermatoses Get access M. Drijkoningen, M. Drijkoningen Department of Pathology, University Hospital St Rafaël, 6‐3000 Leuven, Belgium Search for other works by this author on: Oxford Academic Google Scholar C. De Wolf‐Peeters, C. De Wolf‐Peeters Department of Pathology, University Hospital St Rafaël, 6‐3000 Leuven, Belgium Search for other works by this author on: Oxford Academic Google Scholar V. Desmet V. Desmet Department of Pathology, University Hospital St Rafaël, 6‐3000 Leuven, Belgium Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 115, Issue 4, 1 October 1986, Pages 511–512, https://doi.org/10.1111/j.1365-2133.1986.tb06248.x Published: 01 October 1986
Metabolism and urinary excretion of 5-amino salicylic acid in healthy volunteers when given intravenously or released for absorption at different sites in the gastrointestinal tract.
Authors: B Myers, D N Evans, J Rhodes, B K Evans, B R Hughes, M G Lee, A Richens, D Richards
Journal: Gut (1987)

In six healthy subjects serum concentrations of 5 amino salicylic acid (5ASA) and acetyl 5ASA were measured for up to 24 hours, and urinary excretion over 48 hours. After an intravenous injection of 3.26 mmol 5ASA serum concentrations fell rapidly with a distribution half-life of 17 +/- 2 min and an elimination half-life of 42 +/- 5 min. After 45 minutes acetyl 5ASA became the dominant compound and after seven hours serum concentrations of both components were almost unrecordable. Orally ingested 5ASA in three preparations to ensure its release in the stomach, small intestine and ileocaecal region respectively gave lower serum concentrations and urinary excretion than those obtained after an intravenous infusion. Bioavailabilities which ranged from 19% for ileocaecal release to 75% for release in the upper gastrointestinal tract, were calculated from areas under the serum concentration curves. Urinary excretion of 5ASA and its acetyl metabolite over 48 hours was 78%, 52%, 55%, and 21% respectively of the dose given intravenously and orally for gastric, small intestinal and ileocaecal release.
Commensal Bacteria Calibrate the Activation Threshold of Innate Antiviral Immunity
Authors: Michael C. Abt, Lisa C. Osborne, Laurel A. Monticelli, Travis A. Doering, Theresa Alenghat, Gregory F. Sonnenberg, Michael A. Paley, Marcelo Antenus, Katie L. Williams, Jan Erikson, E. John Wherry, David Artis
Journal: Immunity (2012)
Early American Medical Literature
Authors: John B. Blake
Journal: JAMA (1976)

The first successful English settlement in North America was in Virginia in 1607. There, and in other early settlements in New England and Maryland, the first physicians were men who had trained abroad. With a few exceptions, they were apprentice-trained surgeons, who formed the great bulk of general practitioners in England. By and large, doctors of medicine from Oxford and Cambridge did not emigrate. Apprenticeship continued to be the chief method of training in the colonies, so that it is perhaps not surprising that we find no American medical literature written and published in the British colonies for nearly 100 years. Instead, physicians relied on a few imported books. From inventories at probate, we learn that Dr Henry Willoughby of Virginia in 1676 left 44 medical books (as well as 75 religious ones) and that the library of the Rev Thomas Teackle, who died in 1696 or 1697, included such
Association between Medications That Relax the Lower Esophageal Sphincter and Risk for Esophageal Adenocarcinoma
Authors: Jesper Lagergren
Journal: Annals of Internal Medicine (2000)

Background: The incidence of esophageal adenocarcinoma is increasing rapidly. Gastroesophageal reflux is a strong risk factor for this disease. The increase in incidence of esophageal adenocarcinoma coincided with the introduction of medications that promote reflux by relaxing the lower esophageal sphincter (LES), such as nitroglycerin, anticholinergics, β-adrenergic agonists, aminophyllines, and benzodiazepines. Objective: To test the possible association between use of LES-relaxing medications and risk for adenocarcinoma of the esophagus and gastric cardia. Design: A nationwide population-based case–control study with in-person interviews. Setting: Sweden, 1995 through 1997. Patients: 189 patients with newly diagnosed esophageal adenocarcinoma, 262 with adenocarcinoma of the gastric cardia, and 167 with esophageal squamous-cell carcinoma were compared with 820 population-based controls. Measurements: Estimated incidence rate ratios, calculated by using multivariate logistic regression from case–control data with adjustment for potential confounding. Results: Past use of LES-relaxing drugs was positively associated with risk for esophageal adenocarcinoma. Among daily, long-term users (>5 years) of LES-relaxing drugs, the estimated incidence rate ratio was 3.8 (95% CI, 2.2 to 6.4) compared with persons who had never used these drugs. Drugs of all classes contributed to the increased risk, but the association was particularly strong for anticholinergics. Short-term use of other types of LES-relaxing drugs did not seem to be strongly associated with risk. The association almost disappeared after adjustment for reflux symptoms, indicating that promotion of reflux is the link between use of LES-relaxing drugs and esophageal adenocarcinoma. If 15 490 men in any age group take LES-relaxing drugs daily for 5 years, 1 additional case of adenocarcinoma would be expected (number needed to treat for harm); in men older than 60 years of age, the number needed to treat for harm is 5570. Assuming a causal relation, about 10% of the esophageal adenocarcinomas occurring in the population may be attributable to intake of LES-relaxing drugs. Cardia adenocarcinoma and esophageal squamous-cell carcinoma were not associated with use of LES-relaxing drugs. Conclusions: The widespread use of LES-relaxing drugs may have contributed to the increasing incidence of esophageal adenocarcinoma.
Time-dependent change in electrophysiologic milieu after myocardial infarction in conscious dogs.
Authors: H J Duff, J M Martin, M Rahmberg
Journal: Circulation (1988)

This study was designed to assess the time-dependent change in propensity to induction of malignant ventricular tachyarrhythmia after myocardial infarction. Instrumented conscious dogs were assessed during serial drug-free electrophysiologic studies over 26 +/- 9 days (range 17 to 35 days) after 2 hr occlusion-reperfusion of the left anterior descending coronary artery. Of the 19 animals studied, 11 continued to have sustained ventricular tachyarrhythmias inducible (group I) over this time period. In the eight remaining animals, spontaneous loss in the ability to induce sustained ventricular tachycardia occurred (group II). Myocardial infarct size in group I animals (18 +/- 8%) was significantly greater than that in group II dogs (12.5 +/- 5%; p less than .05). Even in group I animals, time-dependent changes occurred in the number of extrastimuli required to induce ventricular tachycardia and the frequency with which left ventricular stimulation was necessary. A differential pattern of time-dependent changes in electrophysiologic variables was observed when comparing group I and II animals. The conduction time to the infarct zone was prolonged during follow-up in group I animals, while in group II animals this variable was unchanged. Repolarization time recorded in the border zone remained unchanged in group I animals, but it was significantly shortened in group II animals. In addition, ventricular effective refractory period in the infarct zone shortened over time in group I animals but did not change in group II animals. In conclusion, time-dependent changes occur in electrophysiologic variables that are associated with a progressive decrease in propensity to induction of ventricular tachycardia after myocardial infarction. A critical determinant of whether propensity to ventricular tachycardia resolves over time is size of myocardial infarction.
Abstract 75: CpG methylation signature to predict outcome in preoperatively treated rectal cancer.
Authors: Jochen Gaedcke, Rainer Claus, Andreas Leha, Marian Grade, Tim Beißbart, Michael Ghadimi, Dieter Weichenhahn, Christoph Plass
Journal: Cancer Research (2013)

Abstract Introduction: Introducing a preoperative therapy in locally advanced rectal cancer significantly decreased the local recurrence rate whereas outcome was not improved. To identify patient subgroups that could benefit from an adjusted therapy a prediction prior to the preoperative therapy is necessary. Material and methods: Whole genome promoter methylation analyses were applied to a pilot group of patients (n=11) to identify targets that separate a good and a bad prognosis group based on their methylation level. Using a mass spectrometry based approach (MassArray) candidate CpG probes were assessed in set of 63 patients (training set). Relevant probes were then validated independently in an additional patient set (n=93). Data were then compared to the previously identified biomarkers (CpG island methylatior phenotype (CIPM)) and clinical data. Results: Relevant DNA regions from whole genome screen were filtered and the number was reduced down to 20 DNA regions located within 17 different genes (244 different CpGs). In the training set thirteen regions could be confirmed and a clear separation into a good and a bad prognosis group was possible (p=0.0394). Validation in an independent cohort revealed a highly significant result (p=0.000341). Comparing the results the methylation panel outperformed CIMP or clinical data. Conclusion: Using the retrieved methylation panel of 13 different DNA regions allows a highly significant assignment to a good and a bad prognosis group. These data can now be used to identify patients that are well treated by standard therapy and others that benefit from alternative treatment modalities. Citation Format: Jochen Gaedcke, Rainer Claus, Andreas Leha, Marian Grade, Tim Beißbart, Michael Ghadimi, Dieter Weichenhahn, Christoph Plass. CpG methylation signature to predict outcome in preoperatively treated rectal cancer. [abstract]. In: Proceedings of the 104th Annual Meeting of the American Association for Cancer Research; 2013 Apr 6-10; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2013;73(8 Suppl):Abstract nr 75. doi:10.1158/1538-7445.AM2013-75
Selective Service and Military Medical Manpower
Authors: James C. Cain
Journal: JAMA (1968)

Much has been written about the developing shortage of medical manpower. The demand for medical services is greater than the amount physicians under the present system are able to furnish. Obviously, we must increase the output of our existing medical schools, develop new medical schools, and use the physician's time more efficiently and effectively. We have few physicians less than 35 years of age who have not served in the Armed Forces. It is now necessary for us to interrupt residency programs in the second, third, and fourth years, take men from large private practices with a large segment of the community dependent upon them, and interrupt teaching and research programs by taking instructors and assistant professors. Physicians now being selected would have been considered essential to the community welfare three years ago. The need for physicians is obvious; means for obtaining them is complicated. <h3>Classification and Deferment.—</h3> When an
Abstract 2570: The Unrestricted Use Of Paclitaxel-eluting Stents: Five-year Results Of The Research Registry
Authors: Yoshinobu Onuma, Neville Kukreja, Hector M Garcia-Garcia, Joost Daemen, Ron van Domburg, Patrick W Serruys
Journal: Circulation (2008)

Objectives: Although the safety of drug-eluting stents (DES) has been under scrutiny, limited follow-up data up to 5 years are available, particularly among real-world patients. Therefore, we evaluated the 5-year clinical event rates in patients from the The Rapamycin-Eluting Stent Evaluated at Rotterdam Cardiology Hospital (RESEARCH) registry to establish the safety and efficacy of sirolimus-eluting stent (SES) in an unselected all-comer population. Methods: On April 16, 2002, our institution commenced the use of SES (Cypher; Cordis Corporation, Miami Lakes, Florida) as the default strategy for all percutaneous coronary interventions at our institution. In the first 6 months of enrollment, 508 patients with de novo lesions were treated exclusively with SES (the SES group) and compared with a group of 450 consecutive patients treated with BMS for de novo lesions in the preceding 6 months (the pre-SES group), matched for stent diameter. Survival data was acquired from municipal civil registries. Health questionnaires have been sent to all living patients to obtain data on adverse clinical events were collected. Medical records will be reviewed and family doctors or referring cardiologists contacted as necessary. The primary end-point was composite major adverse events (MACE: all-cause death, myocardial infarction or target vessel revascularization [TVR]). Secondary endpoints included all-cause death, TVR and stent thrombosis. A propensity score-adjustment will be performed to compensate for differences in baseline characteristics between the groups. Findings: Survival data is currently available for 94% of the patients after 5 years. The 5-year all-cause mortality rates were 14.0% for SES and 13.4% for BMS (p=0.9). Data on the other 5-year endpoints is currently being collected and will be presented at the time of the meeting. Conclusions: There is no difference in the 5-year survival rates in the real-world unselected patients treated with SES, compared with BMS.
High stimulatory activity of dendritic cells from diabetes-prone BioBreeding/Worcester rats exposed to macrophage-derived factors.
Authors: A Tafuri, W E Bowers, E S Handler, M Appel, R Lew, D Greiner, J P Mordes, A A Rossini
Journal: Journal of Clinical Investigation (1993)

Dendritic cells (DC) present antigen and initiate T cell-mediated immune responses. To investigate the possible association of autoimmunity with DC function, we compared the accessory activity of splenic DC from Wistar/Furth (WF) and diabetes-prone (DP) BioBreeding (BB) rats. The latter develop autoimmune diabetes and thyroiditis. DC function was quantified in vitro by measuring T cell proliferation in mitogen-stimulated and mixed lymphocyte reactions. When purified without macrophage coculture, WF and DP DC displayed similar levels of accessory activity. In contrast, when purified by a method involving coculture with macrophages, DC from DP rats consistently displayed greater accessory activity. This finding could not be explained by morphological or phenotypic differences between DP and WF DC. In accessory activity assays performed after reciprocal DC cocultures with DP and WF macrophages, DP DC exhibited higher accessory activity irrespective of macrophage donor strain. We also compared the accessory activity of WF and DP DC cultured in the presence of conditioned medium and a mixture of IL-1 and GM-CSF. In all assays, DP DC exhibited higher accessory activity. In studies of (WF x DP) F1 hybrids, the high accessory activity of DP DC was observed to be heritable, and studies of WF and DP radiation chimeras indicated that the effect was an intrinsic property of the DP hematopoietic system. We conclude: (a) splenic DC from DP and WF rats possess similar basal levels of accessory potency; (b) after interaction with macrophages, DC of DP origin are capable of greater stimulatory activity than are WF DC; and (c) the mechanism responsible for this phenomenon involves differential responsiveness of DP and WF DC to macrophage-derived factors such as IL-1 and GM-CSF.
Why Bioethics Cannot Figure Out What to Do with Race
Authors: Olivette R. Burton
Journal: The American Journal of Bioethics (2007)

Race and religion are integral parts of bioethics. Harm and oppression, with the aim of social and political control, have been wrought in the name of religion against Blacks and people of color as embodied in the Ten Commandments, the Inquisition, and in the history of the Holy Crusades. Missionaries came armed with Judeo/Christian beliefs went to nations of people of color who had their own belief systems and forced change and caused untold harms because the indigenous belief systems were incompatible with their own. The indigenous people were denounced as ungodly, pagan, uncivilized, and savage. Hence, laws were enacted because of their perceived need to structure a sense of morality and to create and build a culture for these indigenous people of color. To date bioethics continues to be informed by a Western worldview that is Judeo/Christian in belief and orientation. However, missing from bioethical discourse in America is the historical influence of the Black Church as a cultural repository, which continues to influence the culture of Africans and Blacks. Cultural aspects of peoples of color are still largely ignored today. In attempting to deal with issues of race while steering clear of the religious and cultural impact of the Black Church, bioethics finds itself in the middle of a distressing situation: it simply cannot figure out what to do with race.
A seamless service
Authors: I. Heath
Journal: BMJ (1998)

I would put money on the tediously overused, and intrinsically ridiculous, phrase “a seamless service” having been invented by a man. The most rudimentary knowledge and experience of needlework teaches the usefulness of seams.1 Indeed, a structure can be seamless only if it is made of a uniform material, seamless nylon stockings being a classic example. But as soon as the desired structure requires a number of differently shaped pieces or a variety of materials, seams are needed to hold the whole together. The construction of the seam overlaps the edges of the different pieces or materials, and it is the overlap that gives the seam its strength. Without seams, and without overlap, the whole construction ruptures under the …
Retracted: G-Protein–Coupled Receptor 30 and Estrogen Receptor-α Are Involved in the Proliferative Effects Induced by Atrazine in Ovarian Cancer Cells
Authors: Lidia Albanito, Rosamaria Lappano, Antonio Madeo, Adele Chimento, Eric R. Prossnitz, Anna Rita Cappello, Vincenza Dolce, Sergio Abonante, Vincenzo Pezzi, Marcello Maggiolini
Journal: Environmental Health Perspectives (2008)

BackgroundAtrazine, one of the most common pesticide contaminants, has been shown to up-regulate aromatase activity in certain estrogen-sensitive tumors without binding or activating the estrogen receptor (ER). Recent investigations have demonstrated that the orphan G-protein–coupled receptor 30 (GPR30), which is structurally unrelated to the ER, mediates rapid actions of 17β-estradiol and environmental estrogens.ObjectivesGiven the ability of atrazine to exert estrogen-like activity in cancer cells, we evaluated the potential of atrazine to signal through GPR30 in stimulating biological responses in cancer cells.Methods and resultsAtrazine did not transactivate the endogenous ERα in different cancer cell contexts or chimeric proteins encoding the ERα and ERβ hormone-binding domain in gene reporter assays. Moreover, atrazine neither regulated the expression of ERα nor stimulated aromatase activity. Interestingly, atrazine induced extracellular signal-regulated kinase (ERK) phosphorylation and the expression of estrogen target genes. Using specific signaling inhibitors and gene silencing, we demonstrated that atrazine stimulated the proliferation of ovarian cancer cells through the GPR30–epidermal growth factor receptor transduction pathway and the involvement of ERα.ConclusionsOur results indicate a novel mechanism through which atrazine may exert relevant biological effects in cancer cells. On the basis of the present data, atrazine should be included among the environmental contaminants potentially able to signal via GPR30 in eliciting estrogenic action.