tbuckley/cabot-search huggingface dataset:
Neonatal, 1–59 month, and under-5 mortality in 597 Indian districts, 2001 to 2012: estimates from national demographic and mortality surveys
Authors: Usha Ram, Prabhat Jha, Faujdar Ram, Kaushalendra Kumar, Shally Awasthi, Anita Shet, Joy Pader, Stella Nansukusa, Rajesh Kumar
Journal: The Lancet Global Health (2013)

India has the largest number of child deaths of any country in the world, and has wide local variation in under-5 mortality. Worldwide achievement of the UN 2015 Millennium Development Goal for under-5 mortality (MDG 4) will depend on progress in the subregions of India. We aimed to estimate neonatal, 1-59 months, and overall under-5 mortality by sex for 597 Indian districts and to assess whether India is on track to achieve MDG 4.We divided the 2012 UN sex-specific birth and mortality totals for India into state totals using relative birth rates and mortality from recent demographic surveys of 24 million people, and divided state totals into totals for the 597 districts using 3 million birth histories. We then split the results into neonatal mortality and 1-59 month mortality using data for 109,000 deaths in children younger than 5 years from six national surveys. We compared results with the 2001 census for each district.Under-5 mortality fell at a mean rate of 3·7% (IQR 3·2-4·9) per year between 2001 and 2012. 222 (37%) of 597 districts are on track to achieve the MDG 4 of 38 deaths in children younger than 5 years per 1000 livebirths by 2015, but an equal number (222 [37%]) will achieve MDG 4 only after 2020. These 222 lagging districts are home to 41% of India's livebirths and 56% of all deaths in children younger than 5 years. More districts lag behind the relevant goal for neonatal mortality (251 [42%]) than for 1-59 month mortality (197 [33%]). Just 81 (14%) districts account for 37% of deaths in children younger than 5 years nationally. Female mortality at ages 1-59 months exceeded male mortality by 25% in 303 districts in nearly all states of India, totalling about 74,000 excess deaths in girls.At current rates of progress, MDG 4 will be met by India around 2020-by the richer states around 2015 and by the poorer states around 2023. Accelerated progress to reduce mortality during the neonatal period and at ages 1-59 months is needed in most Indian districts.Disease Control Priorities 3, Canadian Institutes of Health Research, International Development Research Centre, US National Institutes of Health.
Does Pay-for-Performance Improve the Quality of Health Care?
Authors: Laura A. Petersen, LeChauncy D. Woodard, Tracy Urech, Christina Daw, Supicha Sookanan
Journal: Annals of Internal Medicine (2006)

Background: Most physicians and hospitals are paid the same regardless of the quality of the health care they provide. This produces no financial incentives and, in some cases, produces disincentives for quality. Increasing numbers of programs link payment to performance. Purpose: To systematically review studies assessing the effect of explicit financial incentives for improved performance on measures of health care quality. Data Sources: PubMed search of English-language literature (1 January 1980 to 14 November 2005), and reference lists of retrieved articles. Study Selection: Empirical studies of the relationship between explicit financial incentives designed to improve health care quality and a quantitative measure of health care quality. Data Extraction: The authors categorized studies according to the level of the incentive (individual physician, provider group, or health care payment system) and the type of quality measure rewarded. Data Synthesis: Thirteen of 17 studies examined process-of-care quality measures, most of which were for preventive services. Five of the 6 studies of physician-level financial incentives and 7 of the 9 studies of provider group-level financial incentives found partial or positive effects on measures of quality. One of the 2 studies of incentives at the payment-system level found a positive effect on access to care, and 1 showed evidence of a negative effect on access to care for the sickest patients. In all, 4 studies suggested unintended effects of incentives. The authors found no studies examining the optimal duration of financial incentives for quality or the persistence of their effects after termination. Only 1 study addressed cost-effectiveness. Limitations: Few empirical studies of explicit financial incentives for quality were available for review. Conclusions: Ongoing monitoring of incentive programs is critical to determine the effectiveness of financial incentives and their possible unintended effects on quality of care. Further research is needed to guide implementation of financial incentives and to assess their cost-effectiveness.
Focal Bone Marrow Involvement in Multicentric Castleman Disease Demonstrated By FDG PET/CT
Authors: Celso Dario Ramos, Celso M. Massumoto, Maria F. Rosa, Mariana F. Mazo-Ruiz, Cristina Mitteldorf, Elba C. Etchebehere, Allan O. Santos, Mariana C. Lima, Giovani G. Cerri, Edwaldo E. Camargo
Journal: Clinical Nuclear Medicine (2007)

Castleman disease is a lymphoproliferative disorder, which usually occurs in the chest. Multicentric Castleman disease with multiple foci involving many anatomic locations is rare. The authors describe a 75-year-old man with a history of fever, shivering, and multiple lymphadenopathies who had a cervical lymph node biopsy which defined the diagnosis as multicentric Castleman disease, hyaline-vascular type, stroma-rich variant. A whole-body F-18 fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) was performed for evaluation of the extent of the disease. The images demonstrated focal areas of intense FDG uptake in multiple foci of enlarged lymph nodes and heterogeneous FDG uptake in the skeleton. Of interest, PET/CT fusion images clearly showed focal areas of more intense FDG uptake in the bone marrow of the right scapula, ribs, right iliac bone, and left acetabulum.
What once was lost, now is found: Restoration of hepatitis B-specific immunity after treatment of chronic hepatitis B
Authors: Margaret James Koziel
Journal: Hepatology (1999)

High viral and/or antigen load may be an important cause of the T cell hyporesponsiveness to hepatitis B virus (HBV) antigens that is often observed in patients withchronic HBV infection.Reduction of viral and antigen load by lamivudine treatment represents an ideal model for investigating this hypothesis.HLA class II restricted T cell responses and serum levels of HBV-DNA, HBsAg, and HBeAg were studied before and during lamivudine treatment in 12 patients with hepatitis B e antigen positive chronic active hepatitis B to assess possible correlations between viral and/or antigen load and vigor of the T cell response.Cell proliferation to HBV nucleocapsid antigens and peptides and frequency of circulating HBV nucleocapsid-specific T cells were assessed to characterize CD4-mediated responses.A highly significant enhancement of the CD4-mediated response to HBV nucleocapsid antigens was already detectable in most patients 7-14 d after the start of lamivudine treatment.This effect was dramatic and persistent in 10 patients but undetectable in 2. It occurred concomitant with a rapid and marked reduction of viremia.Interestingly, lamivudine also enhanced the responses to mitogens and recall antigens, showing that its effect was not limited to HBV-specific T cells.In conclusion, an efficient antiviral T cell response can be restored by lamivudine treatment in patients with chronic hepatitis B concurrently with reduction of viremia, indicating the importance of viral load in the pathogenesis of T cell hyporesponsiveness in these patients.Since lamivudine treatment can overcome T cell hyporeactivity, combining lamivudine with treatments directed to stimulate the T cell response may represent an effective strategy to induce eradication of chronic HBV infection.COMMENTS
Proteinpolysaccharides from human articular and costal cartilage.
Authors: L Rosenberg, B Johnson, M Schubert
Journal: Journal of Clinical Investigation (1965)

From bovine nasal cartilage two products were isolated, each consisting mainly of chondroitin sul- fate and protein (1).These were called protein- polysaccharides (PP), and the two kinds were distinguished as PP-H and PP-L.Human costal cartilage also yielded two products which, in the extraction and fractionation procedures, behaved rather like the two products from bovine nasal cartilage and were also called PP-H and PP-L (2), although they differed from the corresponding products from bovine cartilage in yield and composition.Isolation and fractionation of the prod- ucts from human cartilage was far more difficult and gave results more variable than with bovine cartilage.The PP of bovine and human cartilages contain components other than chondroitin sulfate and pro- tein.Partridge and his co-workers (3, 4) found glucosamine and galactose among degradation products of PP from cartilage.Gregory and Roden found keratan sulfate after digestion of bo- vine nasal PP-L with hyaluronidase and papain (5).Alkaline degradation of bovine nasal PP-L also gave keratan sulfate in an amount 5% of the weight of the PP-L (6).Meyer and his co-work- ers (7, 8) reported obtaining keratan sulfate from whole human costal cartilage and found this com- ponent to increase with age.Anderson (9,10)
Book Review Cutting to the Core: Exploring the Ethics of Contested Surgeries Edited by David Benatar. 236 pp. Lanham, MD, Rowman &amp; Littlefield, 2006. $75 (cloth); $24.95 (paper). 0-7425-5000-1 (cloth); 0-7425-5001-X (paper).
Authors: Alice D. Dreger
Journal: New England Journal of Medicine (2006)
Selective elimination of retrograde conduction by intraoperative neodymium: YAG laser photocoagulation in dogs
Authors: Laszlo Littmann, Robert H. Svenson, Saroja Bharati, Maurice Lev, Chi Hui Chuang, Pal Kempler, Robert Splinter, Jan R. Tuntelder, George P. Tatsis
Journal: Journal of the American College of Cardiology (1993)
Urinary Bisphenol A Concentrations and Implantation Failure among Women Undergoing <i>in Vitro</i> Fertilization
Authors: Shelley Ehrlich, Paige L. Williams, Stacey A. Missmer, Jodi A. Flaws, Katharine F. Berry, Antonia M. Calafat, Xiaoyun Ye, John C. Petrozza, Diane Wright, Russ Hauser
Journal: Environmental Health Perspectives (2012)

Bisphenol A (BPA) is a synthetic chemical widely used in the production of polycarbonate plastic and epoxy resins found in numerous consumer products. In experimental animals, BPA increases embryo implantation failure and reduces litter size.We evaluated the association of urinary BPA concentrations with implantation failure among women undergoing in vitro fertilization (IVF).We used online solid phase extraction-high performance liquid chromatography-isotope dilution tandem mass spectrometry to measure urinary BPA concentrations in 137 women in a prospective cohort study among women undergoing IVF at the Massachusetts General Hospital Fertility Center in Boston, Massachusetts. We used logistic regression to evaluate the association of cycle-specific urinary BPA concentrations with implantation failure, accounting for correlation among multiple IVF cycles in the same woman using generalized estimating equations. Implantation failure was defined as a negative serum β-human chorionic gonadotropin test (β-hCG < 6 IU/L) 17 days after egg retrieval.Among 137 women undergoing 180 IVF cycles, urinary BPA concentrations had a geometric mean (SD) of 1.53 (2.22) µg/L. Overall, 42% (n = 75) of the IVF cycles resulted in implantation failure. In adjusted models, there was an increased odds of implantation failure with higher quartiles of urinary BPA concentrations {odds ratio (OR) 1.02 [95% confidence interval (CI): 0.35, 2.95}, 1.60 (95% CI: 0.70, 3.78), and 2.11 (95% CI: 0.84, 5.31) for quartiles 2, 3, and 4, respectively, compared with the lowest quartile (p-trend = 0.06).There was a positive linear dose-response association between BPA urinary concentrations and implantation failure.
Typhoid Vaccines Ready for Implementation
Authors: Myron M. Levine
Journal: New England Journal of Medicine (2009)

Enteric fevers encompass typhoid fever caused by Salmonella enterica serotype Typhi (S. Typhi) and paratyphoid fever caused by serotype Paratyphi A or B (S. Paratyphi). These human-restricted pathogens are acquired by ingesting contaminated water or food, and in the individual patient, one cannot differentiate clinically which agent is causing illness. S. Typhi expresses a capsular “Vi” (for virulence) polysaccharide, whereas S. Paratyphi A and B cannot synthesize Vi. Before the use of antibiotics, typhoid fever had a case fatality rate of 10 to 20%. Transmission of enteric fever is minimized or eliminated if populations . . .
THE MAN WHO MOST INFLUENCED ME
Authors: C S Breathnach
Journal: BMJ (1995)

Teaching by subterfuge

Born in Arklow in August 1897, John Duffy graduated from University College Dublin in 1922. He early fell victim to tuberculosis and spent periods in Swiss and Scandinavian sanatoriums. Thereafter he devoted his life, until his unexpected death on 2 September 1957, to the scientific study of tuberculosis and to the lay and professional antituberculosis campaigns necessary to shake the authorities out of their lethargy and indifference.

Rialto Chest Hospital in Dublin became part of the municipal Tuberculosis Service in 1943, with Dr Duffy as resident medical superintendent. Within a few years despite its Poor Law past, Rialto developed a reputation …
“Compound blue nevus”: A reappraisal of “superficial blue nevus with prominent intraepidermal dendritic melanocytes” with emphasis on dermoscopic and histopathologic features
Authors: Gerardo Ferrara, Giuseppe Argenziano, Borut Zgavec, Igor Bartenjev, Stefania Staibano, Gaetano De Rosa, H.Peter Soyer
Journal: Journal of the American Academy of Dermatology (2002)
A Journal of the Plague Year
Authors: Christopher Martyn
Journal: BMJ (2007)

A Journal of the Plague Year is a work of fiction masquerading as a work of fact. It reads as if it were an unembellished account of the personal experiences of someone who survived the epidemic of bubonic plague that struck London in the summer of 1665. But, although its author, Daniel Defoe, probably did do exactly that, he can only have been about 5 years old at the time of the epidemic and his childish recollections would surely have been too distant and too unreliable to allow him to write about it more than 50 years later. No, like any modern novelist, he must …
What is new in therapy?
Authors: A. D. Ormerod
Journal: British Journal of Dermatology (2001)

Has the new millennium been accompanied by the anticipated medical progress? Molecular medicine has advanced and the human genome has been mapped, but perhaps the true measure of progress is to assess the latest developments in drug therapy, arguably the most important indicators of progress. The rigour of clinical trials conducted according to good clinical practice guidelines is stronger than ever and licensing requirements are more stringent. If we are to practise evidence‐based medicine, trials need to be of large numbers and have sufficient power. This puts the onus on the pharmaceutical industry to be the innovators. However, for many of the rarer, less profitable dermatoses, small pilot studies undertaken by innovative dermatologists remain our only evidence. With this in mind, I have tried to select the best from all manner of clinical trials published in 2000 and up to July 2001. This is not a systematic review and is not exhaustive.
Atrioventricular block and supraventricular arrhythmias with X-linked muscular dystrophy.
Authors: Z ul Hassan, C P Fastabend, P K Mohanty, E R Isaacs
Journal: Circulation (1979)

This report describes a family showing muscular dystrophy and atrioventricular block with an x-linked hereditary transmission. Among a known pedigree of 101 family members, 12 males were found to have skeletal muscle involvement and six needed pacemakers around age 30 years. Unlike the x-linked muscular dystrophies of Duchenne and of Becker, the predominant skeletal involvement was in humeral muscles, was usually very mild, and did not produce incapacitation. Cardiac involvement consisted of various atrial arrhythmias and atrioventricular block. The few sporadic reports of other families that describe the same disease under different names are briefly reviewed. Recognition of this subtle muscular dystrophy is important for early detection of incipient complete atrioventricular block to prevent fatal complications by pacemaker insertion.
Prosecutors defend decision not pursue doctors over sex selection abortions
Authors: C. Dyer
Journal: BMJ (2013)

England’s health secretary, Jeremy Hunt, has asked the attorney general for “urgent clarification” of a decision by the Crown Prosecution Service (CPS) not to prosecute two doctors for agreeing to perform abortions on the grounds that the unborn child was the “wrong” sex.

The CPS said that, although there was sufficient evidence to prosecute for an attempt to commit an offence under the Abortion Act 1967, prosecutors had decided that it would not be in the public interest to go ahead with a prosecution.

Jenny Hopkins, deputy chief prosecutor for CPS London, said in a statement that “one highly relevant factor” was that the General Medical Council was already involved in the case and had the power to remove doctors from the medical register.

She added, “Taking into account the need for professional judgment …
Agreement Is Poor Among Current Criteria Used to Define Response to Cardiac Resynchronization Therapy
Authors: Brandon K. Fornwalt, William W. Sprague, Patrick BeDell, Jonathan D. Suever, Bart Gerritse, John D. Merlino, Derek A. Fyfe, Angel R. León, John N. Oshinski
Journal: Circulation (2010)

Numerous criteria believed to define a positive response to cardiac resynchronization therapy have been used in the literature. No study has investigated agreement among these response criteria. We hypothesized that the agreement among the various response criteria would be poor.A literature search was conducted with the keywords "cardiac resynchronization" and "response." The 50 publications with the most citations were reviewed. After the exclusion of editorials and reviews, 17 different primary response criteria were identified from 26 relevant articles. The agreement among 15 of these 17 response criteria was assessed in 426 patients from the Predictors of Response to Cardiac Resynchronization Therapy (PROSPECT) study with Cohen's kappa-coefficient (2 response criteria were not calculable from PROSPECT data). The overall response rate ranged from 32% to 91% for the 15 response criteria. Ninety-nine percent of patients showed a positive response according to at least 1 of the 15 criteria, whereas 94% were classified as a nonresponder by at least 1 criterion. kappa-Values were calculated for all 105 possible comparisons among the 15 response criteria and classified into standard ranges: Poor agreement (kappa< or =0.4), moderate agreement (0.4<kappa<0.75), and strong agreement (kappa> or =0.75). Seventy-five percent of the comparisons showed poor agreement, 21% showed moderate agreement, and only 4% showed strong agreement.The 26 most-cited publications on predicting response to cardiac resynchronization therapy define response using 17 different criteria. Agreement between different methods to define response to cardiac resynchronization therapy is poor 75% of the time and strong only 4% of the time, which severely limits the ability to generalize results over multiple studies.
Ashley Revisited: A Response to the Critics
Authors: Douglas S. Diekema, Norman Fost
Journal: The American Journal of Bioethics (2010)

The case of Ashley X involved a young girl with profound and permanent developmental disability who underwent growth attenuation using high-dose estrogen, a hysterectomy, and surgical removal of her breast buds. Many individuals and groups have been critical of the decisions made by Ashley's parents, physicians, and the hospital ethics committee that supported the decision. While some of the opposition has been grounded in distorted facts and misunderstandings, others have raised important concerns. The purpose of this paper is to provide a brief review of the case and the issues it raised, then address 25 distinct substantive arguments that have been proposed as reasons that Ashley's treatment might be unethical. We conclude that while some important concerns have been raised, the weight of these concerns is not sufficient to consider the interventions used in Ashley's case to be contrary to her best interests, nor are they sufficient to preclude similar use of these interventions in the future for carefully selected patients who might also benefit from them.
Experimental localization of intestinal uptake sites for metals (Cd, Hg, Zn, Se) in vivo in mice.
Authors: O Andersen, J B Nielsen, J A Sorensen, L Scherrebeck
Journal: Environmental Health Perspectives (1994)

The intestinal uptake process consists of two separable steps: transport over the luminal membrane into epithelial cytoplasm and transport over the basolateral membrane into serosal fluid. A compound's residence time in mucosal epithelial cytoplasm depends on rates of the two transport processes and, if the rate of the second step is low, on the rate of mucosal sloughing. Using gamma-emitting metal isotopes, in vivo labeling profiles of the intestinal tract were obtained from mice eating their normal diet. The results pertain to processes in the functioning, undisturbed intestinal tract. Single-dose chase experiments indicated that intestinal uptake processes were in fact studied. The labeling profiles varied considerably for different metals. Thus, Cd++ was absorbed mainly in duodenum and early jejunum, while Zn++ was taken up in jejunum and ileum. The uptake profile of Hg++ indicated most rapid uptake in proximal jejunum. Selenomethionine labeled the entire intestinal tract, most rapidly the duodenum, the following intestinal segments were labeled with falling rate. This experimental method is rapid and simple. Further studies aim at developing a quantitative model suited for studying interactions between essential and toxic metals at the level of intestinal metabolism.
Context, causality, and appreciation
Authors: Stephanie Ross
Journal: Behavioral and Brain Sciences (2013)

Abstract I applaud and elaborate on the contextualism at the heart of Bullot &amp; Reber's (B&amp;R's) theory, challenge two aspects of the appreciative structure they posit (the causal reasoning that allegedly underlies the design stance and the segregation of the component stages), suggest that expert and novice appreciators operate differently, and question the degree to which B&amp;R's final theory is open to empirical investigation.
Use of Antidiabetic Plants in Morocco and Québec
Authors: Pierre S. Haddad, Michelle Dépôt, Abdellatif Settaf, Yahia Cherrah
Journal: Diabetes Care (2001)

In the western world, we are witnessing a vastly growing and renewed interest in complementary and alternative medicines. In particular, the herbal medicine market has exploded, evolving from an esoterical and marginal phenomenon (herbal shops and health food stores) to a mass consumer market (pharmacies and department stores). With this increasing interest in phytomedicines, more individuals will explore the possibility of using herbal medicines to complement conventional antidiabetic therapy, as is already the case in certain minority cultures (1,2). Therefore, we carried out an ethnopharmacological survey of the antidiabetic plants most frequently recommended by herbalists, naturopaths, and other traditional practitioners. We compared results obtained in Morocco, where phytotherapy is commonly used in traditional medicine, and in Quebec, …