tbuckley/cabot-search huggingface dataset:
Improved Glycemic Control With Intraperitoneal Versus Subcutaneous Insulin in Type 1 Diabetes
Authors: Susan J. Logtenberg, Nanne Kleefstra, Sebastiaan T. Houweling, Klaas H. Groenier, Reinold O. Gans, Evert van Ballegooie, Henk J. Bilo
Journal: Diabetes Care (2009)

OBJECTIVE Continuous intraperitoneal insulin infusion (CIPII) with an implantable pump has been available for the past 25 years. CIPII, with its specific pharmacodynamic properties, may be a viable treatment alternative to improve glycemic control in patients with type 1 diabetes for whom other therapies have failed. There have been few studies in which CIPII was compared with subcutaneous insulin treatment for patients with type 1 diabetes with poor glycemic control. RESEARCH DESIGN AND METHODS In an open-label, prospective, crossover, randomized, 16-month study, the effects of CIPII and subcutaneous insulin were compared in 24 patients. The primary outcome measure was the incidence of hypoglycemia. Secondary outcome measures were A1C, and glucose profile, including time in euglycemia, as measured by continuous glucose monitoring. RESULTS The incidence of grade 1 hypoglycemic events was 4.0 +/- 2.6 per week with subcutaneous insulin compared with 3.5 +/- 2.3 per week during CIPII (P = 0.13). The absolute mean difference in A1C with CIPII compared with subcutaneous treatment was -0.76% (95% CI -1.41 to -0.11) (P = 0.03). Baseline time spent in euglycemia was 45.2 +/- 12.6% and increased 10.9% (4.6-17.3) with CIPII compared with subcutaneous treatment (absolute value; P = 0.003). There were no differences in the occurrence rate for severe hypoglycemic events, daily insulin use, or BMI. No pump or catheter malfunction was observed during the study. CONCLUSIONS Although we did not observe a significant reduction in hypoglycemic events, improved glycemic control was achieved with the use of CIPII. We saw a 0.8% decrease in A1C and an 11% increase in the time spent in euglycemia.
The problematic transition from specific competences to general competence
Authors: James R. Hurford, Jean-Louis Dessalles
Journal: Behavioral and Brain Sciences (2002)

Postulating a variety of mutually isolated thought domains for prelinguistic creatures is both unparsimonious and implausible, requiring unexplained parallel evolution of each separate module. Furthermore, the proposal that domain-general concepts are not accessible without prior exposure to phonetically realized human language utterances cannot be implemented by any concept-acquisition mechanism.
Cardiomyogenesis in the Adult Human Heart
Authors: Jan Kajstura, Konrad Urbanek, Shira Perl, Toru Hosoda, Hanqiao Zheng, Barbara Ogórek, João Ferreira-Martins, Polina Goichberg, Carlos Rondon-Clavo, Fumihiro Sanada, Domenico D'Amario, Marcello Rota, Federica del Monte, Donald Orlic, John Tisdale, Annarosa Leri, Piero Anversa
Journal: Circulation Research (2010)

RETRACTION This article has been retracted: Circ Res . 2018;123:e00. DOI: 10.1161/RES.0000000000000246
Genetic Heterogeneity of Human Enzymes
Authors: William L. Nyhan
Journal: New England Journal of Medicine (1976)

The careful study of human patients in whom the activity of enzymes is deficient has provided important insights in genetics and biochemistry. Investigation of these deficiencies of enzyme activity at a molecular level is yielding information on the ways in which genes act. In this week's issue of the Journal an article by Gray, Conklin and Townley describes a molecular probing for the enzyme sucrase in the human small intestine. The results raise interesting questions about the mechanisms of gene expression in man.These investigators have studied patients with disaccharidase deficiency. In the absence of an ability to split disaccharides . . .
Texas governor promises to sign abortion law that will close most clinics
Authors: M. McCarthy
Journal: BMJ (2013)

The Republican Texas governor, Rick Perry, has said that he will sign into law controversial new legislation, approved by the state senate over the weekend, that would impose tough restrictions on abortion services.

The law bans abortions after 20 weeks from fertilization, requires that doctors who perform abortions to have admitting privileges at a nearby hospital, and requires that all abortions take place in fully equipped ambulatory surgical centers, complete with air sterilization systems, back-up generators, and specific room and doorway sizes.

“Today the Texas legislature took its final step in our historic effort to protect life,” Perry said 13 July. “This legislation builds on the strong and unwavering commitment we have made to defend life and protect women’s health.”

The law was passed after a bitter legislative fight that included an 11 hour filibuster by Senator …
What Has Happened to the AAMC Since the Coggeshall Report of 1965?
Authors: William G. Anlyan
Journal: JAMA (1969)

There was a day when the part-time dean could steer his medical school. His responsibility involved the four years of undergraduate medical education. Once a year, he could adequately represent his medical school on the national scene at the annual meeting of the Association of American Medical Colleges (AAMC), which was founded in 1876. Today the dean finds himself at the helm of an academic medical center comprising a complex of undergraduate medical education programs; graduate PhD programs in the basic sciences; graduate medical education with interns, residents, and fellows equal in number to the number of medical students; continuing education for physicians in the region; a multimillion dollar research program (which in many instances is multidisciplinary and multidepartmental); one or more teaching hospitals which hover on the brink of financial insolvency; a fast-changing and expanding interest of federal and state government in health affairs; expanding needs of society in
Role of junctional zone cells between Purkinje fibres and ventricular muscle in arrhythmogenesis
Authors: Z.-Y. Li, Y.-h. Wang, C. Maldonado, J. Kupersmith
Journal: Cardiovascular Research (1994)

Objective: The aim was to examine under abnormal conditions the flow of currents across junctional (J-) cells found between Purkinje fibre cells and ventricular muscle cells, and determine whether these currents play a role in increasing the excitation rate of ventricular muscle. Methods: Canine Purkinje fibre and papillary muscle preparations were mapped to locate the Purkinje fibre-ventricular muscle cell junction (PVJ). Using standard techniques, action potentials from Purkinje fibres, J-cells, and ventricular muscle cells and extracellular electrograms were simultaneously recorded at the PVJ. The tissue was then superfused with Tyrode solution plus 4.5-5.0 mmol of ethylenediamine tetra-acetate (EDTA). Results: EDTA prolonged the action potential duration mainly in Purkinje fibres. Secondary plateaus were recorded at membrane potentials of -63.5(SD 7.6) mV (n = 16) in J-cells, and at membrane potentials of -74.9(4.3) mV (n = 9) in ventricular muscle cells. Triggered activations appeared on both secondary plateaus with the earliest site of activation at J-cells (n = 12), at ventricular muscle cells (n = 4), or in both (n = 6). Tetrodotoxin (3-9 × 10−7 M) and verapamil (1 × 10−6−10−5 M) suppressed triggered activations. Conclusion: The PVJ zone appears to be an important site for the generation of triggered activations. Interventions suggest that triggered activations originating in the J-cell depend on delayed repolarisations which trigger the activation of sodium and/or calcium channels. Cardiovascular Research 1994;28:1277-1284
The diagnosis of toxoplasmosis.
Authors: S M Hall
Journal: BMJ (1984)

<h3>Background</h3> Adiposity is associated with asthma although studies do not usually explore the inter-related role of childhood and adult adiposity in asthma risk using a life course perspective. <h3>Methods</h3> We conducted a Mendelian randomisation (MR) study using genetic instruments for childhood body mass index (BMI) (n=47&nbsp;541), childhood obesity (n=29&nbsp;822) and adult BMI (n=681&nbsp;725) applied to the UK Biobank (n=401&nbsp;837), with validation in a genome-wide association study of asthma (GABRIEL, n=5616). We used inverse variance weighting and other sensitivity analyses to examine the relationship between adiposity and asthma risk. We assessed mediation using multivariable Mendelian randomisation (MVMR) analysis. <h3>Results</h3> Childhood BMI was related to asthma in the UK Biobank (OR 1.10 per SD increase, 95% CI 0.99 to 1.22). Adult BMI was associated with asthma risk (OR 1.33 per SD increase, 95% CI 1.25 to 1.43). Analyses in GABRIEL gave directionally consistent results but with wide CI. The relationship between childhood obesity and asthma risk was less clear in both data sources. MVMR suggested the relation of childhood BMI with asthma risk was largely mediated via adult BMI. <h3>Conclusion</h3> Adiposity in childhood likely cause asthma, but the effect is primarily mediated via adult BMI.
Marrow Defect in Idiopathic Ineffective Erythropoiesis
Authors: GEORGE WALTUCH
Journal: Annals of Internal Medicine (1968)

Marrow erythroblasts from three patients with a well-characterized anemia due to idiopathic ineffective erythropoiesis were studied. The erythroblasts from patients incorporated isotopically labeled valine as well as erythroblasts from normal controls. However, erythroblasts also incorporated labeled glycine less than one tenth as well as normal erythroblasts, and the pattern of incorporation was different. It was therefore proposed that the patient's erythroblasts had a defect in their heme synthetic pathway.
Competitive processes during word-form encoding
Authors: Linda R. Wheeldon
Journal: Behavioral and Brain Sciences (1999)

A highly constrained model of phonological encoding, which is minimally affected by the activation levels of alternative morphemes and phonemes, is proposed. In particular, weaver++ predicts only facilitatory effects on word production of the prior activation of form related words. However, inhibitory effects of form priming that suggest that a more strongly competitive system is required exist in the literature.
Resident Physicians’ Preparedness to Provide Cross-Cultural Care
Authors: Joel S. Weissman, Joseph Betancourt, Eric G. Campbell, Elyse R. Park, Minah Kim, Brian Clarridge, David Blumenthal, Karen C. Lee, Angela W. Maina
Journal: JAMA (2005)

Two recent reports from the Institute of Medicine cited cross-cultural training as a mechanism to address racial and ethnic disparities in health care, but little is known about residents' educational experience in this area.To assess residents' attitudes about cross-cultural care, perceptions of their preparedness to deliver quality care to diverse patient populations, and educational experiences and educational climate regarding cross-cultural training.A survey was mailed in the winter of 2003 to a stratified random sample of 3435 resident physicians in their final year of training in emergency medicine, family practice, internal medicine, obstetrics/gynecology, pediatrics, psychiatry, or general surgery at US academic health centers.Responses were obtained from 2047 (60%) of the sample. Virtually all (96%) of the residents indicated that it was moderately or very important to address cultural issues when providing care. The number of respondents who indicated that they believed they were not prepared to care for diverse cultures in a general sense was only 8%. However, a larger percentage of respondents believed they were not prepared to provide specific components of cross-cultural care, including caring for patients with health beliefs at odds with Western medicine (25%), new immigrants (25%), and patients whose religious beliefs affect treatment (20%). In addition, 24% indicated that they lacked the skills to identify relevant cultural customs that impact medical care. In contrast, only a small percentage of respondents (1%-2%) indicated that they were not prepared to treat clinical conditions or perform procedures common in their specialty. Approximately one third to half of the respondents reported receiving little or no instruction in specific areas of cross-cultural care beyond what was learned in medical school. Forty-one percent (family medicine) to 83% (surgery and obstetrics/gynecology) of respondents reported receiving little or no evaluation in cross-cultural care during their residencies. Barriers to delivering cross-cultural care included lack of time (58%) and lack of role models (31%).Resident physicians' self-reported preparedness to deliver cross-cultural care lags well behind preparedness in other clinical and technical areas. Although cross-cultural care was perceived to be important, there was little clinical time allotted during residency to address cultural issues, and there was little training, formal evaluation, or role modeling. These mixed educational messages indicate the need for significant improvement in cross-cultural education to help eliminate racial and ethnic disparities in health care.
Large-Scale Genetic Survey Provides Insights into the Captive Management and Reintroduction of Giant Pandas
Authors: Lei Shan, Yibo Hu, Lifeng Zhu, Li Yan, Chengdong Wang, Desheng Li, Xuelin Jin, Chenglin Zhang, Fuwen Wei
Journal: Molecular Biology and Evolution (2014)

The captive genetic management of threatened species strives to preserve genetic diversity and avoid inbreeding to ensure populations remain available, healthy, and viable for future reintroduction. Determining and responding to the genetic status of captive populations is therefore paramount to these programs. Here, we genotyped 19 microsatellite loci for 240 captive giant pandas (Ailuropoda melanoleuca) (∼64% of the captive population) from four breeding centers, Wolong (WL), Chengdu (CD), Louguantai (LGT), and Beijing (BJ), and analyzed 655 bp of mitochondrial DNA control region sequence for 220 of these animals. High levels of genetic diversity and low levels of inbreeding were estimated in the breeding centers, indicating that the captive population is genetically healthy and deliberate further genetic input from wild animals is unnecessary. However, the LGT population faces a higher risk of inbreeding, and significant genetic structure was detected among breeding centers, with LGT–CD and WL–BJ clustering separately. Based on these findings, we highlight that: 1) the LGT population should be managed as an independent captive population to resemble the genetic distinctness of their Qinling Mountain origins; 2) exchange between CD and WL should be encouraged because of similar wild founder sources; 3) the selection of captive individuals for reintroduction should consider their geographic origin, genetic background, and genetic contribution to wild populations; and 4) combining our molecular genetic data with existing pedigree data will better guide giant panda breeding and further reduce inbreeding into the future.
Venous Access Ports
Authors: IAN G. KERR
Journal: Annals of Internal Medicine (1985)

Letters and Corrections1 October 1985Venous Access PortsIAN G. KERR, M.D., F. R. C. P. (C), NEILL ISCOE, M.D., F. R. C. P. (C), MARICA SONE, R. N., S. HANNA, M.D., F. R. C. S.(C)IAN G. KERR, M.D., F. R. C. P. (C)Search for more papers by this author, NEILL ISCOE, M.D., F. R. C. P. (C)Search for more papers by this author, MARICA SONE, R. N.Search for more papers by this author, S. HANNA, M.D., F. R. C. S.(C)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-103-4-637_2 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: In their recent report, Reed and associates (1) suggest that venous access ports should only be used for short-duration drug infusions and that alternate devices (for example, the Hickman catheter) should be used for overnight or longer infusions. On the basis of our experience and that of others (2), we would like to counter these suggestions.At this centre we have used various venous access ports (Canada Microsurgical Ltd. [Burlington, Ontario, Canada] in 5 cases, Mediport [Cormed Inc., Medina, New York] in 1 case, Infuse-a-Port in 7 cases, Port-a-Cath [Pharmacia Hospital Products, Piscataway, New Jersey] in 11...References1. REEDNEWMANAPPLEFELDSUTTON WKMF. Drug extravasation as a complication of venous access ports. Ann Intern Med. 1985;102:788-90. LinkGoogle Scholar2. LOKICHBOTHEBERNOTTIMOORE JAPC. Complications and management of implanted venous access ports. J Clin Oncol. 1985;3:710-7. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Toronto-Bayview Regional Cancer Centre Toronto, Ontario M4N 3M5 Canada PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byPort-Catheter Systems: Design, Advantages, and ApplicationsClinical evaluation of the cordis vascular access port systems: A multicenter studyIntraosseous Infusions: An Important But Forgotten Method of Vascular AccessEvaluation of a totally implanted venous access port and portable pump in a continuous chemotherapy infusion schedule on an outpatient basis 1 October 1985Volume 103, Issue 4Page: 637-638KeywordsCathetersDrugs Issue Published: 1 October 1985 PDF downloadLoading ...
The volume-mortality relation for radical cystectomy in England: retrospective analysis of hospital episode statistics
Authors: E. K Mayer, A. Bottle, A. W Darzi, T. Athanasiou, J. A Vale
Journal: BMJ (2010)

Task-related neural activity is widespread across populations of neurons during goal-directed behaviors. However, little is known about the synaptic reorganization and circuit mechanisms that lead to broad activity changes. Here we trained a limited subset of neurons in a spiking network with strong synaptic interactions to reproduce the activity of neurons in the motor cortex during a decision-making task. We found that task-related activity, resembling the neural data, emerged across the network, even in the untrained neurons. Analysis of trained networks showed that strong untrained synapses, which were independent of the task and determined the dynamical state of the network, mediated the spread of task-related activity. Optogenetic perturbations suggest that the motor cortex is strongly-coupled, supporting the applicability of the mechanism to cortical networks. Our results reveal a cortical mechanism that facilitates distributed representations of task-variables by spreading the activity from a subset of plastic neurons to the entire network through task-independent strong synapses.
Point: Self-Monitoring of Blood Glucose in Type 2 Diabetic Patients not Receiving Insulin
Authors: Eli Ipp, Roxanne Lucas Aquino, Peter Christenson
Journal: Diabetes Care (2005)

Self-monitoring of blood glucose (SMBG), one of the important technical advances in the management of diabetes in the last few decades (1,2), has provided patients and providers remarkable insights into day-to-day excursions in blood glucose concentrations obtained in natural settings. The best evidence for its acceptance by both patients and providers is the multi–billion dollar industry that has arisen to provide devices and strips that are continually improving in both sophistication and simplicity of use. Despite a documented increase in use of SMBG (3) in response to expert opinion and exhortations of the American Diabetes Association (4), no appreciable corresponding cost reduction in supplies has occurred, leading to an expanding economic burden on health care systems worldwide. Therefore, it is not surprising that the need for routine SMBG in diabetes management is increasingly being questioned (5–8).

Although SMBG as a tool for achieving glycemic targets is considered to be effective in type 1 diabetes (9,10) and type 2 patients on insulin (11,12), questions have been raised about the need for its use (5–8) in the majority of potential users, non–insulin-treated type 2 diabetic (NIT-DM) patients. Those challenging the use of SMBG in NIT-DM patients generally cite two major problems in support of their position: the enormous cost of supplies and the lack of evidence for effectiveness in this group. In many well-run health care systems, this combination is usually sufficient to put an end to a medical practice. In this commentary we will address these two claims and point out why providing SMBG in NIT-DM patients is still necessary.

The cost of SMBG is unarguably a major expense in health care delivery (8). In the U.S. alone, SMBG leads to an annual expense of hundreds of millions of dollars …
Guidelines for topical photodynamic therapy: report of a workshop of the British Photodermatology Group
Authors: C.A. Morton, S.B. Brown, S. Collins, S. Ibbotson, H. Jenkinson, H. Kurwa, K. Langmack, K. Mckenna, H. Moseley, A.D. Pearse, M. Stringer, D.K. Taylor, G. Wong, L.E. Rhodes
Journal: British Journal of Dermatology (2002)

Topical photodynamic therapy (PDT) is effective in the treatment of certain non-melanoma skin cancers and is under evaluation in other dermatoses. Its development has been enhanced by a low rate of adverse events and good cosmesis. 5-Aminolaevulinic acid (ALA) is the main agent used, converted within cells into the photosensitizer protoporphyrin IX, with surface illumination then triggering the photodynamic reaction. Despite the relative simplicity of the technique, accurate dosimetry in PDT is complicated by multiple variables in drug formulation, delivery and duration of application, in addition to light-specific parameters. Several non-coherent and coherent light sources are effective in PDT. Optimal disease-specific irradiance, wavelength and total dose characteristics have yet to be established, and are compounded by difficulties comparing light sources. The carcinogenic risk of ALA-PDT appears to be low. Current evidence indicates topical PDT to be effective in actinic keratoses on the face and scalp, Bowen's disease and superficial basal cell carcinomas (BCCs). PDT may prove advantageous where size, site or number of lesions limits the efficacy and/or acceptability of conventional therapies. Topical ALA-PDT alone is a relatively poor option for both nodular BCCs and squamous cell carcinomas. Experience of the modality in other skin diseases remains limited; areas where there is potential benefit include viral warts, acne, psoriasis and cutaneous T-cell lymphoma. A recent British Photodermatology Group workshop considered published evidence on topical PDT in order to establish guidelines to promote the efficacy and safety of this increasingly practised treatment modality.
720-6 Stenting for Progressive Dissection During PTCA: Clinical, Angiographic and Intravascular Ultrasound Criteria to Define a Low-risk Group not Requiring Subsequent Anticoagulation
Authors: Helmut Schühlen, Rudolf Blasini, Harald Mudra, Volker Klauss, Adnan Kastrati, Eva Zitzmann, Petra Neller, Evelyn Regar, Ralph Paloncy, Albert Schömig
Journal: Journal of the American College of Cardiology (1995)