tbuckley/cabot-search huggingface dataset:
Part-Time Faculty in Academic Medicine: Present Status and Future Challenges
Authors: Wendy Levinson
Journal: Annals of Internal Medicine (1993)

Objective: To determine the number, personal and professional characteristics, and attitudes of part-time medicine faculty. Participants: Part-time faculty in departments of medicine were identified by the chairs of medicine and faculty roster representatives of the Association of American Medical Colleges for each U.S. medical school and by a survey of faculty. Measurements: A 79-item questionnaire including questions about working conditions, attitudes toward professional and personal issues, and institutional policies. Results: A total of 245 eligible questionnaires were returned (69% of the estimated number of eligible part-time faculty). Sixty-three percent were men and 27% were women. Women faculty worked an average of 35 h/wk, combining their careers with childrearing, whereas men worked 51 h/wk, divided between their faculty position and private practice. Respondents' work time was devoted to teaching and patient care, with no time dedicated for research. Most faculty (86%) were in nontenured track positions; approximately one half (47%) developed the position themselves. Only 8% reported that existing institutional policies allowed part-time faculty more time to reach promotion and tenure standards. A high degree of career satisfaction existed (mean score, 8.6 on a 10-point scale) even though faculty believe that part-time status makes promotion more difficult and negatively influences colleagues' perceptions of them. Conclusion: We estimate that more than 400 faculty work part time in departments of medicine in U.S. medical schools. The majority are men who combine academic careers with private practice. Most part-time faculty work as clinician/teachers in nontenure track positions and are satisfied with their careers.
Ramifications of screening for breast cancer: Consent for screening
Authors: Michael Baum
Journal: BMJ (2006)

Ramifications of screening for breast cancerSee Research p 689 in 4 cancers detected by mammography are pseudocancersEditor-In this issue Zackrisson et al report on follow-up data from the Malmö mammographic screening trial and conclude that the rate of overdiagnosis of breast cancer was 10%. 1 They do not, however, calculate the risk we believe is most relevant to women considering mammography: What is the chance that a screen detected cancer represents overdiagnosis?After 15 years of follow-up, there were 1320 diagnosed in the screened group and 1205 in the control group (table 1).The excess detection of 115 cancers associated with screening led to their conclusion of an overdiagnosis rate of 10% (115/1205).However, because the intervention had stopped 15 years earlier and yet breast cancer cases continue to accumulate in both groups, the approach understates the risk of overdiagnosis.A more relevant denominator is the number of cancers found in the screened group at the end of the trial-741 (table 2).This addresses the question: Were I found to have cancer after being randomised to screening, how likely is it to represent overdiagnosis?As shown in the figure, using this denominator the risk of overdiagnosis is 15% (115/741).However, many of the cancers detected in the screened group are not detected by screening.They are instead clinically detected (either during the interval between screening examinations or among nonattenders).The most relevant denominator is the number of screen detected cancers found at the end of the trial.This addresses the question: Were I found to have cancer by a mammogram, how likely is it to represent overdiagnosis?Although this denominator is not reported by Zackrisson et al, the original BMJ article describing Malmö reported that 64% of the cancers detected in the screened group were detected by screening mammography. 2Thus one can deduce that the number of screen detected cancers at the end of the trial was about 475.As shown in the figure, using this denominator the risk of overdiagnosis is 24% (115/475).
Decision Analysis for a New Bioethics
Authors: Connie C. Price
Journal: The American Journal of Bioethics (2006)

Click to increase image sizeClick to decrease image size ACKNOWLEDGMENTS The following colleagues have influenced this paper's contents through creative philosophical discourses: Rev. Dr. Donald E. Arther, Dr. Legand Burge, Dr. Vivian Carter, Dr. Pamela Payne Foster, Dr. Vanessa N. Gamble, Dr. Maurice Graney, Rev. Dr. Isaac Mwase, Dr. Leonard Ortmann, Dr. Edith Powell, Dr. Stephen Sodeke, Dr. John R. Stone.
Heat annd Multiple Sclerosis-Reply
Authors: Virginia A. Clark
Journal: JAMA (1983)

<h3>In Reply.—</h3> We would like to respond to the thoughtful comments cited in the preceding letter. We shall respond to each of the observations separately, in order. The first comment pertained to the statement in our article, "This finding confirms the clinical impression of many investigators that exposure to heat is associated with the occurrence of exacerbations although fever therapy has been used." We did not mean to imply that these publications referred to fever therapy, but that these publications all cited a relationship between exposure to heat and temporary deterioration of function. The point we want to make is that other authors have reported this relationship. The second point suggested that the discussion relating to the higher frequency of adverse responses to heat reported by malignant cases was circuitous. Our point was that the assumption that the response to these adverse effects of heat is completely reversible may be
Common genetic variants in the interleukin-6 and chitotriosidase genes are associated with the risk for serious infection in children undergoing therapy for acute myeloid leukemia
Authors: T Lehrnbecher, T Bernig, M Hanisch, U Koehl, M Behl, D Reinhardt, U Creutzig, T Klingebiel, S J Chanock, D Schwabe
Journal: Leukemia (2005)
Emerging Risk Factors for Atherosclerotic Vascular Disease
Authors: Daniel G. Hackam, Sonia S. Anand
Journal: JAMA (2003)

ContextAtherosclerotic vascular disease is an enormous public health problem. A number of emerging risk factors for atherosclerosis have recently been proposed to help identify high-risk individuals.ObjectiveTo review the epidemiological, basic science, and clinical trial evidence concerning 4 emerging risk factors: C-reactive protein, lipoprotein(a), fibrinogen, and homocysteine.Data SourcesUsing the terms atherosclerosis, cardiovascular disease, risk factors, prevention, screening, C-reactive protein, lipoprotein(a), fibrinogen, and homocysteine, we searched the MEDLINE database from January 1990 to January 2003. Conference proceedings, abstract booklets, bibliographies of pertinent articles and books, and personal files were hand searched to identify additional articles.Study SelectionOriginal investigations and reviews of the epidemiology of atherosclerosis and the association of conventional and novel risk factors with vascular risk were selected. On the basis of the search strategy, 373 relevant studies were identified.Data ExtractionA diverse array of studies were examined, including randomized controlled trials, prospective cohort studies, systematic overviews, case-control, cross-sectional, and mechanistic studies. Data extraction was performed by one of the authors.Data SynthesisThe available epidemiological and basic science evidence supports, to varying degrees, independent associations between these 4 candidate risk factors and atherosclerotic vascular disease. However, there is relatively little data regarding the additive yield of screening for these factors over that of validated global risk assessment strategies currently in use. Furthermore, controlled intervention studies targeting individuals with these factors for proven risk-reduction therapies, or specifically treating these factors with available therapies, are few. The explanatory power of the major, established cardiovascular risk factors has been systematically underestimated.ConclusionsAlthough C-reactive protein, lipoprotein(a), fibrinogen, and homocysteine are associated with vascular disease risk, their optimal use in routine screening and risk stratification remains to be determined.
A phase II pilot study of tacrolimus/sirolimus GVHD prophylaxis for sibling donor hematopoietic stem cell transplantation using 3 conditioning regimens
Authors: Roberto Rodriguez, Ryotaro Nakamura, Joycelynne M. Palmer, Pablo Parker, Sepideh Shayani, Auyaporn Nademanee, David Snyder, Vinod Pullarkat, Neil Kogut, Joseph Rosenthal, Eileen Smith, Chatchada Karanes, Margaret O'Donnell, Amrita Y. Krishnan, David Senitzer, Stephen J. Forman
Journal: Blood (2009)
The control of infective skin diseases—the lessons of leprosy research
Authors: R. J. HAY
Journal: British Journal of Dermatology (1988)

One of the major changes seen in the past 100 years has been a shift in emphasis away from infections as common causes of skin disease in non‐tropical countries. In 1888, dermatoses thought to be caused by, or secondary to, syphilis were common in everyday dermatological practice, and papers on this condition and its treatment were issues regularly aired in the medical literature. The first edition of the British Journal of Dermatology, for instance, contains a paper by Unna, on the association between seborrhoeic eczema and syphilis'. Cutaneous forms of other infectious conditions, such as tuberculosis, as well as endemic scalp ringworm were prevalent in dermatological out‐patient clinics. Since then there has been a decline in the importance of infections as causes of skin disease, largely through the discovery of antibiotics and improvements in social conditions, although this picture is likely to alter with the emergence of the acquired immunodeficiency syndrome which threatens to dominate the pattern of disease for years to come. By contrast, infections are still major causes of skin, as well as internal, disease in the tropics, particularly in rural communities. In recognition of the possibility of eliminating the important transmissible diseases through concerted effort, the World Health Organization has designated six infectious causes of disease as targets for a special programme of tropical disease research. These were malaria, schistosomiasis, trypanosomiasis, filariasis, leishmaniasis and leprosy. While the latter three conditions feature prominently as causes of skin disease in the developing world, the advances, as well as the setbacks, in infectious disease research over the last century are perhaps best illustrated by the only bacterial infection in this group—leprosy.
How general practitioners manage acute asthma attacks
Authors: R. G. Neville, G. Hoskins, B. Smith, R. A. Clark
Journal: Thorax (1997)

BACKGROUND: The management of asthma attacks by general practitioners in 1992/93 was compared with 1991/92 in relation to recommended guidelines. METHODS: The findings from a postal survey of 299 UK general practitioners who managed 2332 patients with an asthma attack in 1992/93 were compared with those from 218 practitioners who managed 1805 attacks in 1991/92. Management by a subgroup of practitioners from a special interest group was analysed separately. RESULTS: In 1992/93 2031 (87%) of attacks were managed entirely by general practitioners, 251 (11%) were referred for admission to hospital, and 50 (2%) were managed by an accident and emergency department. There was no change in the pattern of management relative to 1991/92. Compared with recommended guidelines there was underuse of systemic steroids and nebulised bronchodilators. Between 1991/92 and 1992/93 use of systemic steroids in acute attacks increased from 56% to 71%, nebulised bronchodilators from 31% to 32%, and an increase in prophylactic medication after an acute attack from 41% to 49%. Contrary to guidelines, antibiotic use increased from 32% to 40% of attacks. Practitioners from a special interest asthma group gave more of their patients systemic steroids and nebulised bronchodilators both in 1991/92 and 1992/93. CONCLUSIONS: Some aspects of the management of asthma attacks by general practitioners has changed in line with guidelines, but there is still a large gap between actual and recommended management.
Sea-Blue Histiocytes
Authors: Michael A. Baumann
Journal: JAMA (1983)

Sea-blue histiocytes were found scattered throughout Wright-Giemsa-stained smears of a bone marrow aspiration from a 33-year-old man with recently diagnosed chronic myelogenous leukemia. Such cells have been occasionally discovered in bone marrow since the original report by Wewalka 1 in 1950. A genetic syndrome has become recognized having a usual presentation early in the third decade of life with hepatosplenomegaly and thrombocytopenic purpura. Macular abnormalities, unexplained pulmonary infiltrates, and neurological abnormalities have been seen in some patients. Pathologically, infiltration by histiocytes is seen in bone marrow and spleen. The histiocytes are typically 20 to 60 μm in diameter and have a single eccentric nucleus with a prominent nucleolus. Contained in the cytoplasm are numerous large granules that stain brilliantly blue-green or sea-green on Wright-Giemsa-stained preparations. These granules are also stained intensely by Sudan black and other lipid stains, and increased storage of sphingomyelin and glycosphingolipids has been found in the
Reply to D. Vordermark
Authors: Jaffer A. Ajani
Journal: Journal of Clinical Oncology (2009)

I thank Dr Vordermark 1 for his interest in our articles and useful comments.I agree with his analysis of our report 2 that concluded that the cisplatin-based arm was less effective for local control and lead to a higher rate of colostomy than the mitomycinbased arm.At the present time, I am unable to supply the Kaplan-Meier survival curve that he requests but agree that it would be of considerable interest.I am, however, intrigued by his views that in certain patients, the treatment intensity can be reduced.This compliments the concept of individualization of therapy and a need for understanding the factors that mediate chemoradiotherapy resistance.We have previously suggested that understanding the molecular biology of anal canal cancer by studying pretreatment tissue for various relevant biomarkers could allow optimization of therapy. 2,3However, Dr Vordermark makes a point that takes such concepts to a higher level.By knowing in advance whose cancer is highly chemoradiotherapy sensitive, not only we can optimize therapy but we can also reduce its intensity (and thereby reduce toxicity).This type of concept building will benefit our future patients.
HISTOPATHOLOGICAL VALIDATION OF OPTICAL COHERENCE TOMOGRAPHY ANALYSIS FOR EXTENDED LATE-PHASE IN-STENT NEOINTIMAL TISSUE CHARACTERIZATION AFTER BARE-METAL STENT IMPLANTATION
Authors: Masahiko Shibuya, Kenichi Fujii, Masashi Fukunaga, Kojiro Miki, Tsuyoshi Nakata, Daizo Kawasaki, Mitsumasa Ohyanagi, Tohru Masuyama
Journal: Journal of the American College of Cardiology (2012)
Higher doses of CD34+ peripheral blood stem cells are associated with increased mortality from chronic graft-versus-host disease after allogeneic HLA-identical sibling transplantation
Authors: M Mohty, K Bilger, E Jourdan, M Kuentz, M Michallet, J H Bourhis, N Milpied, L Sutton, J P Jouet, M Attal, P Bordigoni, J Y Cahn, A Sadoun, N Ifrah, D Guyotat, C Faucher, N Fegueux, J Reiffers, D Maraninchi, D Blaise
Journal: Leukemia (2003)
Chernobyl 25 years on
Authors: K. Baverstock
Journal: BMJ (2011)

The olivocerebellar system is known to generate periodic synchronous discharges that result in synchronous (to within 1 msec) climbing fiber activation of Purkinje cells (complex spikes) organized in parasagittally oriented strips. These results have been obtained primarily in anesthetized animals, and so the question remains whether the olivocerebellar system generates such patterns in the awake animal. To this end, multiple electrode recordings of crus 2a complex spike activity were obtained in awake rats conditioned to execute tongue movements in response to a tone. After removal of all movement- and tone-related activity, the remaining data were examined to characterize spontaneous complex spike activity in the alert animal. Spontaneous complex spikes occurred at an average firing rate of 1 Hz and a clear ≈10 Hz rhythmicity. Analysis of the autocorrelograms using a rhythm index indicated that the large majority of Purkinje cells displayed rhythmicity, similar to that in the anesthetized preparation. In addition, the patterns of synchronous complex spike activity were also similar to those observed in the anesthetized preparation (i.e., simultaneous activity was found predominantly among Purkinje cells located within the same parasagittally oriented strip of cortex). The results provide unequivocal evidence that the olivocerebellar system is capable of generating periodic patterns of synchronous activity in the awake animal. These findings support the extrapolation of previous results obtained in the anesthetized preparation to the waking state and are consistent with the timing hypothesis concerning the role of the olivocerebellar system in motor coordination.
Overall and cancer related mortality among patients with ocular inflammation treated with immunosuppressive drugs: retrospective cohort study
Authors: J. H Kempen, E. Daniel, J. P Dunn, C S. Foster, S. Gangaputra, A. Hanish, K. J Helzlsouer, D. A Jabs, R O. Kacmaz, G. A Levy-Clarke, T. L Liesegang, C. W Newcomb, R. B Nussenblatt, S. S Pujari, J. T Rosenbaum, E. B Suhler, J. E Thorne
Journal: BMJ (2009)

<b>Context</b> Whether immunosuppressive treatment adversely affects survival is unclear. <b>Objective</b> To assess whether immunosuppressive drugs increase mortality. <b>Design</b> Retrospective cohort study evaluating overall and cancer mortality in relation to immunosuppressive drug exposure among patients with ocular inflammatory diseases. Demographic, clinical, and treatment data derived from medical records, and mortality results from United States National Death Index linkage. The cohort’s mortality risk was compared with US vital statistics using standardised mortality ratios. Overall and cancer mortality in relation to use or non-use of immunosuppressive drugs within the cohort was studied with survival analysis. <b>Setting</b> Five tertiary ocular inflammation clinics. <b>Patients</b> 7957 US residents with non-infectious ocular inflammation, 2340 of whom received immunosuppressive drugs during follow up. <b>Exposures</b> Use of antimetabolites, T cell inhibitors, alkylating agents, and tumour necrosis factor inhibitors. <b>Main outcome measures</b> Overall mortality, cancer mortality. <b>Results</b> Over 66 802 person years (17 316 after exposure to immunosuppressive drugs), 936 patients died (1.4/100 person years), 230 (24.6%) from cancer. For patients unexposed to immunosuppressive treatment, risks of death overall (standardised mortality ratio 1.02, 95% confidence interval [CI] 0.94 to 1.11) and from cancer (1.10, 0.93 to 1.29) were similar to those of the US population. Patients who used azathioprine, methotrexate, mycophenolate mofetil, ciclosporin, systemic corticosteroids, or dapsone had overall and cancer mortality similar to that of patients who never took immunosuppressive drugs. In patients who used cyclophosphamide, overall mortality was not increased and cancer mortality was non-significantly increased. Tumour necrosis factor inhibitors were associated with increased overall (adjusted hazard ratio [HR] 1.99, 95% CI 1.00 to 3.98) and cancer mortality (adjusted HR 3.83, 1.13 to 13.01). <b>Conclusions</b> Most commonly used immunosuppressive drugs do not seem to increase overall or cancer mortality. Our results suggesting that tumour necrosis factor inhibitors might increase mortality are less robust than the other findings; additional evidence is needed.
An Open Forum
Authors: William R. Barclay
Journal: JAMA (1974)

ABSTRACT JAMA is not just an official organ of the AMA, it is an instrument through which physicians and other professionals concerned with health can express their opinions, observations, and recommendations for judgment by their peers. All editorials are signed and express only the view of the author, unless it is specified that, indeed, the opinion represents AMA policy.A series of indignant protests over the review by J. Harvey Young, PhD, of the book, Pills, Profits, and Politics (JAMA 229:1807, 1974) shows that The Journal is carefully and thoughtfully read, but that our editorial policy is misunderstood. Books are sent to reviewers for their opinions of the content, and the opinion is published, even though it may conflict with the AMA's or the editor's views of the book.With respect to Pills, Profits, and Politics, we differed with the authors, Silverman and Lee, and also with the reviewer, but we
Capacity limits in continuous old-new recognition and in short-term implicit memory
Authors: Elinor McKone
Journal: Behavioral and Brain Sciences (2001)

Using explicit memory measures, Cowan predicts a new circumstance in which the central capacity limit of 4 chunks should obtain. Supporting results for such an experiment, using continuous old-new recognition, are described. With implicit memory measures, Cowan assumes that short-term repetition priming reflects the central capacity limit. I argue that this phenomenon instead reflects limits within individual perceptual processing modules.
Anti-minK Antisense Decreases the Amplitude of the Rapidly Activating Cardiac Delayed Rectifier K <sup>+</sup> Current
Authors: Tao Yang, Sabina Kupershmidt, Dan M. Roden
Journal: Circulation Research (1995)

Abstract The rapidly and slowly activating delayed rectifier K + currents (I Kr and I Ks , respectively), which have different physiological properties, have been identified in cardiac cells from several species, including humans. Although expression of the minimal K + channel protein (minK) cDNA in some systems results in a current resembling I Ks , the role of this gene product in channel function remains controversial. In atrial tumor myocytes (AT-1 cells), no I Ks is recorded, but minK mRNA is detected, raising the possibility that expression of the minK gene serves an as-yet-unidentified function. In these experiments, AT-1 cells were exposed to antisense oligonucleotides targeting the 5′ translation start site of the minK cDNA cloned from an AT-1 library. Cell size, I Kr , and L-type and T-type Ca 2+ currents were measured 24 to 48 hours after exposure and compared with data in cells exposed to the corresponding sense oligonucleotide or grown in medium only. Antisense oligonucleotide significantly reduced I Kr compared with sense and medium-only control cells in 0 of 2 experiments (n=3 to 6 cells per treatment in each experiment) at 50 nmol/L, 1 of 2 at 250 nmol/L, 6 of 6 at 1000 nmol/L, and 2 of 2 at 10 000 nmol/L. At 1000 nmol/L, maximum tail current in antisense-exposed cells was 2.5±0.1 pA/pF (mean±SEM, n=28, 6 separate experiments), 6.6±0.4 pA/pF in sense-exposed cells (n=27), 5.4±0.6 pA/pF in medium-only cells (n=21), and 5.8±0.7 pA/pF in cells exposed to a random oligonucleotide (n=9). I Kr activation, rectification, deactivation, and sensitivity to the blocker dofetilide were unaffected. Two different antisense oligonucleotides produced the same effect, and there was no effect of antisense treatment on cell size or on L- or T-type Ca 2+ currents. These data indicate that in AT-1 cells, expression of the minK gene plays a role in determining I Kr amplitude.