tbuckley/cabot-search huggingface dataset:
Climbie inquiry recommends national agency for children
Authors: H. Marcovitch
Journal: BMJ (2003)

Lord Laming's report on the torture and murder of 8 year old Victoria Climbie by her carers calls for “rigorous attention to the medical model” when evaluating children diagnosed as possibly abused.

Lord Laming added: “The systematic approach commonly applied by paediatricians to the diagnosis and treatment of physical disease should be applied.”

His independent statutory inquiry into how the authorities failed to protect Victoria, who died in London three years ago, criticises many of those who dealt with her during the last seven months of her life. But it reserved its harshest strictures for “managers and senior …
Supplementing the Traditional Institutional Review Board with an Environmental Health and Community Review Board
Authors: Steven G. Gilbert
Journal: Environmental Health Perspectives (2006)

Community-based research often involves additional ethical, legal, and social considerations beyond those of the specific individuals involved in the study. The traditional institutional review board (IRB) typically focuses on protecting the rights and ensuring the safety of the individuals involved. For projects involving community members, IRBs should be more sensitive to issues related to the broader community concerns.The objective of this article is to discuss the concept of community-based participatory research and the shortcomings of the traditional IRBs in dealing with ethical issues associated with broader community concerns such as implications for family members, neighborhood groups, and local businesses. I examine the rationale and benefits for expanding the roles and responsibilities of review boards related to community-based issues.I propose the development of environmental health and community review boards (EHCRBs) that combine the fundamental responsibilities and ethical concept of the traditional review boards with an expanded ethical construct of dignity, veracity, sustainability, and justice, with an added emphasis on community.Only by acknowledging the needs of and working with the community can we ensure ethically based and socially responsible research. An EHCRB will allow researchers and community members to more fully address their mutual interest in conducting scientific, ethical, and socially responsible research.
Limited Utility of Residue Masking for Positive-Selection Inference
Authors: Stephanie J. Spielman, Eric T. Dawson, Claus O. Wilke
Journal: Molecular Biology and Evolution (2014)

Errors in multiple sequence alignments (MSAs) can reduce accuracy in positive-selection inference. Therefore, it has been suggested to filter MSAs before conducting further analyses. One widely used filter, Guidance, allows users to remove MSA positions aligned with low confidence. However, Guidance's utility in positive-selection inference has been disputed in the literature. We have conducted an extensive simulation-based study to characterize fully how Guidance impacts positive-selection inference, specifically for protein-coding sequences of realistic divergence levels. We also investigated whether novel scoring algorithms, which phylogenetically corrected confidence scores, and a new gap-penalization score-normalization scheme improved Guidance's performance. We found that no filter, including original Guidance, consistently benefitted positive-selection inferences. Moreover, all improvements detected were exceedingly minimal, and in certain circumstances, Guidance-based filters worsened inferences.
Immunostimulatory Oligonucleotides Attenuate Airways Remodeling in Allergic Monkeys
Authors: Michelle V. Fanucchi, Edward S. Schelegle, Gregory L. Baker, Michael J. Evans, Ruth J. McDonald, Laurel J. Gershwin, Eyal Raz, Dallas M. Hyde, Charles G. Plopper, Lisa A. Miller
Journal: American Journal of Respiratory and Critical Care Medicine (2004)

To determine whether inhaled immunostimulatory DNA sequence oligonucleotides containing CpG motifs mitigate the pathophysiologic manifestation of the asthmatic phenotype (airways hyperresponsiveness and airways remodeling), rhesus monkeys with experimentally induced allergic airways disease were treated seven times with inhaled immunostimulatory oligonucleotides (or sham) periodically for 33 weeks. Airways hyperresponsiveness was reduced twofold in immunostimulatory DNA sequence-treated compared with sham-treated monkeys. Airways from immunostimulatory oligonucleotide-treated monkeys had thinner reticular basement membranes, fewer mucous cells, fewer eosinophils, and fewer mast cells than sham-treated allergic monkeys. We conclude that inhaled immunostimulatory oligonucleotides can attenuate the magnitude of airway hyperreactivity and airways remodeling produced in nonhuman primates with experimentally induced allergic airways disease.
LIMITATIONS OF THE LARYNGOLOGIST IN THE GENERAL TREATMENT OF NOSE AND THROAT DISEASES.
Authors: H. W. LOEB
Journal: JAMA (1901)

The tendency observable in modern laryngologic literature, to ascribe to the general system a closer etiologic relation with the nose and throat, must have one important effect—to call for a more general treatment of the upper respiratory tract. Before the local propaganda had practically absorbed the attention of specialists in our line, the general or systemic means comprised in great measure the plan of treatment of nose and throat diseases. And now that localism has had full sway, it is to be expected that the general treatment should come more into vogue. Perhaps, if it were merely a return to former conditions, there would not be much call for a paper on, limitations in this regard. But we must not forget that during these years changes have taken place which have increased our knowledge tenfold and our range of instrumentation and manipulation a hundredfold; which have so added to the
Congenital Pulmonary Stenosis Resulting from Dysplasia of Valve
Authors: EMIL D. KORETZKY, JAMES H. MOLLER, MICHAEL E. KORNS, COLIN J. SCHWARTZ, JESSE E. EDWARDS
Journal: Circulation (1969)

A distinctive type of pulmonary valvular stenosis, termed "pulmonary valvular dysplasia," is described from six necropsies and 10 living children. The anatomic features of the stenotic pulmonary valve are unique in that there are three distinct cusps and no commissural fusion. The obstructive mechanism is related to markedly thickened, immobile cusps, characterized by the presence of disorganized myxomatous tissue. Several clinical features tend to distinguish this form of pulmonary stenosis. In each of 16 patients studied, a pulmonary ejection murmur was present, but this was not associated with an ejection click. Other features suggestive of this type of pulmonary stenosis were slow body growth, abnormal facies, and a positive family history of pulmonary stenosis. The electrocardiogram showed a greater degree of right axis deviation than is found in most cases of dome-shaped pulmonary stenosis. Right ventriculography revealed distinctive features of the pulmonary valve which were characterized by lack of typical dome-shaped deformity and by the presence of thick cusps. Experience with simple incision-valvulotomy was associated with a high (38%) operative mortality and significant residual stenosis in survivors. The suggested operative procedures include excision of a valve cusp, placement of a right ventricular outflow patch, or replacement of the pulmonary valve.
Importance of the Colon in Enteric Hyperoxaluria
Authors: John W. Dobbins, Henry J. Binder
Journal: New England Journal of Medicine (1977)

To investigate the role of the colon in increased oxalate absorption, we measured urinary oxalate and fecal fat excretion in 26 patients with gastrointestinal disease. Eight patients with steatorrhea of various causes (Crohn's disease [two], chronic pancreatitis [four], jejunoileal bypass [one] and extrahepatic biliary obstruction [one]) had hyperoxaluria (>45 mg per 24 hours). All these patients had intact colons. In contrast, none of five patients with ileostomies and steatorrhea secondary to ileal resection had hyperoxaluria. Absorption of 14C-oxalate was increased in three patients with steatorrhea and intact colons but not in three patients with steatorrhea and an ileostomy. Thus, the colon is both the site of and required for increased oxalate absorption in enteric hyperoxaluria. The lack of a direct relation between fecal fat excretion and urinary oxalate excretion in the patients with hyperoxaluria and steatorrhea suggests that steatorrhea, although important, is not the only determinant In the pathogenesis of hyperoxaluria. (N Engl J Med 296:298–301, 1977)
What is the best method for assessing the long-term outcome of surgery for accessory pathways and atrioventricular junctional reentrant tachycardias?
Authors: L M Davis, D C Johnson, J B Uther, G Nunn, D A Richards, W Meldrum-Hanna, D L Ross
Journal: Circulation (1991)

The success of surgery for supraventricular tachycardia (SVT) is evaluated by a variety of methods in different hospitals. Unfortunately, the predictive values of these methods are not known. We therefore compared the various methods in 261 patients undergoing surgery for SVT at Westmead Hospital since 1981. Surgical outcome was assessed by early tests during the first week after surgery (serial 12-lead electrocardiograms, telemetric monitoring of the electrocardiogram, and electrophysiological study performed using epicardial wires); later tests at 6 months after surgery (12-lead electrocardiograms and electrophysiological study); and symptomatic review done by telephone interview at a median of 34 months after surgery. Early tests were obtained in 97%, later tests were obtained in 76%, and symptomatic review was obtained in 98% of patients. All of the examined tests were inaccurate methods of surgical assessment compared with the late electrophysiological study. A large proportion of the patients proven to be surgical failures at the late electrophysiological study were not detected by early tests (83%), by later electrocardiograms (66%), or by symptomatic assessment (41%). Accurate assessment of surgical outcome requires a late electrophysiological study to permit comparison of surgical techniques. Late electrophysiological study also provides accurate information on the current risks and benefits of proposed surgery for communication to patients to enable them to make an informed decision on future treatment. Most patients are willing to have a late electrophysiological study and usually benefit from clarification of their true surgical outcome.
Extracorporeal shock wave lithotripsy and gall bladder stones.
Authors: A G Johnson, B Ross
Journal: Gut (1993)

<h3>Objective</h3> The first cohort of Turkish fellows has begun to graduate from a newly accredited training program on gynecologic oncology. This study aimed to investigate the value of experience on the confidence of these fellows to perform surgical procedures. <h3>Methods</h3> We assessed the characteristics of 32 fellows, including the perceived adequacy of their fellowship training, the facilities of the clinics at which they were trained, and their levels of exposure and confidence in performing a total of 44 procedures. Exposure levels were performing, assisting with, observing, or no exposure. Confidence was assessed by asking whether they could perform each procedure. Correlation analysis was used to determine the link between exposure levels and confidence. <h3>Results</h3> The confidence of fellows to perform a surgical procedure increased with exposure to that procedure (<i>r</i> = 0.820, <i>P</i> &lt; 0.001). Performing, assisting with, and observing a procedure created a sense of confidence in 97.2%, 54.1%, and 31.1% of fellows. The majority of fellows (&gt;75%) had performed type 2 hysterectomy, total omentectomy, and pelvic and para-aortic lymphadenectomy. None of the fellows had ever performed a trachelectomy. <h3>Conclusions</h3> Efforts should be made in accredited systems for gynecologic oncology surgical training to provide more opportunities for trainees to perform surgical procedures, rather than assisting with and observing them.
Psychiatric testimony: what are its limits?
Authors: M. F. Goldsmith
Journal: JAMA (1984)

The psychiatrist's role as an expert witness was discussed by Arthur F. Sullwood, M.D., and Gerald T. Bennett, J.D., at the annual meeting of the American Academy of Forensic Sciences (AAFS). Their thesis that there are inherent limits to the application of psychiatry to legal questions was addressed by participants in conjunction with a Supreme Court decision permitting such testimony. Sullwood stated that psychiatrists attempting to predict dangerous behavior are disguising lay opinion as psychiatric theory. Dr. Walter Bromberg, president of the AAFS, disagreed, saying that psychiatrists do have a valid role in helping courts reach an assessment of an offender's personality and mental state.
Fast, frugal, and surprisingly accurate heuristics
Authors: R. Duncan Luce
Journal: Behavioral and Brain Sciences (2000)

A research program is announced, and initial, exciting progress described. Many inference problems, poorly modeled by some traditional approaches, are surprisingly well handled by kinds of simple-minded Bayesian approximations. Fuller Bayesian approaches are typically more accurate but rarely are they either fast or frugal. Open issues include codifying when to use which heuristic and to give detailed evolutionary explanations.
Energy-dispersive X-ray analysis and scanning electron microscopy of pleura. Study of reference, exposed non-pneumoconiotic, and silicotic populations.
Authors: J Ferrer, R Orriols, J M Tura, J Lirola, C Xaus, X Vidal
Journal: American Journal of Respiratory and Critical Care Medicine (1994)

Inorganic element content in pleura and lung was studied by energy-dispersive X-ray analysis (EDXA) and scanning electron microscopy (SEM) in reference, exposed non-pneumoconiotic, and silicotic populations. Samples of parietal pleura, visceral pleura, and lung in 11 subjects with no measurable exposure to inorganic dust and of visceral pleura and lung samples of 10 exposed non-pneumoconiotic individuals and eight silicotic patients were examined. Constant depositions of silicon and calcium were detected in visceral pleura, parietal pleura, and lung of the reference group and in visceral pleura and lung of the exposed non-pneumoconiotic and silicotic groups. Other elements, such as aluminum and iron, were also detected in the exposed non-pneumoconiotic and silicotic patients and, less frequently, in the reference group. There was no difference in silicon content between parietal and visceral pleura in the reference group. Silicon content in silicotic patients was higher and more irregularly distributed in the pleura (p = 0.005 and p < 0.01, respectively) and in the lung (p = 0.005 and p < 0.01, respectively) than in the reference group. Comparison of the silicon content in pleura between silicotic and exposed non-pneumoconiotic subjects showed a nonsignificant probability of difference (p = 0.052), whereas there were no differences with respect to the silicon content in lung. There were no differences in the pleural and lung silicon content between the exposed non-pneumoconiotic and reference groups.(ABSTRACT TRUNCATED AT 250 WORDS)
Congenital Deformities of the Chest Wall and Their Operative Correction
Authors: Jonathan Cohen
Journal: JAMA (1978)

Pediatricians rarely will have had the experience of examining large numbers of adults and, in the process, of realizing how commonly a congenital deformity of the chest occurs. The more serious of these deformities are rare and usually are obvious even in infancy. When and how to treat a deformity surgically are the subjects of this definitive book. Ravitch brings to these questions the experience of several decades, scholarship in the study of embryology, and a clarity of exposition that are exemplary. The book, handsomely illustrated, has six chapters, the first four entitled "Sternal Clefts," "Pectus Excavatum," "Pectus Carinatum," and "Poland's Syndrome." The other two chapters cover deformities not easily classified or ascribable to generalized diseases. All the subjects are exhaustively covered, primarily from the surgeon's standpoint, but pediatricians would do well to consult this monograph when treating a patient with any congenital deformity of the chest.
Effect of changes in load on monophasic action potential and segment length of pig heart in situ
Authors: J. W DEAN, M. J LAB
Journal: Cardiovascular Research (1989)

There is increasing evidence that mechano-electric feedback, defined as a change in mechanical state that precedes and alters transmembrane potential, operates in a wide variety of preparations and species including man. Load reduction is becoming a common therapeutic tool in a variety of clinical settings but the electrophysiological effects of these manoeuvres is not known. In this study the effect of changes in loading conditions on the time course of ventricular repolarisation were examined in the in situ heart in 13 pigs anaesthetised with halothane. Monophasic action potentials, electrocardiograms and segment length changes were recorded from the left ventricular epicardium using suction operated devices. Afterload was decreased by intravenous infusion of sodium nitroprusside, and increased by aortic cross clamping. Infusion of sodium nitroprusside resulted in a rise in action potential duration (measured at 70% repolarisation) in all 21 infusions (mean 3.4 ms), which was linearly related to the fall in systolic left ventricular pressure (r = 0.72, p<0.001) and the change in minimum systolic segment length (r = 0.46, p<0.05), but not to the change in maximum diastolic length (r = 0.33, NS). Aortic constriction, sufficient to elevate peak systolic left ventricular pressure back to the control level, restored the changes in action potential duration to normal. In addition, there were concomitant changes in the QT interval and T wave of the epicardial ECG. These findings show that mechano-electric feedback operates in the in situ heart and has potential importance in the clinical setting where changes in systemic blood pressure may directly alter cardiac electrophysiology.
Mutations in ALMS1 cause obesity, type 2 diabetes and neurosensory degeneration in Alström syndrome
Authors: Gayle B. Collin, Jan D. Marshall, Akihiro Ikeda, W. Venus So, Isabelle Russell-Eggitt, Pietro Maffei, Sebastian Beck, Cornelius F. Boerkoel, Nicola Sicolo, Mitchell Martin, Patsy M. Nishina, Jürgen K. Naggert
Journal: Nature Genetics (2002)
Breaking Tolerance to Thyroid Antigens: Changing Concepts in Thyroid Autoimmunity
Authors: Sandra M. McLachlan, Basil Rapoport
Journal: Endocrine Reviews (2013)

Thyroid autoimmunity involves loss of tolerance to thyroid proteins in genetically susceptible individuals in association with environmental factors. In central tolerance, intrathymic autoantigen presentation deletes immature T cells with high affinity for autoantigen-derived peptides. Regulatory T cells provide an alternative mechanism to silence autoimmune T cells in the periphery. The TSH receptor (TSHR), thyroid peroxidase (TPO), and thyroglobulin (Tg) have unusual properties ("immunogenicity") that contribute to breaking tolerance, including size, abundance, membrane association, glycosylation, and polymorphisms. Insight into loss of tolerance to thyroid proteins comes from spontaneous and induced animal models: 1) intrathymic expression controls self-tolerance to the TSHR, not TPO or Tg; 2) regulatory T cells are not involved in TSHR self-tolerance and instead control the balance between Graves' disease and thyroiditis; 3) breaking TSHR tolerance involves contributions from major histocompatibility complex molecules (humans and induced mouse models), TSHR polymorphism(s) (humans), and alternative splicing (mice); 4) loss of tolerance to Tg before TPO indicates that greater Tg immunogenicity vs TPO dominates central tolerance expectations; 5) tolerance is induced by thyroid autoantigen administration before autoimmunity is established; 6) interferon-α therapy for hepatitis C infection enhances thyroid autoimmunity in patients with intact immunity; Graves' disease developing after T-cell depletion reflects reconstitution autoimmunity; and 7) most environmental factors (including excess iodine) "reveal," but do not induce, thyroid autoimmunity. Micro-organisms likely exert their effects via bystander stimulation. Finally, no single mechanism explains the loss of tolerance to thyroid proteins. The goal of inducing self-tolerance to prevent autoimmune thyroid disease will require accurate prediction of at-risk individuals together with an antigen-specific, not blanket, therapeutic approach.
Studies on Blood Coagulation and the Effect of Digitalis
Authors: GEORGE C. SUTTON
Journal: Circulation (1950)

Preceding the study of the effect of digitalis upon coagulation of the blood, the reliability of the Lee and White method was determined in 173 normal adults. The effect of digitalis was then studied in cardiac patients before and after compenation and with normal controls in eacgroup: digitalis in clinical doses; addition of heparin to the blood; the heparin tolerance curve; the substitution of methyl methacrylate (Lucite) tubes; liver function as determined by excretion of bromsulfalein; prothrombin times.
Dissociated Response to Rheumatoid Factor in Lepromatous Hanseniasis
Authors: F. E. Rabello
Journal: JAMA (1973)

<h3>To the Editor.—</h3> Fever and arthralgia devoid of other clinical connotations are often seen in patients on the verge of the first crop of lepromas. In this situation, a tentative diagnosis usually includes the possible beginning of either rheumatoid arthritis or systemic lupus erythematosus. If confirmed, the combined finding of a dissociation between a positive Rose-Waaler and a negative latex slide test, especially if reinformced by a negative Mitsuda skin test, would lead to an early diagnosis of malignant hanseniasis. This would provide the possibility of treating the patient long before the onset of the clinical symptoms of the lepromatous (virchowian) type of the disease. Controls were made to prevent any false results from the introduction of known reactive and nonreactive sera into the test runs. Zonal phenomena were also considered as a possible source of false results and likewise controlled. No false-positive or negative phenomena were observed. Our findings