tbuckley/cabot-search huggingface dataset:
Predicting Accrual Achievement: Monitoring Accrual Milestones of NCI-CTEP–Sponsored Clinical Trials
Authors: Steven K. Cheng, Mary S. Dietrich, David M. Dilts
Journal: Clinical Cancer Research (2011)

The need to increase the number oncology clinical trials with sufficient enrollments is a well-known issue, particularly for trials targeting therapeutic applications. It is critical to identify early predictors of eventual study accrual achievement.All nonpediatric phase I, I/II, II, and III therapeutic studies supported by the National Cancer Institute Cancer Therapy Evaluation Program (NCI-CTEP) between 2000 and 2007 (n = 764) were analyzed for accrual performance. Accrual achievement is defined as those enrolling 100% or more of the stated minimum accrual goal at the time of trial closure. Two accrual milestones were analyzed per trial: time to first patient enrollment and expected time to accrual goal. Multivariate logistic regression analysis was used to calculate the OR with respect to the likelihood of clinical trial accrual achievement.A total of 81.5% (n = 623) of the trials did not achieve the projected accrual goals within the anticipated accruing period. Furthermore, 37.2% (n = 284) of trials failed to achieve the minimum projected accrual at study closure regardless of time the trial was open. Trials that accrue the first enrollment beyond 2 months (n = 379, 49.6%) are significantly less likely to achieve the accrual performance than those trials that enroll patients under 2 months (OR: 0.637, 95% CI: 0.464-0.875, P = 0.005). Of the studies that are open beyond the anticipated enrollment period (n = 603), those do not achieve at least 60.0% of the projected minimum accrual (n = 391, 64.8%) have a significantly less likelihood of achieving final accruals by study closure (OR: 0.190, 95% CI: 0.055-0.652, P = 0.008).The time to first patient enrollment and expected time to accrual goal are shown to be valid measures to evaluate the likelihood of achieving the minimum projected accrual.
Postural changes in pulmonary blood flow in pulmonary hypertension: a noninvasive technique using ventilation-perfusion scans.
Authors: M Horn, W Hooper, B Brach, W Ashburn, K Moser
Journal: Circulation (1982)

To determine whether postural changes in ratio of upper to lower (U:L) zone pulmonary blood flow reflect pulmonary arterial pressures, we used pulmonary perfusion photoscintigraphy to study 12 normal subjects and 10 patients with precapillary pulmonary hypertension (eight classified as "primary" and two as thromboembolic). All patients underwent right-heart catheterization and measurement of pulmonary arterial systolic, diastolic, mean and capillary (wedge) pressures. The distribution of perfusion was then assessed in the supine and erect positions after i.v. injection of technetium-99m-labeled, macroaggregated albumin. Perfusion distribution was corrected for lung volume by xenon-133 equilibrium ventilation scans. In normal subjects, the U:L lung zone perfusion ratio decreased by 70.7 +/- 12.2% with the change in position. The patient group differed (p less than 0.0001) from normal subjects in that there was only a 19 +/- 17.4% shift of U:L ratio with the postural change. The mean pulmonary arterial pressure in the patient groups was 50 +/- 24.2 mm Hg. The postural change in U:L zone ratio correlated significantly with the mean pulmonary arterial pressure (r = -0.84, p less than 0.01) pulmonary arterial systolic (r = -0.83, p less than 0.01) and diastolic pressures (r = -0.72, p less than 0.05) and with the pulmonary vascular resistance (r = -0.74, p less than 0.02). No correlation was found with other hemodynamic, spirometric or blood gas data. We conclude that the postural shift in U:L ratio warrants further exploration as a noninvasive approach for detecting and quantifying pulmonary hypertension.
Thrombolytic Therapy in Haemolytic-Uraemic Syndrome
Authors: J. Stuart, M. H. Winterborn, R. H. R. White, R. M. Flinn
Journal: BMJ (1974)

The treatment of five children with the haemolytic-uraemic syndrome using streptokinase is described to illustrate the difficulties and limitations of thrombolytic therapy in this disease. This experience is germane to the design of multicentre clinical trials. A multivariate analysis relating clinical outcome to the data obtained at the time of admission was also carried out for 31 children with the disease treated in four centres. The results suggest that this technique may help to identify those patients likely to have a fatal outcome. An expanded form of this type of analysis should be incorporated in future clinical trials.
Polychlorinated dibenzo-p-dioxins, dibenzofurans, and biphenyls in fishermen in Finland.
Authors: Hannu Kiviranta, Terttu Vartiainen, Jouko Tuomisto
Journal: Environmental Health Perspectives (2002)

We measured plasma concentrations of polychlorinated dibenzo-p-dioxins and dibenzofurans (PCDD/Fs), and polychlorinated biphenyls (PCBs) in fishermen from the Finnish Baltic Sea area and fishermen fishing in inland lakes. The concentrations clearly correlated with the frequency of fish meals and consumption of Baltic fatty fish. The body burden of PCDD/Fs reached the median level of 170 pg/g toxic equivalents (I-TEq) in fat for Baltic Sea fishermen, with the maximum being 420 pg/g. Results for 2,3,7,8-tetrachlorodibenzo-p-dioxin (range = 4.9-110 pg/g fat) showed that lifetime exposure in a population consuming much Baltic fatty fish can reach the levels of exposures seen in Seveso, Italy, in 1976. After we summed the PCB-TEqs, the total median exposure of Baltic Sea fishermen increased to 290 pg/g TEq in fat, and the highest concentration was 880 pg/g. There was a noted individual variation in fishermen's PCDD/F congener patterns, and it was possible to associate this variation with congener patterns of PCDD/Fs in the fish species that the fisherman reported they had consumed. Linear regression models for ln WHO(PCDD/F)-TEq, ln WHO(PCB)-TEq, and ln total WHO-TEq, from the World Health Organization, explained 48%, 60%, and 53% of the variability, respectively. Age was the only significant predictor of ln WHO(PCDD/F)-TEq, whereas age, amount of fish eaten, and place of residence were significant predictors of ln WHO(PCB)-TEq, and ln total WHO-TEq.
Turning off class switching
Authors: Shannon Amoils
Journal: Nature reviews. Immunology (2006)

Conventional CD4 + T cells are thought to have an essential role in the pathogenesis of asthma.However, natural killer T (NKT) cells expressing a semi-invariant T-cell receptor (denoted iNKT cells) have been shown to be involved in the development of allergen-induced airway hyper-responsiveness (AHR).Meyer et al. set out to characterize the role of iNKT cells in the development of AHR and found that intranasal administration of an iNKT-cell ligand (either α-galactosylceramide (α-GalCer) or a synthetic version of a glycolipid from some Sphingomonas spp.) induced severe AHR in mice.Induction of AHR required both interleukin-4 (IL-4) and IL-13 but not the presence of conventional CD4 + T cells.The authors therefore suggest that iNKT cells might synergize with conventional CD4 + T cells in the induction of asthma.
Cost Effectiveness of Modified Fractionation Radiotherapy versus Conventional Radiotherapy for Unresected Non–Small-Cell Lung Cancer Patients
Authors: Bram L.T. Ramaekers, Manuela A. Joore, Béranger Lueza, Julia Bonastre, Audrey Mauguen, Jean-Pierre Pignon, Cecile Le Pechoux, Dirk K.M. De Ruysscher, Janneke P.C. Grutters
Journal: Journal of Thoracic Oncology (2013)
Quality of Chart Review for Quality of Care-Reply
Authors: Edward F. Ellerbeck
Journal: JAMA (1995)

<h3>In Reply.</h3> —Drs Localio and Landis illustrate the proper methods for measuring the accuracy of a test when there is a true, knowable result. Unfortunately, in the setting of retrospective data collection, where we cannot control how the data are recorded in the medical record, there are wide variations in how information is recorded. The information may be ambiguous or inconsistent. Therefore, a true result cannot always be known. Given that situation, one is forced to use measures of interrater agreement such as κ. As we implement the Cooperative Cardiovascular Project on a national basis, we plan to extend our measures of interrater agreement beyond simple duplicate reviews by examining the performance of abstractors on "gold standard" charts in which we have established agreement on specific variables and quality indicators by multiple, experienced abstractors. These measures of the reliability of data collection, however, are still an incomplete measure of the
Physician-Assisted Suicide and Euthanasia-Reply
Authors: Anthony L. Back
Journal: JAMA (1996)

In Reply.  —In our study, 88% of physicians who received requests for physician-assisted death during the past year reported only receiving a single request, and 95% reported 1 or 2 requests. The remaining 5% of physicians who received 3 or more requests in the past year were not significantly more likely to provide physician-assisted death, although small numbers limit the power of this comparison. One physician did report 20 requests for physician-assisted death and described in detail a single patient who died of physician-assisted suicide. Obviously we cannot draw meaningful conclusions about this physician or others who received many requests based on a single case. Perhaps, as Dr Masdeu suggests, this physician received many requests by eliciting them from patients. We can speculate about alternative explanations: this physician may be unusually sensitive to patient concerns, may be known for expertise in end-of-life care, or may be sought out by patients who seek
Favorable outcome in infants with AML after intensive first- and second-line treatment: an AML-BFM study group report
Authors: U Creutzig, M Zimmermann, J-P Bourquin, M N Dworzak, B Kremens, T Lehrnbecher, C von Neuhoff, A Sander, A von Stackelberg, I Schmid, J Starý, D Steinbach, J Vormoor, D Reinhardt
Journal: Leukemia (2011)
Reinvention starts here
Authors: T. Delamothe
Journal: BMJ (2003)

If anyone doubts that academic medicine needs all the support it can get then articles in this week's journal should convince them. The centrepiece is a report from the Academy of Medical Sciences on the woeful state of clinical research in the United Kingdom (p 1041).

Some of the problems relate to funding. But what's more corrosive than lack of money is the apparent abandonment of the belief in the value of academic medicine. The full explanation of this fall from grace is unclear, but Jocalyn Clark and Richard Smith provide some clues in their editorial (p 1001). This may …
Atrial Septal Defect in the Older Patient
Authors: FRANKLIN B. SAKSENA, HAROLD E. ALDRIDGE
Journal: Circulation (1970)

Twenty-four patients over 35 years of age with a secundum atrial septal defect (ASD) had a clinical and hemodynamic assessment prior to surgical closure and a follow-up assessment an average of 6 years afterward. All were initially in functional class III or IV. Twenty-three patients had a moderate to large left-to-right shunt. Five had elevated pulmonary vascular resistance (PVR); all had moderate to severe pulmonary hypertension. Left ventricular dysfunction (LVD) was found in 17. Following surgical closure, 22 patients showed sustained clinical improvement and were in class I or II. The mean pulmonary artery pressure fell to normal or mildly elevated values in 21. The PVR was now elevated in 14 patients, suggesting continued progression of obliterative pulmonary vascular disease. Three had small residual shunts. LVD, however, persisted after operation, which may reflect underlying myocardial pathology unrelated to the ASD. Operative closure of ASD, therefore, is recommended for disabled patients over 35, even if they have moderate pulmonary hypertension or congestive heart failure.
Graduate Medical Education and Physician Supply in New York State
Authors: Edward S. Salsberg
Journal: JAMA (1996)

<h3>Objectives.</h3> —To estimate the supply of physicians and residents in New York State and to assess the impact of state policies on the supply and distribution of physicians in the state. <h3>Design.</h3> —A comparison of the number of residents in New York State for 1988 and 1994 (from the American Medical Association Medical Education Database) and the number of active patient care physicians in New York by specialty and age (from the 1995 New York State Physician File). <h3>Main Outcome Measures.</h3> —Changes in the number of residents in New York State between 1988 and 1994 by specialty and medical school location; estimates of the numbers of physicians by age and specialty in New York for 1995; the migration of new physicians into and out of the state. <h3>Results.</h3> —The number of residents in New York State grew by nearly 21% between 1988 and 1994, despite a number of policies and programs encouraging maintenance of production levels. This growth is attributed to increases in the number of international medical graduates (IMGs) entering residency training through a widening "IMG window." Projection models show that, if production of new physicians continues at current levels, the supply of physicians will grow substantially during the next 2 decades. <h3>Conclusions.</h3> —Past policies to influence the supply, production, and distribution of physicians in New York State have not had their desired effects. Future policies and incentives must be carefully framed and coordinated to avoid similar failures.
PKC-β as a therapeutic target in CLL: PKC inhibitor AEB071 demonstrates preclinical activity in CLL
Authors: Dalia El-Gamal, Katie Williams, Taylor D. LaFollette, Matthew Cannon, James S. Blachly, Yiming Zhong, Jennifer A. Woyach, Erich Williams, Farrukh T. Awan, Jeffrey Jones, Leslie Andritsos, Kami Maddocks, Chia-Hsien Wu, Ching-Shih Chen, Amy Lehman, Xiaoli Zhang, Rosa Lapalombella, John C. Byrd
Journal: Blood (2014)
Self-expanding Mesh Stent for Esophageal Cancer Stenosis
Authors: W. Domschke, E. Ch. Foerster, W. Matek, W. Rödl
Journal: Endoscopy (1990)

The implantation of new self-expanding mesh stents (20 mm in diameter, when fully expanded) in a 67-year-old woman with extensive esophageal cancer stenosis is reported. Prosthesis insertion was easily accomplished without the need for general anesthesia. The patient has been doing well since. The potential advantages of the new stenting procedure suggest further investigation.
25-Hydroxyvitamin D concentrations and in vivo insulin sensitivity and β-cell function relative to insulin sensitivity in black and white youth. Diabetes Care 2012;35:627–633
Authors: K Rajakumar, J de las Heras, S Lee, MF Holick, SA Arslanian
Journal: Diabetes Care (2012)

Rajakumar K, de las Heras J, Lee S, Holick MF, Arslanian SA. 25-Hydroxyvitamin D concentrations and in vivo …
Long-Term Expression of Erythropoietin from Myoblasts Immobilized in Biocompatible and Neovascularized Microcapsules
Authors: G. Orive, M. De Castro, S. Ponce, R.M. Hernández, A.R. Gascón, M. Bosch, J. Alberch, José L. Pedraz
Journal: Molecular Therapy (2005)

The present paper investigates the long-term functionality of an ex vivo gene therapy approach based on cell microencapsulation for the continuous delivery of erythropoietin (EPO) without implementation of immunosuppressive protocols. Polymer microcapsules (0.5 ml) loaded with EPO-secreting C(2)C(12) myoblasts and releasing 15,490 +/- 600 IU EPO/24 h were implanted in the peritoneum and subcutaneous tissue of syngeneic and allogeneic mice. High and constant hematocrit levels were maintained for more than 100 days in all implanted mice. Capsules retrieved from the peritoneum were free-floating or forming small capsule clusters, and we detected only a weak fibroblast outgrowth in capsules adhered to organs, whereas capsules explanted from the subcutaneous region appeared altogether as a richly vascularized structure with no signs of major host reaction. Interestingly, the functionality of capsules implanted in the allogeneic mice persisted until day 210 after implantation. These results highlight the feasibility of cell encapsulation technology for the long-term delivery of EPO independent of the method of administration and the mouse strain.
Development and Validation of a Multifactorial Risk Index for Predicting Postoperative Pneumonia after Major Noncardiac Surgery
Authors: Ahsan M. Arozullah, Shukri F. Khuri, William G. Henderson, Jennifer Daley
Journal: Annals of Internal Medicine (2001)

Background: Pneumonia is a common postoperative complication associated with substantial morbidity and mortality. Objective: To develop and validate a preoperative risk index for predicting postoperative pneumonia. Design: Prospective cohort study with outcome assessment based on chart review. Setting: 100 Veterans Affairs Medical Centers performing major surgery. Patients: The risk index was developed by using data on 160 805 patients undergoing major noncardiac surgery between 1 September 1997 and 31 August 1999 and was validated by using data on 155 266 patients undergoing surgery between 1 September 1995 and 31 August 1997. Patients with preoperative pneumonia, ventilator dependence, and pneumonia that developed after postoperative respiratory failure were excluded. Measurements: Postoperative pneumonia was defined by using the Centers for Disease Control and Prevention definition of nosocomial pneumonia. Results: A total of 2466 patients (1.5%) developed pneumonia, and the 30-day postoperative mortality rate was 21%. A postoperative pneumonia risk index was developed that included type of surgery (abdominal aortic aneurysm repair, thoracic, upper abdominal, neck, vascular, and neurosurgery), age, functional status, weight loss, chronic obstructive pulmonary disease, general anesthesia, impaired sensorium, cerebral vascular accident, blood urea nitrogen level, transfusion, emergency surgery, long-term steroid use, smoking, and alcohol use. Patients were divided into five risk classes by using risk index scores. Pneumonia rates were 0.2% among those with 0 to 15 risk points, 1.2% for those with 16 to 25 risk points, 4.0% for those with 26 to 40 risk points, 9.4% for those with 41 to 55 risk points, and 15.3% for those with more than 55 risk points. The C-statistic was 0.805 for the development cohort and 0.817 for the validation cohort. Conclusions: The postoperative pneumonia risk index identifies patients at risk for postoperative pneumonia and may be useful in guiding perioperative respiratory care.
Endoscopic Variceal Ligation Using a Clipping Apparatus in Children with Portal Hypertension
Authors: N. Ohnuma, H. Takahashi, M. Tanabe, H. Yoshida, J. Iwai, T. Muramatsu
Journal: Endoscopy (1997)

Endoscopic variceal sclerotherapy (EVS) is a procedure frequently used to control bleeding from esophageal varices in adults. The use of EVS has been restricted in children due to the associated risks. The present paper describes the safety and efficacy of a new apparatus for endoscopic variceal ligation with clipping (EVLC).Endoscopic variceal ligation using a clipping apparatus (HX-3 L, Olympus, Tokyo, Japan), was carried out in 12 children with portal hypertension (four with extrahepatic portal vein obstruction and eight with congenital biliary atresia; four boys and eight girls, age range 2-14 years). A total of 417 variceal clipping procedures were carried out in 56 separate EVLC sessions; 118 esophageal varices and 65 gastric fundic varices were ligated using 417 clips. Initially, the EVLC sessions were repeated at approximately monthly intervals until the varices were eradicated, but the interval was gradually extended to twice a year or once a year.Varices were successfully ligated at the first attempt in 414 (99.3%) of the 417 clipping procedures. The esophageal varices were initially eradicated in all patients. The follow-up period ranged from nine to 48 months, and complete variceal eradication or reduction of the grade of the varices was obtained in 11 of the 12 patients after initial eradication during this period.These data indicate that EVLC offers advantages in the treatment of patients with esophageal varices combined with gastric fundic varices.
β-Thalassaemia in Cubans: Novel allele increases the genetic diversity at theHBB locus in the Caribbean
Authors: Adriana Muñiz, Gisela Martinez, João Lavinha, Paula Pacheco
Journal: American Journal of Hematology (2000)

In order to establish the molecular basis of β-thalassaemia in Cubans, a total of 75 unrelated individuals, with β-thalassaemia major (7), Hb S-β-thalassaemia (28), Hb C-β-thalassaemia (1), and β-thalassaemia trait (39) yielding 82 β-thalassaemia alleles, were analyzed. Seventeen different point mutations were identified accounting for 93% of the β-thalassaemia alleles studied, revealing a high genetic heterogeneity at the HBB locus in this population. The more prevalent mutations, namely, CD 39 (C → T) (30.5%), −29 (A → G) (13.4%), IVS-I-110 (G → A) (8.5%), and IVS-II-1 (G → A) (8.5%), reflect the Mediterranean and African predominant ancestry of the extant Cuban population. We also report the identification of a novel allele, IVS-I-108 (T → C), that possibly activates a cryptic branch site, in a β-thalassaemia carrier with no other molecular defect within the β-globin gene and its proximal promoter. This study shows that prenatal diagnosis of β-thalassaemia should be feasible in about 60% of at-risk pregnancies by direct detection of selected point mutations. However, due to the wide spectrum of mutations, and in order to offer fully informative prenatal diagnosis to more than 87% of at-risk couples, the screening for β-thalassaemia mutations in Cubans should be performed by using a general point mutation detection method, such as DGGE (denaturing gradient gel electrophoresis). Am. J. Hematol. 64:7–14, 2000. © 2000 Wiley-Liss, Inc.
Staphylococcal Food-poisoning Due to Infected Cow's Milk
Authors: F. D. F. Steede, H. W. Smith
Journal: BMJ (1954)

TABLE II.-Methaemoglobin Formation from Nitrates and Nitrites in WaterTotal Hb Methaemo-% of Normal globin Drinking-Date Subject (Haden) as % of water (100%-= Total Hb Supply 15-6 g./100 mL) 4/7/53 Baby (cyanosed) -93 56-8 Well 8/12/53 ,, (cured) 80 Nil Town to, Child (aged 2) 75 16-7 Well ., ,, 3) 70 9-5 Mother 77 9 5 11/12/53 Father 90 Nil Well-water at night; meals out during the daydescribed is applicable to the Evelyn-Rubicon photometer, whereas the instrument used here is similar to that described by Salt (1950), fitted with a Tinsley galvanometer.An instrument-correction factor was therefore worked out by means of known solutions of methaemoglobin, and has been applied to the values quoted.
Gastric acid secretion in patients with duodenal ulcer treated for one year with anticholinergic drugs
Authors: M. D. Kaye, P. Beck, J. Rhodes, P. M. Sweetnam
Journal: Gut (1969)

Although most universities run a health service, students with important mental health problems are often seen by their general practitioner. There are a number of reasons for this; first, health services in the colleges of higher education outside universities are still patchy and incomplete. Second, students are on vacation for up to 24 weeks a year. Third, a student may choose to consult anyone, and may prefer someone unconnected with the university. Last, many students live at home and continue to see their general practitioner. This underlines the need for close liason between the general practitioner and student health services.