tbuckley/cabot-search huggingface dataset:
New consultation exercise on health white paper has not been inclusive enough, critics say
Authors: Caroline White
Journal: BMJ (2005)

Doctors' and patients' groups fear that the UK government's new style public consultation exercise on what the health secretary, Patricia Hewitt, has called “health outside hospitals” has not been sufficiently inclusive. They also say that it will raise unrealistic expectations among staff and the public for service delivery and quality.

Views from the exercise, which the government has called “Your health, your care, your say,” will shape the white paper on improving primary care, community and social care services, which is due to be published in December.

Mrs Hewitt announced in June that she wanted to adopt a method of consultation that was different from the usual procedure of just …
Survival of Patients with Turcot's Syndrome and Glioblastoma
Authors: Adrian Merlo, Christoph Rochlitz, Rodney Scott
Journal: New England Journal of Medicine (1996)

To the Editor: Using molecular evidence, Hamilton et al. (March 30 issue)1 defined two germ-line defects associated with Turcot's syndrome, one of which is usually found in hereditary nonpolyposis ...
Regulation of the α<sub>1</sub>-Antitrypsin Gene and a Disease-associated Mutation in a Related Enhancer Sequence
Authors: Noor A. Kalsheker, K. Morgan
Journal: American Journal of Respiratory and Critical Care Medicine (1994)

Ten years ago a search was initiated for DNA variation in the alpha-1-antitrypsin gene (α1-AT) to determine whether there were mutations more commonly associated with patients who had chronic obstructive airways disease (COAD) than with healthy individuals. Using the conventional approach of Southern blotting and searching for restriction fragment length polymorphisms, we identified a potentially useful polymorphism that resulted in the loss of a recognition site for the restriction enzyme, Taq I. The polymorphism occurred in about 17% of patients with COAD and about 5% of the general population (p = 0.0016). The normal sequence in the 3′ flanking region of the α1-antitrypsin gene had to be characterized, as it was not known. On the basis of homology, a number of closely clustered sequence motifs demonstrating the characteristics of an enhancer were identified that would potentially increase the transcription and expression of α1-antitrypsin. The normal Taq I sequence occurred in a motif that demonstrated homology to a DNA sequence for octamer transcription factors. The mutation was characterized by in vitro amplification of the region and direct sequencing as a G to A transition (Taq I site TCGA < TCAA). Specific binding of nuclear proteins by gel-shift analysis and DNase I footprinting and increased in vivo transcriptional activity were demonstrated by transfection of mammalian cells containing DNA fragments corresponding to the region of interest. In contrast, the mutant sequence demonstrated loss of binding to nuclear proteins and reduced transcriptional activity. The latter finding was not confined to tissues known to express α1-antitrypsin. However, these results do not exclude the influence of trans-activating factors that may modulate tissue-specific expression. The mutation does not appear to affect basal expression, as the plasma concentration of α1-antitrypsin protein is normal in individuals who carry it. It may, however, reduce the three- to fourfold rise in plasma concentrations that occurs during inflammation. We have recently obtained evidence that the transcription factor, octamer-1 protein, specifically binds to wild-type sequence in this region. Adjacent to the octamer-1 binding site is a sequence that potentially interacts with factors stimulated by the cytokine interleukin-6. This cytokine is known to increase α1-antitrypsin transcription approximately three- to four-fold. These data suggest that the mutation may cause disease by a novel mechanism related to a diminished response of the α1-antitrypsin gene to stimuli such as interleukin-6.
Infants with Fever
Authors: Paul L. McCarthy
Journal: New England Journal of Medicine (1993)

Fever in infants in the first three months of life is not infrequent. Although fever is usually self-limited, serious infections may be present, the most important of which are bacteremia and bacterial meningitis. Defining fever in infants is a complex issue, but most would agree that any rectal temperature of 38 °C or higher constitutes a fever.At birth, the capacity of the immune system to defend against infectious pathogens is not fully developed. The capacity increases during the early months and years of life,1 with this evolution most pronounced during the first two to three months. The transition to . . .
Advertising: Informational but Not Educational
Authors: F. J. Ingelfinger
Journal: New England Journal of Medicine (1972)

Information is a part of education, but the two processes are not the same. The words informational and educational should therefore not be used loosely or interchangeably. If they are, trouble ensues.Pharmaceutical advertising, for example, is often said to be educational. It is not; such advertising is informational but almost never educational. Pharmaceutical advertising provides the doctor with some facts. Such and such an agent is available and is marketed under a pronounceable name by a given drug house. The agent is recommended – in large letters – for the treatment of a certain condition. Disadvantages of the agent . . .
Common variants on 8p12 and 1q24.2 confer risk of schizophrenia
Authors: Yongyong Shi, Zhiqiang Li, Qi Xu, Ti Wang, Tao Li, Jiawei Shen, Fengyu Zhang, Jianhua Chen, Guoquan Zhou, Weidong Ji, Baojie Li, Yifeng Xu, Dengtang Liu, Peng Wang, Ping Yang, Benxiu Liu, Wensheng Sun, Chunling Wan, Shengying Qin, Guang He, Stacy Steinberg, Sven Cichon, Thomas Werge, Engilbert Sigurdsson, Sarah Tosato, Aarno Palotie, Markus M Nöthen, Marcella Rietschel, Roel A Ophoff, David A Collier, Dan Rujescu, David St Clair, Hreinn Stefansson, Kari Stefansson, Jue Ji, Qingzhong Wang, Wenjin Li, Linqing Zheng, Hairong Zhang, Guoyin Feng, Lin He
Journal: Nature Genetics (2011)
Mountain Air in the Treatment of Phthisis
Authors: R. Sinclair
Journal: BMJ (1879)

THE BRITISH MEDICAL 7OURNAL.573 (2) that the sanguineo-lymphatic temperament is the usual predisposing diathetic cause;(3) that exhaustion of nerve-force, especially through the brain, is the common exciting cause; (4) that it is not inflammatory in na.ture, nor accompanied by pyrexia; (5) that the vascular system, probably through the vaso-motor nerves, is principally involved in the production of the objective phenomena; and (6) that the affection or disease itself consists essentially of a passive congestion of the venous plexuses within the vertebral canal, which induces pressure on the nervous structures to which they correspond, either directly from increase of calibre from dilatation, or indirectly from inducing a certain amount of local oedema in the spinal membranes.This theory of the pathological anatomy of one form at least of irritable spine is, of course, in the absence of any opportunity of lost mortem examination, based entirely on a study of the symptomatology of the affection, and as such only it is brought forward on this occasion.
GW25-e1558 High Serum Bisphenol A level might increases the risk of Dilated Cardiomyopathy
Authors: Xiong Qinmei, Yuan Ping, Wang Hongsheng, Zhou Qiongqiong, Liu Xin, Shen Yang, He Wenfeng, Ma Jianyong, Hong Kui
Journal: Journal of the American College of Cardiology (2014)
Abstract 234: Assessment of a Newly Designed Resuscitation Trolley in a Simulated Environment
Authors: Susanna Walker, Anthony McKay, Vashist Deelchand, Sanjay Gautama, Nick Sevdalis, Charles Vincent
Journal: Circulation (2011)

Introduction In 2006, data from the UK National Reporting and Learning System (NRLS) database highlighted the fact that ill-stocked resuscitation trolleys directly led to a number of preventable deaths. Of 86 reported incidents involving resuscitation trolleys, 10 contributed to the deaths of patients. In light of this data the National Patient Safety Agency (NPSA) sponsored a redesign of the resuscitation trolley. Over the past 2 years a complex design process culminated in a new ergonomically designed “Resus:Station” prototype. Objectives To assess the usability and impact on teamwork of “Resus:Station” when compared with the standard resuscitation trolley in a series of simulated cardiac arrest scenarios. Methods 15 expert Cardiac Arrest Teams comprising an Anesthesiologist, a Physician, and a Nurse were recruited (45 participants in total). Teams performed resuscitation simulations using both trolleys, with order of use randomised. All research sessions were recorded to facilitate structured debriefing. Following each simulation participants completed questionnaires scoring trolley usability, safety, effects on Resuscitation, and design on 7-point Likert scales. They also indicated their preference for trolley (Resus:Station or old trolley). Team performance was assessed from the video recordings by two trained blinded raters using a validated tool to assess quality of teamworking with each trolley, and to determine differences in efficiency of resuscitation. Results Strongly significant (p&lt;0.001) differences favouring the Resus:Station over the old trolley were obtained on all user-rated aspects (usability, safety, effects on Resuscitation, and design). Quality of teamworking in the observed teams did not differ significantly between trolleys, however efficiency of the team was seen to improve when using the new Resus:Station. Conclusions The Resus:Station is safe to use in a simulated environment, there is no detrimental effect on team performance, some improvement in efficiency, and it is strongly preferred by clinical staff. In view of these strongly positive results, the “Resus:Station is being assessed further in a real clinical environment.
The cardiovascular morbidity associated with hyperglycaemia
Authors: Dhanya Kalathil, Kashif Mussarat, George I Varughese
Journal: Journal of the Royal Society of Medicine (2008)

Asadollahi et al. highlight some important aspects with regard to the cardiovascular mortality associated with hyperglycaemia (JRSM 2007;100:503–7).1 More recently, the cardiovascular morbidity related to hyperglycaemia has become of interest with implications in routine clinical practice. Of late, fasting plasma glucose levels have been demonstrated to independently predict hospitalization for congestive heart failure (CHF) in patients at high cardiovascular risk.2 Of note, glucose levels have also been significantly associated with the risk of developing atrial fibrillation – the most common sustained cardiac arrhythmia.3 Indeed this was also noted in the Framingham study more than a decade ago, when glucose levels were found to be more important than the diagnosis of diabetes mellitus per se.3

The pathophysiology of complications in the setting of hyperglycaemia is multifactorial, and in addition to the classical cardiovascular risk factors such as hypertension, dyslipidaemia and obesity, there are other factors such as urine albumin excretion, endothelial damage/dysfunction and inflammation that develop in parallel, progress with time and eventually contribute towards cardiovascular morbidity.3

Interestingly, if we take into account the results of the national diabetes audit which showed that only a quarter of people with diabetes in the UK have been diagnosed,4 and also consider the large variations in diabetes care,5 this matter becomes all the more pertinent and has substantial implications for the future given the pressing need for strategies to promote and optimize diabetes care from a practical perspective (JRSM 2007;100:67 and JRSM 2006;99:576–81).4,5
Drug-Resistant Pneumococcal Infections in the United States
Authors: Michael S. Simberkoff
Journal: JAMA (1994)

Drug-resistant<i>Streptococcus pneumoniae</i>(DRSP) strains were once considered to be laboratory curiosities<sup>1,2</sup>or problems for far-off areas of the world.<sup>3-5</sup>In the United States, however, pneumococci that were relatively resistant to penicillin (minimum inhibitory concentration, 0.12 to 1.0 μg/mL) were found among the isolates from Navajo Indians living in New Mexico in 1974,<sup>6</sup>and a serotype 14<i>S pneumoniae</i>isolate with high-level resistance to penicillin (minimum inhibitory concentration, ≥2.0 μg/mL) was recovered from the blood of an immunocompromised child from Minnesota in 1977.<sup>7</sup>Since these initial reports, foci of DRSP have been identified in various parts of this country.<sup>8-12</sup>The reports from the Centers for Disease Control and Prevention from Kentucky and Tennessee,<sup>13</sup>from Connecticut,<sup>14</sup>and by Breiman et al<sup>15</sup>in this issue ofThe JOURNALare alarming because they prove that DRSP isolates can now be found in unselected, diverse sites
Acute Toxicity of Conventional Radiation Therapy for High-Risk Prostate Cancer in EORTC Trial 22863
Authors: A Zurlo, L Collette, G van Tienhoven, L.E Blank, P Warde, J.B Dubois, W Jeanneret, G Storme, J Bernier, A Kuten, M Pierart, M Bolla
Journal: European Urology (2002)
“Polysomy 17” by FISH for HER2 in breast cancer is a misnomer: results of chromosome 17 analysis by array comparative genomic hybridization.
Authors: I Yeh, MA Martin, RS Robetorye, S Gunn
Journal: Cancer Research (2009)

Abstract Abstract #3008 Background: The term “polysomy 17” has been widely used to refer to breast cancer cases in which fluorescence in situ hybridization (FISH) assays for HER2 were performed and found to contain &amp;gt;3 copies of the chromosome 17 centromere (probe CEP 17, D17Z1). The proportion of breast cancers that are reported to have polysomy 17 varies, but some studies report over 40% incidence. In these cases, the centromere is assumed to be representative of the entire chromosome. In this study, we analyzed chromosome 17 in breast cancers using bacterial artificial chromosome (BAC) array comparative genomic hybridization (array CGH) to assess the incidence of whole chromosome 17 polysomy.&amp;#x2028; Design: Fresh frozen tissue from 95 breast cancers was analyzed, including 84 invasive ductal carcinomas, 10 invasive lobular carcinomas, and one case with mixed ductal-lobular features. Frozen sections were reviewed to ascertain tumor content, and genomic DNA was isolated from 25-50 mg of tissue from each case. Samples were then analyzed by array CGH using an array that included whole genome coverage as well 63 probes for chromosome 17. A subset of 29 cases was also analyzed by FISH using the Vysis Pathvysion HER2 assay, which includes a chromosome 17 centromere probe and a HER2 probe.&amp;#x2028; Results: Multiple abnormalities were identified on chromosome 17, including losses and gains in both the p and q arms. Examination of the centromeric region by array CGH showed 6 cases with gains, and 10 cases with losses. Three of six cases with centromeric gains also showed HER2 amplifications. Two cases showed polysomy by FISH. Although other chromosomes in our study exhibited whole chromosome polysomy using array CGH, no cases showed complete polysomy of chromosome 17.&amp;#x2028; Conclusions: A review of the literature for chromosome 17 polysomy in breast cancer reveals that this finding almost exclusively relies on FISH analysis using chromosome 17 centromere probes. Our analysis of 95 breast cases by array CGH did not reveal any gains of whole chromosome 17. These results suggest that whole chromosome 17 polysomy is extremely uncommon in breast cancer. Those cases that are identified to have chromosome 17 polysomy by FISH are better termed “chromosome 17 centromere amplified.” Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 3008.
Children face same social problems as they did 100 years ago
Authors: Zosia Kmietowicz
Journal: BMJ (2005)

<h3>ABSTRACT</h3> <h3>Introduction</h3> Diverticulitis is the inflammation and/or infection of small pouches known as diverticula that develop along the walls of the intestines. Patients with diverticulitis are at risk of mortality as high as 17% with abscess formation and 45% with secondary perforation, especially patients that get admitted to the inpatient services are at risk of complications including mortality. We developed a deep neural networks (DNN) based machine learning framework that could predict premature death in patients that are admitted with diverticulitis using electronic health records (EHR) to calculate the statistically significant risk factors first and then to apply deep neural network. <h3>Methods</h3> Our proposed framework (Deep FLAIM) is a two-phase hybrid works framework. In the first phase, we used National In-patient Sample 2014 dataset to extract patients with diverticulitis patients with and without hemorrhage with the ICD-9 codes 562.11 and 562.13 respectively and analyzed these patients for different risk factors for statistical significance with univariate and multivariate analyses to generate hazard ratios, to rank the diverticulitis associated risk factors. In the second phase, we applied deep neural network model to predict death. Additionally, we have compared the performance of our proposed system by using the popular machine learning models such as DNN and Logistic Regression (LR). <h3>Results</h3> A total of 128,258 patients were used, we tested 64 different variables for using univariate and multivariate (age, gender and ethnicity) cox-regression for significance only 16 factors were statistically significant for both univariate and multivariate analysis. The mortality prediction for our DNN out-performed the conventional machine learning (logistic regression) in terms of AUC (0.977 vs 0.904), training accuracy (0.931 vs 0.900), testing accuracy (0.930 vs 0.910), sensitivity (90% vs 88%) and specificity (95% vs 93%). <h3>Conclusion</h3> Our Deep FLAIM Framework can predict mortality in patients admitted to the hospital with diverticulitis with high accuracy. The proposed framework can be expanded to predict premature death for other disease.
The pulmonary physician and critical care. 2. The injured lung: conventional and novel respiratory therapy.
Authors: A Swami, B F Keogh
Journal: Thorax (1992)

Several alternatives to conventional ventilation in acute lung injury are now available and have been investigated to a varying degree. The assessment of all such techniques is limited by difficulties in designing proper comparative studies and by the time needed to recruit a large number of appropriate patients with acute lung injury. A common theme of lung volume maintenance combined with strategies designed to limit the extent of ventilator induced lung damage has emerged and should encourage reassessment of the conventional approach. The results of several large prospective comparative studies are eagerly awaited. Meanwhile we may reasonably suggest that improvements in respiratory support, together with advances in microbiological and pharmacological treatment, have the potential for improving the persistently disappointing survival rate in acute lung injury.
Effect of a high-fat diet on food intake and hypothalamic neuropeptide gene expression in streptozotocin diabetes.
Authors: M Chavez, R J Seeley, P J Havel, M I Friedman, C A Matson, S C Woods, M W Schwartz
Journal: Journal of Clinical Investigation (1998)

Insulin-deficient diabetic rats are markedly hyperphagic when fed a high-carbohydrate (HC) diet, but normophagic when fed a high-fat (HF) diet. When maintained on a HC diet, diabetic rats also exhibit increased gene expression of the orexigenic peptide neuropeptide Y (NPY) in the hypothalamic arcuate nucleus, and reduced expression of the anorectic peptide corticotropin-releasing hormone (CRH) in the paraventricular nucleus, and these changes are hypothesized to contribute to diabetic hyperphagia. In this experiment we assessed whether the normophagia displayed by HF-fed diabetic rats is associated with the opposite profile of NPY and CRH expression. Our results show that relative to diabetic rats on the HC diet, the diabetic rats on the HF diet exhibited significantly reduced caloric intake (-40%), NPY expression in the arcuate nucleus (-27%), and elevated CRH expression in the paraventricular nucleus (+37%). Insulin and corticosterone, which are known to affect hypothalamic NPY and CRH expression, were not different between these two groups, making it unlikely that they can account for the differences in either feeding behavior or hypothalamic peptide expression. There was a small but significant increase in plasma leptin levels in the diabetic animals maintained on the HF, and large differences in parameters associated with elevated fat oxidation. These observations support the hypothesis that the normalization of food intake observed in diabetic rats consuming a HF diet may in part be mediated by reductions in NPY expression and elevations in CRH expression.
Automated External Defibrillators and Survival After In-Hospital Cardiac Arrest
Authors: Paul S. Chan
Journal: JAMA (2010)

<h3>Context</h3>Automated external defibrillators (AEDs) improve survival from out-of-hospital cardiac arrests, but data on their effectiveness in hospitalized patients are limited.<h3>Objective</h3>To evaluate the association between AED use and survival for in-hospital cardiac arrest.<h3>Design, Setting, and Patients</h3>Cohort study of 11 695 hospitalized patients with cardiac arrests between January 1, 2000, and August 26, 2008, at 204 US hospitals following the introduction of AEDs on general hospital wards.<h3>Main Outcome Measure</h3>Survival to hospital discharge by AED use, using multivariable hierarchical regression analyses to adjust for patient factors and hospital site.<h3>Results</h3>Of 11 695 patients, 9616 (82.2%) had nonshockable rhythms (asystole and pulseless electrical activity) and 2079 (17.8%) had shockable rhythms (ventricular fibrillation and pulseless ventricular tachycardia). AEDs were used in 4515 patients (38.6%). Overall, 2117 patients (18.1%) survived to hospital discharge. Within the entire study population, AED use was associated with a lower rate of survival after in-hospital cardiac arrest compared with no AED use (16.3% vs 19.3%; adjusted rate ratio [RR], 0.85; 95% confidence interval [CI], 0.78-0.92; P &lt; .001). Among cardiac arrests due to nonshockable rhythms, AED use was associated with lower survival (10.4% vs 15.4%; adjusted RR, 0.74; 95% CI, 0.65-0.83; P &lt; .001). In contrast, for cardiac arrests due to shockable rhythms, AED use was not associated with survival (38.4% vs 39.8%; adjusted RR, 1.00; 95% CI, 0.88-1.13; P = .99). These patterns were consistently observed in both monitored and nonmonitored hospital units where AEDs were used, after matching patients to the individual units in each hospital where the cardiac arrest occurred, and with a propensity score analysis.<h3>Conclusion</h3>Among hospitalized patients with cardiac arrest, use of AEDs was not associated with improved survival.
Peers, cooperative play, and the development of empathy in children
Authors: Celia A. Brownell, Stephanie Zerwas, Geetha Balaram
Journal: Behavioral and Brain Sciences (2002)

Cooperative peer play emerges in the second year of life. How applicable is Preston &amp; de Waal's (P&amp;deW's) model to the empathic processes in cooperative play? Empathic responses during peer play are more general than they propose, and more dependent on mental state understanding. Moreover, peer play forces children to reason about others' feelings, possibly serving as a unique mechanism for empathy development.