tbuckley/cabot-search huggingface dataset:
Understanding emotion: Lessons from anxiety
Authors: Katherine S. Button, Glyn Lewis, Marcus R. Munafò
Journal: Behavioral and Brain Sciences (2012)

Abstract We agree that conceptualisation is key in understanding the brain basis of emotion. We argue that by conflating facial emotion recognition with subjective emotion experience, Lindquist et al. understate the importance of biological predisposition in emotion. We use examples from the anxiety disorders to illustrate the distinction between these two phenomena, emphasising the importance of both emotional hardware and contextual learning.
Standard deviation versus standard error
Authors: P. Sedgwick
Journal: BMJ (2011)

Researchers investigated the effectiveness of a weight loss programme in men with moderate to severe obstructive sleep apnoea. Men were eligible to join the programme if aged 30-65 years, had a body mass index between 30 and 40, had moderate to severe obstructive sleep apnoea (as measured by an apnoea-hypopnoea index ≥15 events/hour), and were being treated with continuous positive airway pressure. The weight loss programme lasted one year and consisted of a very low energy diet for nine weeks followed by a weight loss maintenance programme. A total of 63 men were recruited at an outpatient obesity clinic in a university hospital in Stockholm, Sweden.1 Outcome measures included the change in body weight after participation in the weight loss programme. At baseline the sample had a mean weight of 113.1 kg (SD=14.2 kg). The researchers reported that the weight loss programme resulted in a significant decrease in weight. The mean change in body weight at one year from baseline was a reduction of 12.1 kg (95% confidence interval 9.8 to 14.3) (SD=9 kg; SEM=1.13 kg). Which of the following, if any, are true?
Management of Tic Douloureux
Authors: Martin L. Lazar
Journal: JAMA (1978)

To the Editor.—  Dr Shenkin (240:22, 1978) seems to have missed the point of Loeser's SPECIAL COMMUNICATION (239:1153, 1978). The ideal form of management of trigeminal neuralgia is the permanent relief of pain without producing neurologic deficit. The initial response to medication is usually satisfactory. However, ultimately a large percent of patients fail medical management. The problem then becomes one to be solved surgically. Dr Loeser has made a plea to use surgical therapies that are based on physiologic principles and aimed at dealing with the known neuropathologic states associated with this excruciating condition.  Dandy1clearly demonstrated compression of the fifth cranial nerve in the posterior fossa when he operated on these patients. Other investigators2-4were able to substantiate these findings. Jannetta5has taken us one step further in devising an operative approach to the region and in demonstrating how to achieve long-standing pain relief without producing
Interdisciplinary Study of Diazepam Sedation for Outpatient Dentistry
Authors: T. E. J. Healy, H. Lautch, N. Hall, P. J. Tomlin, M. D. Vickers
Journal: BMJ (1970)

Patients unable to submit themselves to routine dental treatment under local anaesthesia were studied during treatment under diazepam sedation accompanied by local anaesthesia, and compared with a matched control group for psychiatric assessment. Physiological responses, operating conditions, amnesia, pain threshold, and recovery were all assessed by various tests.Some of the patients had an anxiety neurosis, and several had been referred because of previous failure to complete dental treatment. Satisfactory conditions were obtained in all but two instances, and no adverse physiological responses occurred with diazepam in an intravenous dose of 0.2 mg./kg. Patients were clinically safe to leave accompanied by a responsible adult within one hour of administration of the drug. Some patients showed an improvement in attitude towards dentistry following treatment.
Fibrinogen degradation product fragment D induces endothelial cell detachment by activation of cell-mediated fibrinolysis.
Authors: M Ge, G Tang, T J Ryan, A B Malik
Journal: Journal of Clinical Investigation (1992)

We studied the effects of fibrinogen degradation product (FDP) fragment D on endothelial monolayer integrity and the mechanisms of fragment D-induced endothelial cell detachment from the substratum. Incubation of bovine pulmonary artery endothelial cells (BPAEC) with fragment D caused concentration- and time-dependent cell detachment from the substratum. The optimal response occurred at fragment D concentrations of 2 microM and required an incubation time of 24 h. BPAEC challenged with fragment D increased the concentration and activity of urokinase-type plasminogen activator (uPA) in the conditioned medium within 2 to 4 h of incubation. Fragment D also induced the release of tissue-type plasminogen activator, but to a lesser extent than uPA. Fragment D concurrently increased plasminogen activator (PA) activity in a concentration-dependent manner. Increased PA activity was followed by augmentation of cell-associated plasmin activity and subsequent increase in the degradation of 125I-fibrinogen and 125I-vitronectin precoated in the subendothelial matrix. Pretreatment of BPAEC with anti-uPA antibody, and inhibitors of uPA (dansyl-GGACK) and plasmin (aprotinin) prevented approximately 60% of the fragment D-induced endothelial cell detachment. We conclude that FDP fragment D increases secretion of endothelial PAs and enhances the generation of plasmin, thereby contributing to proteolysis of extracellular matrix and endothelial cell detachment. Fragment D may be a critical mediator linking activation of fibrinolysis to vascular endothelial injury in inflammatory disorders.
Hodgkin Disease With Acute Lymphoblastic Leukemia
Authors: Morton D. Grant
Journal: JAMA (1975)

THE PROGNOSIS in acute lymphoblastic leukemia (ALL) has greatly improved because of effective chemotherapy, irradiation, or both for the prevention of central nervous system (CNS) leukemia. As prolonged remissions become more frequent, larger concern now focuses on the undesirable consequences of therapy.<sup>1</sup>Immunosuppression is the most serious problem, since this is thought to lead to the fatal nonbacterial infections seen increasingly during remissions.<sup>2</sup>Treatment may also potentiate the development of a second neoplasm, as shown in the following case report. <h3>Report of a Case</h3> In December 1972, a 17-year-old boy found to have acute lymphoblastic leukemia was admitted to St. Agnes Hospital. Hematological remission was obtained with vincristine sulfate, prednisone, and daunorubicin. He also received three courses of methotrexate intrathecally and craniospinal irradiation to a total of 1,800 R as prophylaxis against CNS leukemia. Therapy was maintained with mercaptopurine and methotrexate, with periodic reinforcement by the three drugs
Cryptococcal Meningitis Treatment Strategies in Resource-Limited Settings: A Cost-Effectiveness Analysis
Authors: Radha Rajasingham, Melissa A. Rolfes, Kate E. Birkenkamp, David B. Meya, David R. Boulware
Journal: PLoS Medicine (2012)

Cryptococcal meningitis (CM) is the most common form of meningitis in Africa. World Health Organization guidelines recommend 14-d amphotericin-based induction therapy; however, this is impractical for many resource-limited settings due to cost and intensive monitoring needs. A cost-effectiveness analysis was performed to guide stakeholders with respect to optimal CM treatment within resource limitations.We conducted a decision analysis to estimate the incremental cost-effectiveness ratio (ICER) of six CM induction regimens: fluconazole (800-1,200 mg/d) monotherapy, fluconazole + flucytosine (5FC), short-course amphotericin (7-d) + fluconazole, 14-d of amphotericin alone, amphotericin + fluconazole, and amphotericin + 5FC. We computed actual 2012 healthcare costs in Uganda for medications, supplies, and personnel, and average laboratory costs for three African countries. A systematic review of cryptococcal treatment trials in resource-limited areas summarized 10-wk survival outcomes. We modeled one-year survival based on South African, Ugandan, and Thai CM outcome data, and survival beyond one-year on Ugandan and Thai data. Quality-adjusted life years (QALYs) were determined and used to calculate the cost-effectiveness ratio and ICER. The cost of hospital care ranged from $154 for fluconazole monotherapy to $467 for 14 d of amphotericin + 5FC. Based on 18 studies investigating outcomes for HIV-infected individuals with CM in resource-limited settings, the estimated mean one-year survival was lowest for fluconazole monotherapy, at 40%. The cost-effectiveness ratio ranged from $20 to $44 per QALY. Overall, amphotericin-based regimens had higher costs but better survival. Short-course amphotericin (1 mg/kg/d for 7 d) with fluconazole (1,200 mg/d for14 d) had the best one-year survival (66%) and the most favorable cost-effectiveness ratio, at $20.24/QALY, with an ICER of $15.11 per additional QALY over fluconazole monotherapy. The main limitation of this study is the pooled nature of a systematic review, with a paucity of outcome data with direct comparisons between regimens.Short-course (7-d) amphotericin induction therapy coupled with high-dose (1,200 mg/d) fluconazole is "very cost effective" per World Health Organization criteria and may be a worthy investment for policy-makers seeking cost-effective clinical outcomes. More head-to-head clinical trials are needed on treatments for this neglected tropical disease. Please see later in the article for the Editors' Summary.
Raf-1 Kinase Is Required for Cardiac Hypertrophy and Cardiomyocyte Survival in Response to Pressure Overload
Authors: Ian S. Harris, Shaosong Zhang, Ilya Treskov, Attila Kovacs, Carla Weinheimer, Anthony J. Muslin
Journal: Circulation (2004)

Cardiac hypertrophy is a common response to pressure overload and is associated with increased mortality. Mechanical stress in the heart results in the activation of the small GTPase ras and the Raf-1/MEK/ERK signaling cascade in addition to other signaling pathways.In an attempt to determine the requirement for the serine/threonine kinase Raf-1 in the pathogenesis of cardiac hypertrophy, we generated transgenic mice with cardiac-specific expression of a dominant negative form of Raf-1 (DN-Raf). DN-Raf mice appeared normal at birth, were fertile, and had normal cardiac structure and function in the absence of provocative stimulation. In response to pressure overload, cardiac extracellular signal-regulated kinase (ERK) activation was inhibited, but c-Jun N-terminal kinase (JNK) activation and p38 mitogen-activated protein kinase (MAPK) activation were normal. DN-Raf mice were sensitized to pressure overload and the development of cardiomyocyte apoptosis, and >35% of animals died within 7 days of aortic banding. Surviving DN-Raf animals were markedly resistant to the development of cardiac hypertrophy and hypertrophic gene induction in response to transverse aortic constriction.These results establish that Raf-1 kinase activity is essential for cardiac hypertrophy and cardiomyocyte survival in response to pressure overload.
Hypertriglyceridemia in Gout
Authors: ELAINE B. FELDMAN, STANLEY L. WALLACE
Journal: Circulation (1964)

Serum triglyceride levels were significantly higher in 34 patients with gout (42 mg. per 100 ml.) in comparison to the levels in 28 healthy men over 35 years of age (100 mg. per 100 ml.). There was no significant predictive relation between levels of serum uric acid and triglycerides in either group. No significant difference in serum cholesterol levels nor lipoprotein profile was apparent between the two groups. The patients with gout had been selected to exclude any manifestations of atherosclerosis or other disease known to be associated with abnormalities in circulating lipids. The results provide support for possible linkage of genetic factors influencing uric acid and triglyceride metabolism. The presence of hypertriglyceridemia in gout may be correlated with the increased incidence of arteriosclerosis.
Ectopic overexpression of second mitochondria-derived activator of caspases (Smac/DIABLO) or cotreatment with N-terminus of Smac/DIABLO peptide potentiates epothilone B derivative–(BMS 247550) and Apo-2L/TRAIL–induced apoptosis
Authors: Fei Guo, Ramadevi Nimmanapalli, Shanthi Paranawithana, Sylvie Wittman, David Griffin, Purva Bali, Erica O'Bryan, Carlos Fumero, Hong Gang Wang, Kapil Bhalla
Journal: Blood (2002)
Inflammatory Cytokines and Postmyocardial Infarction Remodeling
Authors: Min Nian, Paul Lee, Neelam Khaper, Peter Liu
Journal: Circulation Research (2004)

Inflammatory response and cytokine elaboration are particularly active after myocardial infarction and contribute to cardiac remodeling and eventual host outcome. The triggers of cytokine release in the acute postinfarction period include mechanical deformation, ischemic stimulus, reactive oxygen species (ROS), and cytokine self-amplification pathways. Acutely, the elaboration of tumor necrosis factor, IL-1 and IL-6, transforming growth factor families of cytokines, contribute to survival or deaths of myocytes, modulation of cardiac contractility, alterations of vascular endothelium, and recruitment of additional circulating cells of inflammation to the injured myocardium. This leads to further local oxidative stress and remodeling but also initiates the processes of wound healing. Chronically, sustained presence of cytokines leads to myocyte phenotype transition and activation of matrix metalloproteinases that modifies interstitial matrix, augmenting further the remodeling process. This in turn alters the local collagen composition and also the integrins that constitute the interface between myocytes and the matrix. These processes ultimately, when favorable, pave the way for angiogenesis and cellular regeneration. Thus, the insightful modulation of cytokines through current and future therapies could promote improved healing and cardiac remodeling postmyocardial infarction.
The perils of commissioning bias
Authors: Des Spence
Journal: BMJ (2008)

The late Friday night debriefing in the kitchen: “You’re not listening.” I have that male trait of being easily distracted by other ideas. 

She was right, but fortunately we’d had this discussion many times. “Well, you believe that ADHD is not a ‘condition,’ but an evolutionary trait of men. That boys need exercise to function and that in modern society, and in particular our education system, this is lacking. Boys are like puppies—coop them up, and they will chew the legs off your furniture and shred the newspaper. That vigorous exercise should be used …
Treatment of Gram-Negative Bacteremia and Septic Shock with HA-1A Human Monoclonal Antibody against Endotoxin
Authors: Elizabeth J. Ziegler, Charles J. Fisher, Charles L. Sprung, Richard C. Straube, Jerald C. Sadoff, Garrett E. Foulke, Cornelis H. Wortel, Mitchell P. Fink, R. Phillip Dellinger, Nelson N.H. Teng, I. Elaine Allen, Harvey J. Berger, Genell L. Knatterud, Albert F. LoBuglio, Craig R. Smith
Journal: New England Journal of Medicine (1991)

HA-1A is a human monoclonal IgM antibody that binds specifically to the lipid A domain of endotoxin and prevents death in laboratory animals with gram-negative bacteremia and endotoxemia.
Imipramine in Depressive Illness
Authors: I. W. Browne, D. Walsh
Journal: BMJ (1964)

MEBDCLOUUpast year.It is remarkable that this has been achieved without accurate proof of specific pathological damage by these drugs.It is more remarkable that the Witts and Dunlop Committees have issued guidance to the profession on these matters without in- cluding any psychiatrist among their num- bers.This unusual attitude is placing psychiatrists in an extremely difficult posi- tion.It does not seem to be realized adequately enough that there are now more psychiatrists than general physicians, and that psychiatric disorders account for the bulk of general practice.It is most remark-
Longitudinal study of genital infection by herpes simplex virus type 1 in western Scotland over 15 years
Authors: A. Scoular
Journal: BMJ (2002)

and the likelihood of finding healthy elderly people colonised with MRSA is relatively small.Carriage of MRSA can, however, be expected in patients who have chronic conditions or who have had recent admissions to hospital.MRSA in the community seems to be a consequence of a "spill over" of an uncontrolled hospital epidemic, and the few isolates found in the community are classic hospital strains.It continues to be safe to treat community acquired S aureus infections in England with conventional antistaphylococcal agents effective against methicillin sensitive strains, and third line antibiotics should be considered only when typical risk factors can be ascertained.Contributors: HG designed and coordinated the study.AT took part in every aspect of the study and carried out the statistical analysis.SH and MH carried out the bacteriological investigations and the genetic typing.All authors were involved in collecting samples and recording data.RS coordinated the general practitioner and community participation.HG
Peer Review and the NCI's Clinical Alert on Node-Negative Breast Cancer-Reply
Authors: Maryann Roper
Journal: JAMA (1989)

<h3>In Reply.—</h3> The NCI's recent clinical alert was intended to inform practicing physicians of the potential benefits of postoperative treatment for patients with node-negative breast cancer. These data could affect the lives of thousands of women before formal publications appear in a peer-reviewed journal. With every month's delay, 2000 to 5000 newly diagnosed patients could lose the chance to benefit. It has now been several months since manuscripts describing two of these trials were submitted to peer-reviewed journals; neither has been published yet. Perhaps predictably, the alert has engendered considerable controversy. Dr Feinberg cites the bypassing of peer review and the incompleteness of the mailing and of the data. We agree with some of these concerns and plan to improve the content and completeness of any such future mailing. The NCI did not undertake the mailing of the clinical alert without due process and, in retrospect, should have described this
Is this your first time too?
Authors: C. Douglas
Journal: BMJ (1998)

A long time ago I sat the exam. Only once. Perhaps that was a mistake. Passing first time, I now realise, deprived me of much that would have been useful today. My colleagues seem infinitely more relaxed. I am compelled to put that down to their greater experience. Presumably they sat the exam as often as was allowable, got to know its moods and nuances, encountered a whole range of cases and examiners, and emerged not just with the membership of the Royal College of Physicians but with a deep understanding of the process by which it is awarded. Lucky them.



Of course, it is also possible …
Prevention of High-Altitude Pulmonary Edema by Nifedipine
Authors: Peter Bartsch, Marco Maggiorini, Manfred Ritter, Christof Noti, Peter Vock, Oswald Oelz
Journal: New England Journal of Medicine (1991)

Exaggerated pulmonary-artery pressure due to hypoxic vasoconstriction is considered an important pathogenetic factor in high-altitude pulmonary edema. We previously found that nifedipine lowered pulmonary-artery pressure and improved exercise performance, gas exchange, and the radiographic manifestations of disease in patients with high-altitude pulmonary edema. We therefore hypothesized that the prophylactic administration of nifedipine would prevent its recurrence.
Impact of Mobile Radiographic Screening on Tuberculosis among Drug Users and Homeless Persons
Authors: Gerard de Vries, Rob A. H. van Hest, Jan H. Richardus
Journal: American Journal of Respiratory and Critical Care Medicine (2007)

In 2002, a mobile radiographic screening program was started in Rotterdam to respond to high rates of tuberculosis (TB) among illicit drug users and homeless persons.We studied trends and characteristics of TB among these risk groups and assessed the impact of the screening program on transmission, using molecular typing.Description of trends, and of demographic and disease-related characteristics of tuberculosis cases among these risk groups between 1993 and 2005. TB was considered to result from recent transmission if the mycobacterial DNA fingerprints of cases were identical to those of other cases in the risk groups in the previous 2 years.During the study period, 206 individuals with TB among illicit drug users and homeless persons were notified, representing 11.4% of the total case load of 1,811 in Rotterdam. The annual number of tuberculosis cases declined from 24 at the start of the screening program to 11 cases in 2005. The screening program identified 28 cases (a prevalence rate of 327 per 100,000 radiographs), of which 12 were smear positive. In 1997-2002, more than 80% of the illicit drug users or homeless persons with TB were infected with one of the Mycobacterium tuberculosis strains prevalent among these risk groups. After nearly 4 years of systematic radiographic screening this proportion declined to 45% in 2005.DNA fingerprinting can be a useful tool to evaluate the impact of a TB screening program. We advocate that screening of illicit drug users and homeless persons should be continued to prevent a resurgence of TB.
Site-directed bronchoalveolar lavage and transbronchial biopsy in HIV-infected patients with pneumonia.
Authors: J Cadranel, K Gillet-Juvin, M Antoine, F Carnot, P Reynaud, A Parrot, M F Carette, C Mayaud, D Israël-Biet
Journal: American Journal of Respiratory and Critical Care Medicine (1995)

We have assessed the diagnostic value of site-directed bronchoalveolar lavage (BAL) and combined transbronchial biopsy (TBB) in 29 HIV-infected patients with localized pneumonia, in whom a previous BAL was nondiagnostic and in whom improvement did not occur with empiric antibiotic therapy. All patients but three had a CD4 cell count < 100/microliters. A definite diagnosis could be reached in 26 of 29 (90%) individuals, including 24 pathogens. Neither the radiologic pattern nor the type of Pneumocystis carinii (PC) prophylaxis could predict the positivity of either one of these two diagnostic procedures. Site-directed BAL alone allowed a diagnosis in infection in eight (28%) cases. TBB alone led to diagnosis in eight (28%) cases, including three PC and two toxoplasma gondii, undiagnosed by the site-directed BAL. Both techniques were positive and in agreement in 10 (34%) cases. The majority of the diagnosis led to a specific treatment. Therefore, the patients' survival was positively altered by the procedure. In conclusion, the performance of site-directed BAL and combined TBB markedly optimizes the diagnostic yield of each of these procedures performed separately in HIV-infected patients with localized pneumonia.
Setting a New Syllabus: Environmental Health Science in the Classroom
Authors: Valerie J. Brown
Journal: Environmental Health Perspectives (2004)

Environmental health is a subject that has only relatively recently become prominent in the social consciousness. Even as its significance becomes known, finding ways to integrate the subject into education for primary and secondary students is difficult because of federal testing requirements under the No Child Left Behind Act of 2001 and other demands placed on teachers. A number of efforts are under way, however, to provide teachers with resources to help them bring environment health into their classrooms.
736–6 Economic Impact of Advancing Implantable Cardloverter Defibrillator Technologies: Decreased Monetary Costs and Earlier Hospital Discharge
Authors: Thomas M. Munger, Marshall S. Stanton, Win K. Shen, Michael J. Osborn, Douglas L. Packer, Raul E. Espinosa, Douglas L. Wood, Stephen C. Hammill
Journal: Journal of the American College of Cardiology (1995)