tbuckley/cabot-search huggingface dataset:
Decomposing the socioeconomic inequality in utilisation of maternal health-care services in selected Asian and sub-Saharan African countries
Authors: Dipty Nawal, TV Sekher, Srinivas Goli
Journal: The Lancet (2013)

BackgroundThe persistence of socioeconomic-related inequality in health-care services has been extensively explored by scholars and researchers in developing countries, and policy has been endorsed. This paper locates the current existing reality of four developing countries, which lag behind in achieving the fifth Millennium Development Goal. The countries studied are Bangladesh, Ethiopia, Nepal, and Zimbabwe. The principal objective is to estimate socioeconomic inequality in the utilisation of maternal health-care services and propose individual-level policies to improve utilisation and a more equitable distribution of health services.MethodsAn approved method of Wagstaff inequality decomposition (concentration index [CI] and decomposition of CI) has been operationalised with recently released Demographic and Health Survey data (2010–11) for inequality analysis.FindingsThe estimated value of the CI is negative in all selected countries with fewer than three antenatal care (ANC) visits (CI −0·1147, −0·1146, −0·2859, −0·0637), no institutional delivery (–0·1333, −0·0925, −0·1959, −0·2527), and no postnatal care within 2 days of delivery (–0·2468, −0·0370, −0·1816, −0·0577) for Bangladesh, Ethiopia, Nepal, and Zimbabwe, respectively. CI estimation shows that health inequality is more concentrated on economically poor people, but the strength of the association varies between countries. Results of decomposition analyses indicate that the critical factor contributing to disparity in the number of ANC visits is the poor economic status of the household (41% [95% CI 37·5–44·5], 31% [28–34], and 68% [64–72], respectively, excluding Bangladesh). However, place of residence was the major contributor for delivery outside of a health-care setting (10% [7·3–12·7], 58% [50·2–66·4], 20% [16·4–23·7], 34% [30–38]). For postnatal care, the absolute level of association is greater with birth order 3+ (β=0·1748) in Nepal and with no institutional delivery (β=0·7100) in Bangladesh. Similarly, the result of proportional contribution also shows that the rural place of residence contributes 40% (37–43) of the total inequalities, followed by no institutional delivery (38% [33·5–42·5]) and poor economic status (17% [15–19·5]) in Zimbabwe.InterpretationHousehold economic status emerges as a dominant contributor of inequalities in health-care access. However, individual-level factors should be considered in order to improve overall maternal health-care services in selected countries.FundingThis research is the authors' independent work and was not funded by any person or organisation. The data used in this paper are in the public domain. Access to these data is available to all researchers.
Public Profiling of Clinical Performance
Authors: C. David Naylor
Journal: JAMA (2002)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
Response of Fibronectin to Liver Regeneration After Hepatectomy
Authors: A-Hon Kwon, Yoshiaki Inada, Shoji Uetsuji, Manabu Yamamura, Koshiro Hioki, Masakatsu Yamamoto
Journal: Hepatology (1990)

The relationship between plasma fibronectin concentration and the regenerative process in liver remnants after hepatectomy was studied in 12 patients and in male Sprague-Dawley rats with and without cirrhosis. Plasma fibronectin levels were reduced immediately after hepatectomy in humans and rats. Patients and rats without cirrhosis displayed preoperative fibronectin levels within 1 mo and 1 wk, respectively, but low fibronectin levels persisted longer in those with cirrhosis. Plasma fibronectin levels correlated well with the degree of hepatic regeneration in the patients with cirrhosis (r = 0.4227; p less than 0.05) and without cirrhosis (r = 0.8148; p less than 0.001), and also with the percentage of change in liver weight during regeneration in the rat with thioacetamide-induced cirrhosis (r = 0.4905; p less than 0.01) or in the rat without cirrhosis (r = 0.6422; p less than 0.001). These results suggest that plasma fibronectin is a useful marker for the detection of regenerating liver.
Quantitative Relation Between Myocardial Viability and Improvement in Heart Failure Symptoms After Revascularization in Patients With Ischemic Cardiomyopathy
Authors: Marcelo F. Di Carli, Farbod Asgarzadie, Heinrich R. Schelbert, Richard C. Brunken, Hillel Laks, Michael E. Phelps, Jamshid Maddahi
Journal: Circulation (1995)

Background Studies of patients with coronary artery disease and left ventricular dysfunction have shown that preoperative quantification of myocardial viability may be clinically useful to identify those patients who will benefit most from revascularization both functionally and prognostically. However, the relation between preoperative extent of viability and change in heart failure symptoms has not been documented carefully. We assessed the relation between the magnitude of improvement in heart failure symptoms after coronary artery bypass surgery (CABG) and the extent of myocardial viability as assessed by use of quantitative analysis of preoperative positron emission tomography (PET) images. Methods and Results We studied 36 patients with ischemic cardiomyopathy (mean left ventricular ejection fraction, 28±6%) undergoing CABG. Preoperative extent and severity of perfusion abnormalities and myocardial viability (flow-metabolism mismatch) were assessed by use of quantitative analysis of PET images with 13 N ammonia and fluorine-18-deoxyglucose. Each patient’s functional status was determined before and after CABG by use of a Specific Activity Scale. Mean perfusion defect size and severity were 63±13% and 33±12%, respectively. Total extent of a PET mismatch correlated linearly and significantly with percent improvement in functional status after CABG ( r =.87, P &lt;.0001). A blood flow–metabolism mismatch ≥18% was associated with a sensitivity of 76% and a specificity of 78% for predicting a change in functional status after revascularization. Patients with large mismatches (≥18%) achieved a significantly higher functional status compared with those with minimal or no PET mismatch (&lt;5%) (5.7±0.8 versus 4.9±0.7 metabolic equivalents, P =.009). This resulted in an improvement of 107% in patients with large mismatches compared with only 34% in patients with minimal or no PET mismatch. Conclusions In patients with ischemic cardiomyopathy, the magnitude of improvement in heart failure symptoms after CABG is related to the preoperative extent and magnitude of myocardial viability as assessed by use of PET imaging. Patients with large perfusion-metabolism mismatches exhibit the greatest clinical benefit after CABG.
From the authors
Authors: M. Confalonieri, M. Kodric
Journal: European Respiratory Journal (2005)

We would like to thank A. Cuvelier and J-F. Muir for their interesting comment on our article 1. They have highlighted the importance of technical factors to determine the rate of success of noninvasive ventilation (NIV) in patients with exacerbation of chronic obstructive pulmonary disorder (COPD).

From a theoretical point of view, we agree that problems related to humidification, interfaces, ventilator modes and patient–ventilator interaction may be crucial to ensure the best results of NIV in single patients, but we believe that experience, skills …
Noncoding RNAs in Prostate Cancer: The Long and the Short of It
Authors: Eva M. Bolton, Alexandra V. Tuzova, Anna L. Walsh, Thomas Lynch, Antoinette S. Perry
Journal: Clinical Cancer Research (2013)

As the leading culprit in cancer incidence for American men, prostate cancer continues to pose significant diagnostic, prognostic, and therapeutic tribulations for clinicians. The vast spectrum of disease behavior warrants better molecular classification to facilitate the development of more robust biomarkers that can identify the more aggressive and clinically significant tumor subtypes that require treatment. The untranslated portion of the human transcriptome, namely noncoding RNAs (ncRNA), is emerging as a key player in cancer initiation and progression and boasts many attractive features for both biomarker and therapeutic research. Genetic linkage studies show that many ncRNAs are located in cancer-associated genomic regions that are frequently deleted or amplified in prostate cancer, whereas aberrant ncRNA expression patterns have well-established links with prostate tumor cell proliferation and survival. The dysregulation of pathways controlled by ncRNAs results in a cascade of multicellular events leading to carcinogenesis and tumor progression. The characterization of RNA species, their functions, and their clinical applicability is a major area of biologic and clinical importance. This review summarizes the growing body of evidence, supporting a pivotal role for ncRNAs in the pathogenesis of prostate cancer. We highlight the most promising ncRNA biomarkers for detection and risk stratification and present the state-of-play for RNA-based personalized medicine in treating the "untreatable" prostate tumors.
CONDITIONS IN THE INDIAN MEDICAL SERVICE
Authors: Otis O. Benson
Journal: JAMA (1923)

<h3>To the Editor:</h3> —I have read the communications of Mr. Hoffman and Dr. Darey on health matters relating to the government Indian Service in recent issues ofThe Journalwhich seem to indicate "open season" on this service. While I have no authority delegated by the latter to enter any controversial discussion of this subject, a rather long service as boarding school physician, agency physician, special physician in the field, and superintendent of both boarding school and agency has given me, I think, a thorough knowledge of Indian health conditions and the causes therefor, from which I beg to point out certain considerations that should not be excluded from the fair presentation of the subject. Primarily, in medical and surgical practice, the physician is in a position analogous to that of the sportsman, who must catch his rabbit before he eats it. The physician must reckon with his patient's understanding
STD Clinics and the Prevention of Sexually Transmitted Diseases
Authors: Robert Carlen
Journal: JAMA (1986)

<h3>To the Editor.—</h3> I am grateful to Dr Cates<sup>1</sup>for calling attention to my ideas.<sup>2,3</sup> Dr Cates says, "No data support the assertion that relatively small financial incentives may influence the vicissitudes of sexual decision making and/ or behavior." But he presents no data that refute what is, if nothing else, a sound economic presumption. Patients with venereal disease are not stupid. They know that condoms cost them money but treatment is free so therefore it's economically irrational to buy condoms, and they don't. If we establish economically irrational policies then we're irrational, too. No one should be surprised if they fail. Dr Cates says it's cheaper for the public to treat sexually transmitted diseases earlier than later. I'm sure he's right. But his argument can be made for<i>every</i>treatable illness or injury: breast cancer, for example, or diabetic retinopathy. People with serious conditions may eventually become
Physician-Patient Communication-Reply
Authors: John P. Callan
Journal: JAMA (1981)

In Reply.—  As radio hams know, there are two components to communication: transmitting and receiving. One is no less important than the other; if either becomes garbled, the message is lost. Ms Franco is correct when she says it is important that a physician hear both spoken and unspoken patient transmission. Without such hearing, therapeutic responses for the greatest benefit cannot be made.  I believe all aspects of physicianpatient communication should be emphasized more during medical training. And what has been learned in this area should be refreshed from time to time. However, I think there is more recognition by clinicians of the need to listen therapeutically than of the need to talk therapeutically. Much more has been written on hearing than talk. For example, listening with a third ear is a commonly used expression by medical students.  My essay was not an overview of communication; it simply addressed one
Expert Advice and Patient Expectations
Authors: Alan G. Barbour
Journal: JAMA (1998)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
England's new research funding system leaves some fields of psychiatry out in cold
Authors: Susan Mayor
Journal: BMJ (2007)

New arrangements for funding academic medical research in England have left some disciplines, particularly in the field of psychiatry, out in the cold, depriving them of research funds and limiting career prospects for people wanting to work in these areas, researchers have warned.

The new system, announced last year, merged the budgets from the two existing streams for the public funding of medical research, those of the Medical Research Council and NHS Research ( BMJ 2006;332:994, doi: 10.1136/bmj.332.7548.994).

There is now a single fund for academic medical research, administered by the National Institute for Health Research, which was set up to deliver the government's research strategy. Researchers in many disciplines who previously received funding directly from their NHS trusts have had to apply to the institute, and some have now been told that their research money will cease next year.

Peter Tyrer, professor of community psychiatry at Imperial College London, and a member of the panel that reviewed applications for funding in mental health, considers that research applications in forensic psychiatry, child psychiatry, and intellectual difficulties have fared particularly badly. None of the bids in these fields were funded, even though many of the researchers making them have international reputations and have previously been successful in gaining funding from a wide range of research bodies.

Of the 132 applications in mental health, only 15 were funded, …
Recurrent Venous Thromboembolism in Patients with a Partial Deficiency of Protein S
Authors: Charles T. Esmon
Journal: New England Journal of Medicine (1984)

Protein S is an antithrombotic plasma protein that serves as a cofactor for another plasma protein, activated protein C. Protein S is required for the expression of the anticoagulant effect of activated protein C, which inhibits blood clotting at the levels of factors V and VIII in the blood-clotting cascade. We postulated that patients deficient in protein S would have inadequate regulatory control of the clotting cascade and would be prone to thrombotic disease in a manner similar to that of patients congenitally deficient in protein C. To determine whether protein S deficiency is associated with recurrent thrombosis, we developed a functional assay for the plasma protein. With this assay, the protein S activity of normal persons ranges from 63 to 160 per cent. Using this test, we have now identified six unrelated persons with severe recurrent venous thrombosis who were deficient in protein S, with levels between 15 and 37 per cent while they were not receiving warfarin therapy. Our data suggest that the determination of protein S levels will be useful in the evaluation of patients with recurrent thrombosis.
50. Transcript Profiling Identifies Novel Role for SGK1 in Promoting Cardiomyocyte Survival
Authors: Takuma Aoyama, Takashi Matsui, Mikhail Novikov, Anthony Rosenzweig
Journal: Molecular Therapy (2005)

FasL only induces cardiomyocyte (CM) apoptosis when transcription is inhibited. To identify transcription-dependent cardioprotective pathways, we performed microarray analyses on CM that were untreated or stimulated with FasL, in the absence or presence of low-dose Actinomycin D (ActD, to inhibit transcription). 23 transcripts were identified as upregulated by FasL and inhibited by ActD, including Serum- and Glucocorticoid-responsive Kinase-1 (SGK1), a serine-threonine kinase that is expressed in the heart and previously reported to regulate sodium channels. Studies of rats after aortic constriction demonstrated that both phospho- and total SGK1 increased 2 to 7 days after banding. Phospho-SGK1 was also upregulated in CM stimulated in vitro with IGF-I or phenylephrine (PE). To examine the functional effects of SGK1 in CM, we generated recombinant Adenoviral vectors (Ad) carrying HA-tagged, constitutively-active (CA, S422D) and kinase-dead (KD, K127M) mutants of SGK1. In the absence of stimulation, Ad.SGK1.CA increased SGK1 activity 2.45|[plusmn]|0.21-fold (p<0.05), while Ad.SGK1.KD reduced it (0.44|[plusmn]|0.02-fold, p<0.05) compared to control-Ad infected CMs. Stimulation of control-Ad infected CMs with IGF-I induced a comparable, 2.3-fold increase in SGK1 activity. Treatment of Ad.SGK1.CA-infected CM with IGF-I further increased SGK1 activity while Ad. SGK1.KD inhibited it (2.26|[plusmn]|0.07- and 0.40|[plusmn]|0.02-fold, respectively, p<0.05 vs IGF-I-treated control cells). Thus, Ad.SGK1.CA increases SGK1 activity in CMs but remains responsive to further stimulation, and Ad.SGK1.KD acts as a dominant negative to inhibit endogenous SGK1 activity. Neither Ad.SGK1.CA nor Ad.SGK1.KD had significant effects on CM apoptosis in unstimulated CMs. In contrast, Ad.SGK1.CA substantially protected CMs against both serum deprivation (SD)- and hypoxia-induced apoptosis, while inhibition of SGK1 significantly increased the number of apoptotic nuclei compared with control virus-infected CM in both models. These changes in nuclear morphology correlated well with DNA laddering, the biochemical hallmark of apoptosis, and cleavage (activation) of caspase-3, as well as overall cell viability, as indicated by the MTT assay. Of note, the protective effect of IGF-I was significantly but incompletely reversed by expression of SGK1.KD (p<0.05). Evaluation of potential downstream signaling pathways demonstrated that SGK1 induces phosphorylation of Tuberin, p70s6kinase, and GSK3|[beta]| in CM which may contribute to its effects. We conclude that SGK1 is dynamically regulated during acute biomechanical stress in the heart and inhibits CM apoptosis. Thus, SGK1 may represent a novel therapeutic target for conditions such as heart failure or ischemic injury characterized by CM death.
P2-12-20: Adjuvant! Online Is Overoptimistic in Predicting Survival of Asian Breast Cancer Patients.
Authors: Pathy N Bhoo, CH Yip, M Hartman, N Saxena, NA Taib, AM Bulgiba, der Graaf Y van, HM Verkooijen
Journal: Cancer Research (2011)

Abstract Background Adjuvant! Online is a free web-based tool which predicts 10-year breast cancer outcomes and efficacy of adjuvant therapy in patients with breast cancer. As its prognostic performance has only been validated in high income Caucasian populations, the model was validated in a middle income Asian setting. Material and Methods: Within the University Malaya Hospital-Based Breast Cancer Registry, all 631 women receiving standard surgery for invasive non-metastatic breast cancer between 1993 and 2000 were identified. Calibration of Adjuvant! Online was evaluated by comparing the predicted 10-year overall survival with observed 10-year survival. Discrimination of the model was tested by receiver operating characteristic (ROC) analysis. Results: For the entire cohort, Adjuvant! Online predicted 10 year survival (70.3%) was significantly higher than the observed 10 years survival (63.6 %) by a difference of 6.7% (95%CI: 3.0%- 10.4%). The model was especially overoptimistic in women under 40 years and in women of Malay ethnicity, where survival was overestimated by approximately 20% (95%CI: 9.8- 29.8%) and 15% (95%CI: 5.3−24.5%) respectively. Adjuvant! Online performed fairly in terms of discrimination, with an area under ROC curve of 0.73 (95%CI: 0.69−0.77). Conclusion: Even though Adjuvant! Online is capable of discriminating between good and poor survivors, it systematically overestimates survival. These findings suggest that the model requires adaptation prior to use in Asian settings. Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P2-12-20.