tbuckley/cabot-search huggingface dataset:
Diagnostic Performance by Medical Students Working Individually or in Teams
Authors: Wolf E. Hautz, Juliane E. Kämmer, Stefan K. Schauber, Claudia D. Spies, Wolfgang Gaissmaier
Journal: JAMA (2015)

Diagnostic Performance by Medical Students Working Individually or in TeamsDiagnostic errors contribute substantially to preventable medical error.'Cognitive error is among the leading causes and mostly results from faulty data synthesis. 2Furthermore, reflecting on their confidence does not prevent physicians from committing diagnostic errors.'Diagnostic decisions usually are not made by individual physidans working alone.Our aim was to investigate the effect of working in pairs as opposed to alone on diagnostic performance.Methods I Volunteer fourth-year medical students recruited via mailing lists at Charite Medical School, Berlin, Germany, partidpated in the study during June 2013 and gave written informed consent.Their main task was to evaluate 6 simulated cases of respiratory distress on a computer, which were previously validated with students and experts. 3Partidpants were randomized (stratified by sex) to work individually or in pairs.Participants received a software demonstration prior to randomization; postrandomization and prior to starting the case assessments, they received a training case.The 6 diagnostic performance cases were presented in random order.Each case started with a video presentation of a prototypical patient.Thereafter, participants could select, in any order, from 30 diagnostic tests as many as desired, but were instructed to be as fast and accurate as possible.Results were presented as real-world clinical data (eg, auscultation sounds or x-ray images).To complete a case, participants had to select 1 of2o diagnoses and indicate their confidence.Dependent variables were diagnostic accuracy (correct or incorrect), number and relevance of diagnostic tests (obtained from expert data 3 ) , time to diagnoses, time tests would Table.Accuracy, Background Knowledge, lnfonnation Search Measures, and Confidence of Medical Students, Across Cases• Mt!an (95% Cl) Tt!.~t SUtlstJcs IndiVIduals Pairs t Scoreb dValue FScoreb " 2 PValue Accuracy No. of correct cases, 3.00 (3) [2-4] 4.07 (4) [3-5] mean (median) [IQRJ t 56 = -2.98 0.78 .004Percentage 50.00 (40.53 to 59.47) 67 .78(59.95 to 75.60) c Group (Individuals vs pairs) as a fixed factor.s Indicated on a Ukert scale (1 =least to 10 = most confident).
Prognostic Factors in Psychotherapy
Authors: Norman Q. Brill, Hugh A. Storrow
Journal: JAMA (1963)

From a large number of applicants to the psychiatric clinic, those patients who expressed a great desire for help which involved more than just symptomatic relief and who stimulated a positive reaction in the doctor, tended to be accepted for treatment more often than others. These "well-motivated" patients were more likely to be diagnosed as having psychoneurotic reactions while the more poorly motivated patients were more likely to be diagnosed as having personality disorders. The well-motivated patients were apt to be considered good subjects for brief nonintensive psychotherapy, and in fact a very high percentage of them were helped by such treatment. There is some danger that the poorly motivated, more difficult patient will be avoided rather than considered a greater challenge.
ASSOCIATION BETWEEN EYE VASCULATURE ALTERATIONS AND RENAL DAMAGE IN ESSENTIAL HYPERTENSIVES WITH METABOLIC SYNDROME
Authors: Vasiliki Katsi, Georges Souretis, Ioannis Skiadas, Charalambos Vlachopoulos, Manos Kallistratos, Christodoulos Stefanadis, Ioannis Kallikazaros
Journal: Journal of the American College of Cardiology (2011)
Endothelium-specific overexpression of human IC53 downregulates endothelial nitric oxide synthase activity and elevates systolic blood pressure in mice
Authors: M.-L. Zhuo, Y. Huang, J.-Z. Chen, L.-H. Sun, R.-F. Yang, H.-Z. Chen, X. Lv, H.-L. Li, Y.-S. Wei, G. Liu, R. Zhang, T.-M. Ma, H. Cai, R.-T. Hui, D.-P. Liu, C.-C. Liang
Journal: Cardiovascular Research (2009)

Hypertension is one of the major risk factors for cardiovascular diseases. Endothelial cells (ECs) exert important functions in the regulation of blood pressure. A novel gene, IC53, as an isoform of the cyclin-dependent kinase (CDK)-binding protein gene C53, is mainly expressed in vascular ECs and is upregulated in the failing heart of rats. Overexpression of IC53 promotes proliferation of ECs. To examine whether IC53 plays a role in the regulation of vascular tone and blood pressure, we constructed a transgenic (tg) mouse model of the IC53 gene and studied its phenotypes relevant to vascular function. IC53 cDNA was cloned from a human aorta cDNA library. Using the endothelium-specific VE-cadherin promoter, we constructed tg mice in which IC53 was specifically overexpressed in vascular endothelia and found that the tg mice exhibit elevated systolic blood pressure (SBP) in contrast to the wild-type (wt) controls. Further studies revealed impaired endothelium-dependent vasodilation, reduced nitric oxide (NO) production and decreased endothelial NO synthase (eNOS) expression, and activity in the tg mice. Inhibition of IC53 in human umbilical vein ECs induces upregulation of eNOS activity. Our results indicate that IC53 participates in the regulation of vascular homeostasis. Endothelium-specific overexpression of IC53 is associated with elevated SBP, which may be in part attributed to the downregulation of eNOS signalling.
Clonal Deleterious Mutations in the Iκbα Gene in the Malignant Cells in Hodgkin's Lymphoma
Authors: Berit Jungnickel, Andrea Staratschek-Jox, Andreas Bräuninger, Tilmann Spieker, Jürgen Wolf, Volker Diehl, Martin-Leo Hansmann, Klaus Rajewsky, Ralf Küppers
Journal: The Journal of Experimental Medicine (2000)

Members of the nuclear factor (NF)-κB family of transcription factors play a crucial role in cellular activation, immune responses, and oncogenesis. In most cells, they are kept inactive in the cytosol by complex formation with members of the inhibitor of NF-κB (IκB) family, whose degradation activates NF-κB in response to diverse stimuli. In Hodgkin's lymphoma (HL), high constitutive nuclear activity of NF-κB is characteristic of the malignant Hodgkin and Reed-Sternberg (H/RS) cells, which occur at low number in a background of nonneoplastic inflammatory cells. In single H/RS cells micromanipulated from histological sections of HL, we detect clonal deleterious somatic mutations in the IκBα gene in two of three Epstein-Barr virus (EBV)-negative cases but not in two EBV-positive cases (in which a viral oncogene may account for NF-κB activation). There was no evidence for IκBα mutations in two non-HL entities or in normal germinal center B cells. This study establishes deleterious IκBα mutations as the first recurrent genetic defect found in H/RS cells, indicating a role of IκBα defects in the pathogenesis of HL and implying that IκBα is a tumor suppressor gene.
Quality of Care Among Obese Patients
Authors: Virginia W. Chang, David A. Asch, Rachel M. Werner
Journal: JAMA (2010)

Context Clinicians often have negative attitudes toward obesity and express dissatisfaction in caring for obese patients.Moreover, obese patients often feel that clinicians are biased or disrespectful because of their weight.These observations raise the concern that obese patients may receive lower quality of care.Objective To determine whether performance on common outpatient quality measures differs by patient weight status.Design, Setting, and Participants Eight different performance measures were examined in 2 national-level patient populations: (1) Medicare beneficiaries (n=36 122) using data from the Medicare Beneficiary Survey (1994-2006); and (2) recipients of care from the Veterans Health Administration (VHA) (n=33 550) using data from an ongoing performance-evaluation program (2003-2004).Main Outcome Measures Performance measures among eligible patients for diabetes care (eye examination, glycated hemoglobin [HbA 1c ] testing, and lipid screening), pneumococcal vaccination, influenza vaccination, screening mammography, colorectal cancer screening, and cervical cancer screening.Measures were based on a combination of administrative claims, survey, and chart review data. ResultsWe found no evidence that obese or overweight patients were less likely to receive recommended care relative to normal-weight patients.Moreover, success rates were marginally higher for obese and/or overweight patients on several measures.The most notable differentials were observed for recommended diabetes care among Medicare beneficiaries: comparing obese vs normal-weight patients with diabetes, obese patients were more likely to receive recommended care on lipid screening (72% vs 65%; odds ratio, 1.37 [95% confidence interval, 1.09-1.73])and HbA 1c testing (74% vs 62%; odds ratio, 1.73 [95% confidence interval, 1.41-2.11]).All analyses were adjusted for sociodemographic factors, health status, clinical complexity, and visit frequency.Conclusions Among samples of patients from the Medicare and VHA populations, there was no evidence across 8 performance measures that obese or overweight patients received inferior care when compared with normal-weight patients.Being obese or overweight was associated with a marginally higher rate of recommended care on several measures.
What Can We Learn about Autism from Autistic Persons?
Authors: Brigitte Chamak, Beatrice Bonniau, Emmanuel Jaunay, David Cohen
Journal: Psychotherapy and Psychosomatics (2008)

&lt;i&gt;Background:&lt;/i&gt; To date, few studies have focused on the viewpoints of autistic persons themselves despite an increasing number of published autobiographies. The aim of this study is to highlight their personal experiences, and to compare them to scientific and medical knowledge and representations. &lt;i&gt;Method:&lt;/i&gt; Adopting an anthropological approach, we analyzed 16 autobiographical writings and 5 interviews with autistic persons. We systematically screened this material and explored the writers’ sociodemographic characteristics, cognitive skills and interests with a focus on their sensory-perceptual experiences and their representations of autism. &lt;i&gt;Results:&lt;/i&gt; The authors’ ages (22–67 years), their countries (n = 8) and backgrounds were varied, and most of them were high-functioning individuals with autism or Asperger syndrome. The most striking observations were that all of them pointed out that unusual perceptions and information processing, as well as impairments in emotional regulation, were the core symptoms of autism, whereas the current classifications do not mention them. &lt;i&gt;Conclusions:&lt;/i&gt; Our results suggest that what has been selected as major signs by psychiatric nosography is regarded as manifestations induced by perceptive peculiarities and strong emotional reactions by the autistic persons who expressed themselves. These considerations deserve to be taken into account by professionals to better understand the behavior and needs of autistic persons. We propose to include this point in the reflection on the next psychiatric classifications.
"CONTROLLING THE ODOR AND TASTE OF ARSPHENAMINE"
Authors: Joseph H. Barach
Journal: JAMA (1926)

To the Editor:  —InThe Journal, March 20, Stokes called attention to his observation that the disagreeable odor and taste of the arsphenamines, when given intravenously, may be overcome by the use of a wafer containing wintergreen or clove. I imagine that Dr. Stokes' patient used a life saver such as are sold at the corner drugstores. This expedient was apparently helpful.  InThe Journal, May 1, Broeman calls attention to the fact that good results were obtained by having his patients smell a cotton plug moistened with bay rum. Both of these are inexpensive, easily carried out and apparently effectual.  No doubt there are other methods, the descriptions of which might tax the allotted space inThe Journal. Will you please allow me to inform the readers of this column that an efficient and economical way of controlling such disagreeable effects of the arsphenamines is to have the patient
Evaluation of the Cardiovascular Effects of Methylmercury Exposures: Current Evidence Supports Development of a Dose–Response Function for Regulatory Benefits Analysis
Authors: Henry A. Roman, Tyra L. Walsh, Brent A. Coull, Éric Dewailly, Eliseo Guallar, Dale Hattis, Koenraad Mariën, Joel Schwartz, Alan H. Stern, Jyrki K. Virtanen, Glenn Rice
Journal: Environmental Health Perspectives (2011)

The U.S. Environmental Protection Agency (U.S. EPA) has estimated the neurological benefits of reductions in prenatal methylmercury (MeHg) exposure in past assessments of rules controlling mercury (Hg) emissions. A growing body of evidence suggests that MeHg exposure can also lead to increased risks of adverse cardiovascular impacts in exposed populations.The U.S. EPA assembled the authors of this article to participate in a workshop, where we reviewed the current science concerning cardiovascular health effects of MeHg exposure via fish and seafood consumption and provided recommendations concerning whether cardiovascular health effects should be included in future Hg regulatory impact analyses.We found the body of evidence exploring the link between MeHg and acute myocardial infarction (MI) to be sufficiently strong to support its inclusion in future benefits analyses, based both on direct epidemiological evidence of an MeHg-MI link and on MeHg's association with intermediary impacts that contribute to MI risk. Although additional research in this area would be beneficial to further clarify key characteristics of this relationship and the biological mechanisms that underlie it, we consider the current epidemiological literature sufficiently robust to support the development of a dose- response function.We recommend the development of a dose- response function relating MeHg exposures with MIs for use in regulatory benefits analyses of future rules targeting Hg air emissions.
Hyperamylasemia in Ethiopian Immigrants to Israel
Authors: DAVID HUMINER
Journal: Annals of Internal Medicine (1987)

Letters and Corrections1 June 1987Hyperamylasemia in Ethiopian Immigrants to IsraelDAVID HUMINER, M.D., SILVIO D. PITLIK, M.D.DAVID HUMINER, M.D.Search for more papers by this author, SILVIO D. PITLIK, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-106-6-910_1 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: In 1985 we examined 13 newly arrived Ethiopian immigrants to Israel who were very ill on arrival. These patients came from a tropical area and most were affected by famine and had severe malnutrition and many infectious diseases(1).A striking laboratory finding was noted: 9 of the 13 patients had hyperamylasemia (greater than 324 U/L, Phadebas method) in blood samples taken shortly after refeeding. Six patients also had hyperamylasuria (less than 2000 U/L, Phadebas method). Isoenzyme analysis showed isolated elevation of pancreatic or salivary isoamylase activity in 3 patients, and of both isoenzymes in 2 other patients....References1. MORDUCHOWICZSHMUELYPITLIK GHS. Nutritional status and infections in Ethiopian immigrants to Israel. Lancet. 1985;1:704-5. CrossrefMedlineGoogle Scholar2. TSIANOSJALALIGOWENLOCKBRAGANZA EMAJ. Ethnic "hyperamylasemia": clarification by isoamylase analysis. Clin Chim Acta. 1982;124:13-21. CrossrefMedlineGoogle Scholar3. HUMPHRIESADAMSECKFELDTLEVITTMCCLAIN LLJMC. Hyperamylasemia in patients with eating disorders. Ann Intern Med. 1987;106:50-2. LinkGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: DAVID HUMINER, M.D.; SILVIO D. PITLIK, M.D.Affiliations: Beilinson Medical Center Petah Tikva Israel PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byCorrection: Letter in Hyperamylasemia in Ethiopian Immigrants 1 June 1987Volume 106, Issue 6Page: 910-910KeywordsBloodInfectious diseasesMalnutritionResearch laboratoriesStarvation ePublished: 1 December 2008 Issue Published: 1 June 1987 PDF downloadLoading ...
Measurement of Peristalsis of the Ureter and its Relation to Drugs
Authors: Sidney R. Weinberg
Journal: JAMA (1961)

An electronic device, the electromanometer, was used to obtain a record of peristalsis of the normal human ureter before, during, and after the administration of morphine sulfate, atropine sulfate, propantheline, and atropine tannate in 31 patients. Because of its sensitivity the electromanometer can measure directly the absolute value of pressure in the ureter and the alterations that occur with peristalsis. It is used with a small-caliber catheter in order to avoid obstructive factors that were inherent in prior methods used to evaluate peristalsis of the ureter. The tracings obtained showed that these four drugs in the dosages used did not alter peristalsis of the ureter.
Gag Clauses in Clinical-Trial Agreements
Authors: Robert Steinbrook
Journal: New England Journal of Medicine (2005)

Gag clauses in clinical-trial agreements prevent investigators from examining the data independently or submitting a manuscript for publication without first obtaining the consent of the sponsor. Sponsors with a financial interest in the outcome of clinical research can suppress negative results. They can also interfere with the publication of unfavorable data on safety, as it was recently alleged that Merck officials did in the company-sponsored “Advantage” study of rofecoxib for the treatment of osteoarthritis published in 2003.1 Some of the hidden data, like those related to cyclooxygenase-2 inhibitors and the use of antidepressants in children, may eventually become public, but . . .
Abstract 1053: Mouse Kremen 1 negatively regulates Wnt/β-catenin signaling in human breast cancer MDA-MB-231 cells
Authors: Taj King, Yonghe Li
Journal: Cancer Research (2011)

Abstract The canonical Wnt/β-catenin signaling pathway is a major developmental pathway that regulates embryonic development, cell motility, polarity, growth, and progression. Wnts are secreted glycoproteins that bind to the low-density lipoprotein receptor-related protein 5/6 (LRP5/6) and Frizzled, a seven pass transmembrane receptor protein, which increase cytosolic β-catenin levels and subsequent β-catenin transcriptional activity via the inhibition of glycogen synthase kinase-3β. Kremen receptors are single-pass transmembrane proteins that consist of two isoforms (Kremen 1 and 2) in mammals. Dickkopf (Dkk) proteins are secreted glycoproteins that inhibit Wnt signaling. Kremen antagonizes Wnt signaling by forming a ternary complex with Dkk1 and LRP5/6, while Kremen alone is able to promote LRP6 cell-surface localization and stimulate LRP6 signaling. Previous studies have shown that aberrant Wnt/β-catenin signaling promotes tumorigenesis in breast cancer and that LRP6 is an important mediator in mammary gland development and in breast cancer tumorigenesis. In the present studies, we found that breast cancer MDA-MB-231 cells express LRP6 and Dkk1, but not Kremen 1 and 2. Therefore, MDA-MB-231 breast cancer cells were used to make stable cell lines that conditionally express mouse Kremen 1 in the presence of doxycycline. We found that doxycycline-induced Kremen 1 expression resulted in the down-regulation of endogenous LRP6 expression and inhibition of Wnt/β-catenin signaling in MDA-MB-231 cells. Furthermore, we demonstrated that Kremen 1 expression blocked Wnt-3a-indced activation of Wnt/β-catenin signaling in MDA-MB-231 cells. Future studies will focus on the effects of Kremen 1 on tumor progression in vitro and in vivo. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr 1053. doi:10.1158/1538-7445.AM2011-1053
WHEN EVISCERATION IS PREFERABLE TO ENUCLEATION.
Authors: J. C. DUNLAVY
Journal: JAMA (1898)

The services of an eye surgeon are so often demanded in cases of either recent or remote traumatism of the eyeball, as well as for many conditions resulting from disease of this organ, that some general rules of surgical procedure should be adopted for the guidance of those whose advantages for rational information have been necessarily more or less curtailed, and who for lack of proper knowledge are more liable to treat a patient in the generally recognized plan of the surgeons of his community, whether or not this plan is practiced or sanctioned by the better and more enlightened surgeons as being the more rational. In general surgery we have amputating surgeons, and in eye surgery we have enucleating surgeons, both of whom are perfectly proper and indispensable, but, alas, either are liable to travel at too rapid a pace and leave death and maimed bodies with their baneful
Microbial and metabolic interactions between the gastrointestinal tract and<i>Clostridium difficile</i>infection
Authors: Casey M Theriot, Vincent B Young
Journal: Gut Microbes (2013)

Antibiotics disturb the gastrointestinal tract microbiota and in turn reduce colonization resistance against Clostridium difficile. The mechanism for this loss of colonization resistance is still unknown but likely reflects structural (microbial) and functional (metabolic) changes to the gastrointestinal tract. Members of the gut microbial community shape intestinal metabolism that provides nutrients and ultimately supports host immunity. This review will discuss how antibiotics alter the structure of the gut microbiota and how this impacts bacterial metabolism in the gut. It will also explore the chemical requirements for C. difficile germination, growth, toxin production and sporulation. Many of the metabolites that influence C. difficile physiology are products of gut microbial metabolism including bile acids, carbohydrates and amino acids. To restore colonization resistance against C. difficile after antibiotics a targeted approach restoring both the structure and function of the gastrointestinal tract is needed.
E-Z Reader 7 provides a platform for explaining how low- and high-level linguistic processes influence eye movements
Authors: Gary E. Raney
Journal: Behavioral and Brain Sciences (2003)

E-Z Reader 7 is a processing model of eye-movement control. One constraint imposed on the model is that high-level cognitive processes do not influence eye movements unless normal reading processes are disturbed. I suggest that this constraint is unnecessary, and that the model provides a sensible architecture for explaining how both low- and high-level processes influence eye movements.
Adrenal Insufficiency Following Bilateral Adrenal Venography
Authors: Robert T. Eagan
Journal: JAMA (1971)

Bilateral adrenal phlebography for the diagnostic study of hypertension led to prolonged severe bilateral flank pain. Adrenal insufficiency was unrecognized because its occurrence following adrenal phlebography had not previously been reported. Following discharge he became nauseated, weak, and severely hypotensive and responded only to hormonal replacement therapy. The patient subsequently failed to respond to corticotropin stimulation.
A biologic role of HIF-1 in the renal medulla
Authors: Krissanapong Manotham, Tetsuhiro Tanaka, Takamoto Ohse, Ichiro Kojima, Toshio Miyata, Reiko Inagi, Hirotoshi Tanaka, Ryoji Sassa, Toshiro Fujita, Masaomi Nangaku
Journal: Kidney International (2005)
Sympathetic Denervation Due to Neuroblastoma
Authors: PAUL J. ROACH, S. TED TREVES
Journal: Clinical Nuclear Medicine (1994)

A case of sympathetic denervation due to infiltration of the thoracic sympathetic chain by a posterior mediastinal neuroblastoma is presented. A Tc-99m MDP bone scan in a 15-month-old girl showed increased activity in the bones and soft tissues of the left lower limb. Other causes of asymmetrical uptake of bone-seeking radiotracers in the lower limbs are discussed.