tbuckley/cabot-search huggingface dataset:
Defamation threat leaves people "terrified" to publish articles
Authors: A. O'Dowd
Journal: BMJ (2011)

Writers and clinicians are often “terrified” to publish articles that are potentially defamatory because of the legal consequences, politicians have been told.

Witnesses appearing on 13 June before the parliamentary joint committee looking into the draft Defamation Bill for England and Wales heard that the current laws on defamation and libel needed to change to ensure fairness. The committee, made up of MPs and peers, was holding an evidence session for its inquiry into the bill.

Under the bill the government is proposing to change libel laws in England and Wales to ensure that people can state honest opinions with confidence. The proposal is a response to concerns that defamation laws are crushing freedom of expression and that the threat of libel proceedings is sometimes …
Public health experts predict NHS reforms could lead to "chaos"
Authors: A. O'Dowd
Journal: BMJ (2011)

Most experts in public health have condemned the NHS reforms, saying they could make it harder to reduce health inequalities and to respond to emergencies.

A survey of almost 1000 public health specialist members of the UK Faculty of Public Health—the standard setting body for these clinicians—found little support for the reforms.

The faculty surveyed its members on the reforms contained in the Health and Social Care Bill, which is currently being scrutinised by the House of Lords as it progresses through parliament on its way to becoming law next year.

The survey, …
Clinical Activity of Pertuzumab (rhuMAb 2C4), a HER Dimerization Inhibitor, in Advanced Ovarian Cancer: Potential Predictive Relationship With Tumor HER2 Activation Status
Authors: Michael S. Gordon, Daniela Matei, Carol Aghajanian, Ursula A. Matulonis, Molly Brewer, Gini F. Fleming, John D. Hainsworth, Agustin A. Garcia, Mark D. Pegram, Russell J. Schilder, David E. Cohn, Lynda Roman, Mika K. Derynck, Kimmie Ng, Benjamin Lyons, David E. Allison, David A. Eberhard, Thinh Q. Pham, Randall C. Dere, Beth Y. Karlan
Journal: Journal of Clinical Oncology (2006)

Ovarian cancers (OCs) frequently have HER2 activation in the absence of HER2 overexpression. Pertuzumab, a humanized antibody that prevents HER2 dimerization and inhibits multiple HER-mediated pathways, was studied in a phase II, multicenter trial in advanced, refractory OC.Sixty-one patients (cohort 1) with relapsed OC received a loading dose of 840 mg pertuzumab intravenously followed by 420 mg every 3 weeks; 62 patients (cohort 2) received 1,050 mg every 3 weeks. Response rate was the primary end point. Fresh tumor biopsies were obtained in cohort 1 to assay for phosphorylated HER2 (pHER2).Median age was 57 years and median number of prior chemotherapy regimens was five. Fifty-five patients in cohort 1 and 62 patients in cohort 2 were assessable for efficacy. There were five partial responses (response rate [RR] = 4.3%; 95% CI, 1.7% to 9.4%), eight patients (6.8%) with stable disease (SD) lasting at least 6 months, and 10 patients with CA-125 reduction of at least 50% (includes two partial responses and four patients with SD > or = 6 months; total clinical activity, 14.5%). Median progression-free survival (PFS) was 6.6 weeks. Eight of 28 tumor biopsies (28.6%) were pHER2+ by enzyme-linked immunosorbent assay (ELISA; without gene amplification). Median PFS for pHER2+ patients was 20.9 weeks (n = 8) versus 5.8 weeks for pHER2- (n = 20; P = .14) and 9.1 weeks for unknown pHER2 status (n = 27). Pertuzumab was well tolerated with diarrhea in 69.1% (11.4% grade 3, no grade 4). Five patients had asymptomatic left ventricular ejection fraction decreases to less than 50% (one confirmed by central facility).Pertuzumab is well tolerated with a RR of 4.3% in heavily-pretreated OC patients. Further studies on pHER2 as a diagnostic are warranted.
Chronic localized hypotension and resetting of carotid sinus baroreceptors. Electrophysiological and histological studies in the dog.
Authors: F O Igler, J H Donegan, K C Hoo, M E Korns, J P Kampine
Journal: Circulation Research (1981)

Resetting of carotid sinus (CS) baroreceptors to chronically elevated systemic pressure in hypertension has been demonstrated. The effects of chronic system hypotension on CS baroreceptor afferents has not been elucidated, however. The purpose of the present study was to determine the electrophysiological and histological characteristics of CS baroreceptors exposed to chronic hypotension. Chronic unilateral hypotension was produced by anastomosis of the common carotid artery to the external jugular vein. CS nerve activity and histology of the normotensive sinus (mean CS pressure +/- SD = 96 +/- 10.9 torr) were compared to those of the hypotensive sinus (mean CF pressure 50 +/- 14.2 torr) 44-49 days after anastomosis in nine mongrel dogs. An isolated CS pouch preparation was used to produce standard pressure changes. Threshold pressure for hypotensive sinuses (15.5 +/- 5.19 torr) was significantly less (P less than 0.05) than for normotensive sinuses (40.6 +/- 9.73 torr). Saturation pressure was also significantly less in the hypotensive sinus (P less than 0.05). There were no significant differences between slopes of the stimulus-response curve or in architecture of intima or media of the two sides. Thus, the stimulus-response curve was shifted to the left in chronic CS hypotension, and this effect could not be related to a change in CS light microscopic histology.
A Call to Action
Authors: Jonathan Bergman, Robert H. Brook, Mark S. Litwin
Journal: JAMA Surgery (2013)

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 Surgery HomeNew OnlineCurrent IssueFor Authors Podcast 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) 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 Surgery journal
IL-23 plays a key role in<i>Helicobacter hepaticus</i>–induced T cell–dependent colitis
Authors: Marika C. Kullberg, Dragana Jankovic, Carl G. Feng, Sophie Hue, Peter L. Gorelick, Brent S. McKenzie, Daniel J. Cua, Fiona Powrie, Allen W. Cheever, Kevin J. Maloy, Alan Sher
Journal: The Journal of Experimental Medicine (2006)

Inflammatory bowel disease (IBD) is a chronic inflammatory disorder of the gastrointestinal tract that is caused in part by a dysregulated immune response to the intestinal flora. The common interleukin (IL)-12/IL-23p40 subunit is thought to be critical for the pathogenesis of IBD. We have analyzed the role of IL-12 versus IL-23 in two models of Helicobacter hepaticus-triggered T cell-dependent colitis, one involving anti-IL-10R monoclonal antibody treatment of infected T cell-sufficient hosts, and the other involving CD4+ T cell transfer into infected Rag-/- recipients. Our data demonstrate that IL-23 and not IL-12 is essential for the development of maximal intestinal disease. Although IL-23 has been implicated in the differentiation of IL-17-producing CD4+ T cells that alone are sufficient to induce autoimmune tissue reactivity, our results instead support a model in which IL-23 drives both interferon gamma and IL-17 responses that together synergize to trigger severe intestinal inflammation.
Comparative Methods for the Analysis of Gene-Expression Evolution: An Example Using Yeast Functional Genomic Data
Authors: Todd H. Oakley, Zhenglong Gu, Ehab Abouheif, Nipam H. Patel, Wen-Hsiung Li
Journal: Molecular Biology and Evolution (2004)

Understanding the evolution of gene function is a primary challenge of modern evolutionary biology. Despite an expanding database from genomic and developmental studies, we are lacking quantitative methods for analyzing the evolution of some important measures of gene function, such as gene-expression patterns. Here, we introduce phylogenetic comparative methods to compare different models of gene-expression evolution in a maximum-likelihood framework. We find that expression of duplicated genes has evolved according to a nonphylogenetic model, where closely related genes are no more likely than more distantly related genes to share common expression patterns. These results are consistent with previous studies that found rapid evolution of gene expression during the history of yeast. The comparative methods presented here are general enough to test a wide range of evolutionary hypotheses using genomic-scale data from any organism.
Communication About Serious Illness Care Goals
Authors: Rachelle E. Bernacki, Susan D. Block
Journal: JAMA Internal Medicine (2014)

An understanding of patients' care goals in the context of a serious illness is an essential element of high-quality care, allowing clinicians to align the care provided with what is most important to the patient. Early discussions about goals of care are associated with better quality of life, reduced use of nonbeneficial medical care near death, enhanced goal-consistent care, positive family outcomes, and reduced costs. Existing evidence does not support the commonly held belief that communication about end-of-life issues increases patient distress. However, conversations about care goals are often conducted by physicians who do not know the patient, do not routinely address patients' nonmedical goals, and often fail to provide patients with sufficient information about prognosis to allow appropriate decisions; in addition, they tend to occur so late in the patient's illness that their impact on care processes is reduced. This article (1) reviews the evidence and describes best practices in conversations about serious illness care goals and (2) offers practical advice for clinicians and health care systems about developing a systematic approach to quality and timing of such communication to assure that each patient has a personalized serious illness care plan. Best practices in discussing goals of care include the following: sharing prognostic information, eliciting decision-making preferences, understanding fears and goals, exploring views on trade-offs and impaired function, and wishes for family involvement. Several interventions hold promise in systematizing conversations with patients about serious illness care goals: better education of physicians; systems to identify and trigger early discussions for appropriate patients; patient and family education; structured formats to guide discussions; dedicated, structured sections in the electronic health record for recording information; and continuous measurement. We conclude that communication about serious illness care goals is an intervention that should be systematically integrated into our clinical care structures and processes.
Plasma Lipopolysaccharide Is Closely Associated With Glycemic Control and Abdominal Obesity
Authors: Marius Trøseid, Torunn K. Nestvold, Knut Rudi, Hanne Thoresen, Erik W. Nielsen, Knut T. Lappegård
Journal: Diabetes Care (2013)

OBJECTIVE It is of vital importance to elucidate the triggering factors of obesity and type 2 diabetes to improve patient care. Bariatric surgery has been shown to prevent and even cure diabetes, but the mechanism is unknown. Elevated levels of lipopolysaccharide (LPS) predict incident diabetes, but the sources of LPS are not clarified. The objective of the current study was to evaluate the potential impact of plasma LPS on abdominal obesity and glycemic control in subjects undergoing bariatric surgery. RESEARCH DESIGN AND METHODS This was a prospective observational study involving a consecutive sample of 49 obese subjects undergoing bariatric surgery and 17 controls. Main assessments were plasma LPS, HbA1c, adipose tissue volumes (computed tomography), and quantified bacterial DNA in adipose tissue compartments. RESULTS Plasma levels of LPS were elevated in obese individuals compared with controls (P &amp;lt; 0.001) and were reduced after bariatric surgery (P = 0.010). LPS levels were closely correlated with HbA1c (r = 0.56; P = 0.001) and intra-abdominal fat volumes (r = 0.61; P &amp;lt; 0.001), but only moderately correlated with subcutaneous fat volumes (r = 0.33; P = 0.038). Moreover, there was a decreasing gradient (twofold) in bacterial DNA levels going from mesenteric via omental to subcutaneous adipose tissue compartments (P = 0.041). Finally, reduced LPS levels after bariatric surgery were directly correlated with a reduction in HbA1c (r = 0.85; P &amp;lt; 0.001). CONCLUSIONS Our findings support a hypothesis of translocated gut bacteria as a potential trigger of obesity and diabetes, and suggest that the antidiabetic effects of bariatric surgery might be mechanistically linked to, and even the result of, a reduction in plasma levels of LPS.
Lack of mitochondrial DNA variation in Australian Drosophila buzzatii.
Authors: R Halliburton, J S Barker
Journal: Molecular Biology and Evolution (1993)

Drosophila buzzatii is native to Argentina and Brazil and was introduced to Australia, probably between 193 1 and 1936, during the biological control program for prickly pear cacti (Opuntia spp.) (Mann 1970; Barker 1982; Barker et al. 1985). It lives and breeds in rotting tissues of prickly pear and apparently is restricted to this niche (Barker and Mulley 1976 ) . Populations of D. buzzatii in Australia occur in islands corresponding to patches of Opuntia. Before the introduction of the moth Cactoblastis cactorum as a biological control agent, prickly pears formed a nearly continuous distribution throughout much of Queensland and northern New South Wales ( fig. 1) . Cactoblastis cactorum rapidly reduced the distribution of Opuntia to isolated patches (Dodd 1940; Mann 1970); consequently, the distribution of D. buzzatii is restricted to these same patches. The sizes of the populations, as well as their degree of isolation, vary widely. Barker and Mulley ( 1976) and Barker ( 198 1) found low levels of allozyme variation in Australian D. buzzatii. They compared their results with those for related species and concluded that low levels of allozyme variation may be typical of the mulleri subgroup and that their data did not necessarily indicate a founder effect at the time of introduction to Australia. In this report we present the results of a survey of mitochondrial DNA (mtDNA) restriction-site variation in Australian D. buzzatii and conclude that lack of variation is probably due to the founder effect. We studied 25 isofemale lines established from wild caught females. The 25 lines represented nine populations from throughout the Australian range of D. buzzatii (fig. 1). Flies were maintained in the laboratory on cactus-sucrose-yeast medium (Starmer and Barker 1986). mtDNA extraction followed the procedure of Tamura and Aotsuka ( 1988 ) , with minor modifications. mtDNA was digested with 12 restriction enzymes ( AvaII, BarnHI, BgZII, ClaI, EcoRI, EcoRV, HaeIII, HindIII, Hid, HpaII, PstI, and XhoI). Fragments were separated in 0.8% agarose gels, were transferred to charged nylon membranes by Southern blotting, and were probed with mtDNA isolated as above and labeled with digoxigenin-dUTP ( Boehringer Mannheim) . Bands were visualized by using the DNA Detection Kit (Boehringer Mannheim) . Sizes of bands were estimated either graphically or by using the computer program of Halliburton ( 199 1). Forty-two restriction sites were detected, representing 1.3% of the mtDNA molecule. The sum of fragment sizes was 15.8-16.5 kb for different enzymes. The smaller figures probably indicate undetected small ( ~300 bp) fragments. No size variation or restriction-site variation was detected. All lines showed the same pattern for a given enzyme. The most reasonable explanation for the lack of variation in Australian D. buzzatii is that it indicates a founder effect at the time when the species colonized Australia. Other evidence is consistent with this hypothesis. Allozyme studies (for the same set
Apolipoproteins and Diabetic Retinopathy
Authors: Alan Chait, Vince N. Montes
Journal: Diabetes Care (2011)

In this issue of Diabetes Care Sasongko et al. (1) make the intriguing observation that apolipoprotein (apo)B and apoA-I, and particularly the apoB-to-apoA-I ratio, are related to the presence of diabetic retinopathy in a small cohort of type 1 and type 2 diabetic patients. Moreover, this ratio correlated with the retinopathy severity and also was a better predictor of retinopathy than traditional lipid measures such as total cholesterol, LDL or HDL cholesterol, or even the LDL-to-HDL cholesterol ratio.

This study raises many important questions. For example, why are these relationships between retinopathy and lipoproteins seen in this small study, whereas previous studies, some in much larger cohorts, have not shown a consistent relationship? Did measurement of apolipoproteins rather than the lipid components of the lipoproteins make the difference? Lipids and lipoproteins are well-accepted risk factors for macrovascular disease in diabetes via mechanisms that are reasonably well understood. However, do lipids and lipoproteins play a role in microvascular complications such as retinopathy in addition to better known risk factors such as diabetes duration, glycemic control, and hypertension? And if so, by what mechanisms does HDL protect and the apoB-containing lipoproteins increase the risk of retinopathy?

In the current study, stronger relationships were observed between retinopathy and apolipoproteins than with lipid components of the lipoproteins. ApoA-I is the major structural apolipoprotein present in HDL and is reflective of the number of HDL particles. A single molecule of apoB is present in LDL, as well as in VLDL, remnant lipoproteins (often present in the intermediate-density lipoprotein [IDL] density range) and lipoprotein(a) (Lp(a)), another atherogenic lipoprotein. Because each of these lipoproteins contains a single molecule of apoB, apoB concentration is a measure of the total number of these atherogenic particles. If these lipoproteins also have an adverse effect on microvascular complications such as retinopathy, …
Absolute Risk of Endometrial Carcinoma During 20-Year Follow-Up Among Women With Endometrial Hyperplasia
Authors: James V. Lacey, Mark E. Sherman, Brenda B. Rush, Brigitte M. Ronnett, Olga B. Ioffe, Máire A. Duggan, Andrew G. Glass, Douglas A. Richesson, Nilanjan Chatterjee, Bryan Langholz
Journal: Journal of Clinical Oncology (2010)

PURPOSE The severity of endometrial hyperplasia (EH)-simple (SH), complex (CH), or atypical (AH)-influences clinical management, but valid estimates of absolute risk of clinical progression to carcinoma are lacking. Materials and METHODS We conducted a case-control study nested in a cohort of 7,947 women diagnosed with EH (1970-2002) at one prepaid health plan who remained at risk for at least 1 year. Patient cases (N = 138) were diagnosed with carcinoma, on average, 6 years later (range, 1 to 24 years). Patient controls (N = 241) were matched to patient cases on age at EH, date of EH, and duration of follow-up, and they were counter-matched to patient cases on EH severity. After we independently reviewed original slides and medical records of patient controls and patient cases, we combined progression relative risks (AH v SH, CH, or disordered proliferative endometrium [ie, equivocal EH]) from the case-control analysis with clinical censoring information (ie, hysterectomy, death, or left the health plan) on all cohort members to estimate interval-specific (ie, 1 to 4, 5 to 9, and 10 to 19 years) and cumulative (ie, through 4, 9, and 19 years) progression risks. Results For nonatypical EH, cumulative progression risk increased from 1.2% (95% CI, 0.6% to 1.9%) through 4 years to 1.9% (95% CI, 1.2% to 2.6%) through 9 years to 4.6% (95% CI, 3.3% to 5.8%) through 19 years after EH diagnosis. For AH, cumulative risk increased from 8.2% (95% CI, 1.3% to 14.6%) through 4 years to 12.4% (95% CI, 3.0% to 20.8%) through 9 years to 27.5% (95% CI, 8.6% to 42.5%) through 19 years after AH. CONCLUSION Cumulative 20-year progression risk among women who remain at risk for at least 1 year is less than 5% for nonatypical EH but is 28% for AH.
Acute colorectal ischaemia after anaphylactoid shock.
Authors: S Travis, D R Davies, B Creamer
Journal: Gut (1991)

The role of ascitic fluid collagen in the pathogenesis of the coagulopathy that follows peritoneovenous shunting was examined. Collagen was partially purified from ascitic fluid and infused into rabbits. All animals developed changes in their haemostatic profile consistent with intravascular coagulation. Aspirin therapy, for five days before the collagen infusion, prevented these changes. Seven patients undergoing a total of eight peritoneovenous shunts for intractable ascites received antiplatelet therapy (aspirin and dipyridamole) in the immediate pre- and postoperative period. After six shunts no thrombocytopenia or prolongation of clotting times developed to suggest decompensated consumptive coagulopathy. Complicating factors may have contributed to the deterioration in haemostasis in the other two patients. There was no early shunt occlusion. The results support the hypothesis that ascitic fluid collagen is important in the pathogenesis of intravascular coagulation postascitic fluid infusion and indicate that antiplatelet drugs may be of value in preventing this complication.
Physical activity and its relation with exercise capacity in patients with early COPD
Authors: Hans Van Remoortel, Miek Hornikx, Kristien De Bent, Erica Balligand, Chris Burtin, Daniel Langer, Rik Gosselink, Marc Decramer, Wim Janssens, Thierry Troosters
Journal: European Respiratory Journal (2011)

Background: Physical activity (PA) and exercise capacity are reduced in patients with severe COPD. We aimed to assess PA and its relation with exercise capacity in mild COPD.

Methods: We assessed PA (SenseWear Armband) for 7 days (reported as the average number of steps (PAsteps) and the time spent in moderate PA (> 3METs, PAmod)) in 123 (ex-)smokers (49 with COPD; 33 GOLD I and 16 GOLD II) and 55 non-smokers. Exercise capacity was determined by VO2max and six minute walking distance (6MWD).

Results: Group characteristics are given in table1. PA was significantly correlated (p<0.0001) with 6MWD (r=0.37 and r=0.27 with PAsteps and PAmod, respectively) and VO2max (r=0.39 and r=0.35 with PAsteps and PAmod, respectively).Stepwise multiple regression analysis showed that PAsteps is determined by age (R2=0.17), 6MWT (R2=0.09), season of PA assessment (1=summer/spring/autumn, R2=0.02) and diagnosis of COPD (R2=0.02; total R2=0.30). PAmod is determined by season (R2=0.12), age (R2=0.05), 6MWD (R2=0.04), gender (R2=0.02) and COPD (R2=0.02; total R2=0.25).

View this table:

Table 1. Group characteristics





Conclusion: PA is reduced in patients with mild COPD. Age, season of PA assessment and 6MWD are predictors of PA.