tbuckley/cabot-search huggingface dataset:
Assessment of current criteria for primary nonresponse in chronic hepatitis B patients receiving entecavir therapy
Authors: Young-Joo Yang, Ju Hyun Shim, Kang Mo Kim, Young-Suk Lim, Han Chu Lee
Journal: Hepatology (2013)

A primary nonresponse to oral drugs against hepatitis B virus (HBV) is a generally accepted criterion for interrupting treatment. We investigated whether the concept of primary nonresponse suggested by current American (AASLD) and European (EASL) guidelines is appropriate for treatment with entecavir (ETV). The study included 1,254 treatment-naïve patients who had pretreatment HBV DNA levels of >2,000 IU/mL and received ETV 0.5 mg/day for over 6 months. "Primary nonresponse" was defined as a <2 log drop in HBV DNA after 6 months of therapy by AASLD and as a <1 log drop after 3 months by EASL. The cumulative probability of virological response (VR; HBV DNA of <15 IU/mL) was compared in patients with and without primary nonresponse. Median time to achieve VR was significantly shorter in primary responders by AASLD than nonresponders (12 versus 24 months; P = 0.004), but the cumulative probability of achieving a VR at 54 months was similar in the two groups (95.8% versus 100%). Time to achieve a VR and cumulative probability of VR over time did not differ between primary responders and nonresponders by EASL. On-treatment virological breakthrough occurred in 18 patients with a cumulative rate of 5.6% at 72 months. ETV resistance was detected in 13 of these 18 patients (72.2%), who were all classified as primary responder according to both guidelines.Long-term ETV therapy generally leads to a VR in treatment-naïve patients, although the time to achieve it is delayed in primary nonresponders. The current recommendation to change therapy in primary nonresponders needs to be modified to reflect drug differences in antiviral potency and resistance risk.
880-1 Repeat intracoronary gamma radiation for patients with in-stent restenosis who failed radiation therapy: Results from the re-WRIST clinical trial
Authors: Ron Waksman, Andrew E Ajani, Rebecca Torguson, Donna J Whitman, Daniel A Canos, Regina Deible, Lowell F Satler, William O Suddath, Augusto D Pichard, Kenneth M Kent, Joseph Lindsay
Journal: Journal of the American College of Cardiology (2004)
Abstract 3054: Snail-induced epithelial-mesenchymal transition generates the properties of cancer stem cells in head and neck cancer cells
Authors: Ichiro Ota, Takashi Masui, Shinji Mikami, Toshiaki Yamanaka, Hiroshi Hosoi
Journal: Cancer Research (2014)

Abstract Head and neck squamous cell carcinoma (HNSCC) is known to its rapid clinical progression and poor prognosis. Notably, regional and distant metastases in HNSCC correspond to an extremely poor prognosis with limited treatment options. The treatment resistance and tumor recurrence are important clinical problems in the management of HNSCC. Epithelial-mesenchymal transition (EMT) is a key process in successful execution of many steps such as invasion and metastasis for cancer cells. Snail is one of master regulators that promote EMT in many types of malignancies including HNSCC. Recently, it has been reported that Snail-induced EMT could induce cancer stem cell (CSC)-like phenotype in a number of tumor types. Herein, we investigated the role of Snail in inducing EMT properties and CSC-like phenotype in HNSCC. We constructed HNSCC cell lines transfected with Snail. E-cadherin was analyzed using western blotting and immunofluorescence staining. Cell migration and invasion were assessed using wound healing assay and modified Boyden chamber assay, respectively. CSC markers of HNSCC, CD44 and aldehyde dehydrogenase 1 (ALDH1), were also evaluated with western blotting, and chemosensitivity was assessed with WST-8 assay. Introduction of Snail induced EMT properties in HNSCC cells and enhanced cell migration and invasion. Moreover, Snail-induced EMT gained CSC-like phenotype and was associated with increased chemoresistance. These results suggest that Snail can be one of the attractive targets for the development of therapeutic strategies in HNSCC. Citation Format: Ichiro Ota, Takashi Masui, Shinji Mikami, Toshiaki Yamanaka, Hiroshi Hosoi. Snail-induced epithelial-mesenchymal transition generates the properties of cancer stem cells in head and neck cancer cells. [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr 3054. doi:10.1158/1538-7445.AM2014-3054
"THE CONTROL OF TRACHOMA"
Authors: H. B. Young
Journal: JAMA (1923)

<h3>To the Editor:</h3> —In the editorial comment, April 21, I was disappointed in finding no reference to the more recent conceptions of the etiology of trachoma, when the citation of the Minnesota investigation made it particularly apropos. These are, briefly, that, if trachoma is a disease entity, its spread may be better explained by an intermediary host than by interhuman contact (<i>Am. J. Ophth.</i>, September, 1922, p. 766), or that it is not a disease entity and may be developed from any infection (ibid., October, 1922, p. 799). Further study along these lines will have to be made before a decision can be reached, but the facts recorded, through observations for many years, are rather subversive of contagion in the ordinary sense; and the Minnesota returns add emphasis to this, unless the two races mingle there to a greater extent than in other states.
Outcomes of Critically Ill Patients Denied Consideration for Liver Transplantation
Authors: JOHN P. KRESS, ARNON RUBIN, ANNE S. POHLMAN, JESSE B. HALL
Journal: American Journal of Respiratory and Critical Care Medicine (2000)

Patients with advanced liver disease (ALD) leading to admission to the ICU are often evaluated for possible orthotopic liver transplantation (OLT). Those deemed ineligible for listing for OLT must be managed by medical therapy. The number of patients not eligible for OLT listing will likely increase given the current organ transplant shortage. We performed a retrospective multivariate analysis of mortality predictors for patients denied listing for OLT. One hundred and eighty-three patients denied OLT listing were evaluated over a 3(1)/(2)-yr period, beginning in 1994. Overall mortality was 56% for those not listed versus 12% for those listed for OLT (p < 0.001). Independent predictors of increased mortality among those not listed were APACHE II score (p = 0.001; OR 1.11), sepsis (p = 0.04; OR 2.41), and the need for mechanical ventilation (p = 0.001; OR 3.71). Gastrointestinal (GI) bleeding was associated with decreased mortality (p = 0.02; OR 0.44). We conclude that critically ill patients with ALD denied OLT listing have substantially higher mortality than those listed for OLT. APACHE II score, sepsis, and the need for mechanical ventilation predict increased mortality in this group. Conversely, GI bleeding predicts decreased mortality; therefore, aggressive resuscitative measures seem merited in these patients.
Psychosomatic Parameters and the Problem-Oriented Approach to Biopsychosocial Management
Authors: Adam J. Krakowski
Journal: Psychotherapy and Psychosomatics (1984)

While rigid systemization in the method of psychosocial management of patients in the general hospital is not recommended, guidelines to such management are of value to facilitate collaboration between members of the medical-surgical teams and liaison psychiatrists. The method utilizes psychosomatic parameters: biological, social, and psychological, in the framework of the problem-oriented approach. When used by the medical-surgical specialists, the method is conducive to facilitating diagnosis and decision-making for either the direct management by the physicians or selection of cases which may require more specialized intervention by liaison psychiatrists. The method also has considerable value for didactic and research purposes.
Genetic variation in the IL-10 pathway modulates severity of acute graft-versus-host disease following hematopoietic cell transplantation: synergism between IL-10 genotype of patient and IL-10 receptor β genotype of donor
Authors: Ming-Tseh Lin, Barry Storer, Paul J. Martin, Li-Hui Tseng, Bryan Grogan, Pei-Jer Chen, Lue P. Zhao, John A. Hansen
Journal: Blood (2005)
Norethindrone Acetate, Postheparin Lipolytic Activity, and Plasma Triglycerides in Familial Types I, III, IV, and V Hyperlipoproteinemia
Authors: C. J. GLUECK
Journal: Annals of Internal Medicine (1971)

Norethindrone acetate, a synthetic progestagen, was given to 5 normal persons and 26 patients with familial types I, III, IV, and V hyperlipoproteinemia. Triglyceride levels fell in all women with type V, in some males with type V, and in 9 of 13 patients with types III and IV hyperlipoproteinemia. Triglycerides did not fall in the two patients with familial type I hyperlipoproteinemia. Decrements in triglyceride induced by norethindrone acetate were often associated with simultaneous increments in postheparin lipolytic activity and postheparin triglyceride lipase. Triglyceride clearing was most marked in those women with type V, whose low postheparin lipolytic activity was elevated into the normal range during therapy.
Influence of perfusate PO2 on hypoxic pulmonary vasoconstriction in rats.
Authors: C Marshall, B E Marshall
Journal: Circulation Research (1983)

The purpose of these studies was to evaluate the influence of perfusate oxygen tension on hypoxic pulmonary vasoconstriction and to identify the site at which both alveolar and perfusate gas tensions stimulate hypoxic pulmonary vasoconstriction. Lungs from adult rats were ventilated and perfused in vitro at constant temperature, PCO2, and pH, with a perfusion circuit incorporating a membrane oxygenator that allowed independent control of the alveolar and perfusate gas tensions. Blood flow to the lung was constant (0.06 ml per g body weight per min), and pulmonary vascular resistance was therefore proportional to pulmonary artery pressure. In study 1, the pulmonary artery pressor response to zero or 22 mm Hg alveolar oxygen was measured when the perfusate oxygen tensions were approximately 8, 26, 41, 64, or 128 mm Hg. The pressor response as a percent of the maximum pressure change was progressively reduced as perfusate oxygen tension increased. For alveolar oxygen tension of zero; the pressor response = 128 -39 (Log PPO2) and r = 0.8 (P less than 0.01), the effect of perfusate gas tension on the response to alveolar gas tension of 22 mm Hg was similar. These results demonstrate that the stimulus for hypoxic pulmonary vasoconstriction is a function of both alveolar and perfusate oxygen tension. In study 2, the response to alveolar oxygen tension of 42 mm Hg was measured with mean perfusate oxygen tensions of 130, 52, and 17 mm Hg. In six animals with forward perfusion, the responses decreased with increasing perfusate oxygen tension, as in study 1. In another six animals, with retrograde perfusion, the responses to alveolar hypoxia were not altered when perfusate oxygen tension was increased. These results demonstrate that the sensor region for hypoxic pulmonary vasoconstriction is precapillary. These studies confirm and extend previous hypotheses that alveolar and perfusate oxygen tensions together, determine the PO2 at a precapillary site to stimulate hypoxic pulmonary vasoconstriction.
Preservation of Left Ventricular Function and Attenuation of Remodeling After Transplantation of Human Epicardium-Derived Cells Into the Infarcted Mouse Heart
Authors: E.M. Winter, R.W. Grauss, B. Hogers, J. van Tuyn, R. van der Geest, H. Lie-Venema, R. Vicente Steijn, S. Maas, M.C. DeRuiter, A.A.F. deVries, P. Steendijk, P.A. Doevendans, A. van der Laarse, R.E. Poelmann, M.J. Schalij, D.E. Atsma, A.C. Gittenberger-de Groot
Journal: Circulation (2007)

Proper development of compact myocardium, coronary vessels, and Purkinje fibers depends on the presence of epicardium-derived cells (EPDCs) in embryonic myocardium. We hypothesized that adult human EPDCs might partly reactivate their embryonic program when transplanted into ischemic myocardium and improve cardiac performance after myocardial infarction.EPDCs were isolated from human adult atrial tissue. Myocardial infarction was created in immunodeficient mice, followed by intramyocardial injection of 4x10(5) enhanced green fluorescent protein-labeled EPDCs (2-week survival, n=22; 6-week survival, n=15) or culture medium (n=24 and n=18, respectively). Left ventricular function was assessed with a 9.4T animal MRI unit. Ejection fraction was similar between groups on day 2 but was significantly higher in the EPDC-injected group at 2 weeks (short term), as well as after long-term survival at 6 weeks. End-systolic and end-diastolic volumes were significantly smaller in the EPDC-injected group than in the medium-injected group at all ages evaluated. At 2 weeks, vascularization was significantly increased in the EPDC-treated group, as was wall thickness, a development that might be explained by augmented DNA-damage repair activity in the infarcted area. Immunohistochemical analysis showed massive engraftment of injected EPDCs at 2 weeks, with expression of alpha-smooth muscle actin, von Willebrand factor, sarcoplasmic reticulum Ca2+-ATPase, and voltage-gated sodium channel (alpha-subunit; SCN5a). EPDCs were negative for cardiomyocyte markers. At 6-weeks survival, wall thickness was still increased, but only a few EPDCs could be detected.After transplantation into ischemic myocardium, adult human EPDCs preserve cardiac function and attenuate ventricular remodeling. Autologous human EPDCs are promising candidates for clinical application in infarcted hearts.
MANAGEMENT OF CORONARY ARTERY DISEASE IN PATIENTS UNDERGOING TRANSCATHETER AORTIC VALVE IMPLANTATION
Authors: Kay Woon Ho, Mark Osten, Chris Feindel, Robert James Cusimano, Melitta Mezody, Massimiliano Meineri, Vladimír Džavík, Eric Horlick
Journal: Journal of the American College of Cardiology (2011)
Association between use of a quilt and sudden infant death syndrome: case-control study
Authors: A.-L. Ponsonby, T. Dwyer, D. Couper, J. Cochrane
Journal: BMJ (1998)

in the allocation of distinction awards can be also brought against the system.AE carried out this study while a Harkness Fellow of the Commonwealth Fund of New York.We thank the Department of Health for providing us with the data on the NHS workforce.Contributors: AE planned the study
A single polymorphic amino acid on <i>Toxoplasma gondii</i> kinase ROP16 determines the direct and strain-specific activation of Stat3
Authors: Masahiro Yamamoto, Daron M. Standley, Seiji Takashima, Hiroyuki Saiga, Megumi Okuyama, Hisako Kayama, Emi Kubo, Hiroshi Ito, Mutsumi Takaura, Tadashi Matsuda, Dominique Soldati-Favre, Kiyoshi Takeda
Journal: The Journal of Experimental Medicine (2009)

Infection by Toxoplasma gondii down-regulates the host innate immune responses, such as proinflammatory cytokine production, in a Stat3-dependent manner. A forward genetic approach recently demonstrated that the type II strain fails to suppress immune responses because of a potential defect in a highly polymorphic parasite-derived kinase, ROP16. We generated ROP16-deficient type I parasites by reverse genetics and found a severe defect in parasite-induced Stat3 activation, culminating in enhanced production of interleukin (IL) 6 and IL-12 p40 in the infected macrophages. Furthermore, overexpression of ROP16 but not ROP18 in mammalian cells resulted in Stat3 phosphorylation and strong activation of Stat3-dependent promoters. In addition, kinase-inactive ROP16 failed to activate Stat3. Comparison of type I and type II ROP16 revealed that a single amino acid substitution in the kinase domain determined the strain difference in terms of Stat3 activation. Moreover, ROP16 bound Stat3 and directly induced phosphorylation of this transcription factor. These results formally establish an essential and direct requirement of ROP16 in parasite-induced Stat3 activation and the significance of a single amino acid replacement in the function of type II ROP16.
Nosocomial Meningitis of the Newborn Caused by a Flavobacterium
Authors: Stanley A. Plotkin
Journal: JAMA (1966)

GRAM-NEGATIVE as well as gram-positive bacteria may be agents of infection in a nursery for the newborn. A number of species of gram-negative bacteria are capable of multiplying at ordinary room temperature in aqueous environments devoid of organic carbon and nitrogen sources. These organisms have been termed "water bugs"<sup>1</sup>and have been the cause of many documented epidemics of neonatal meningitis.<sup>2-6</sup> We report here two cases of meningitis in newborns caused by flavobacteria that were apparently transmitted via saline solution used to wash the infants' eyes at birth. Hydrocephalus developed in both patients, and one died, which illustrated the seriousness of the infection. <h3>Report of Cases</h3><h3>Case 1.—</h3> A boy was born at term on April 16, 1965, in a 50-bed rural hospital in the Philadelphia area. The pregnancy had been uneventful except for an episode of urinary tract infection during the sixth month, which was treated with
Closure of GP practice in Camden was a casualty of NHS changes, says inquiry
Authors: T. Foot
Journal: BMJ (2012)

A public inquiry into the closure of a GP surgery in north London that was run by a private company says there is “a serious loophole” in the national contract for alternative providers. It raises concerns about two other practices in the area.

Camden Road Surgery closed on 13 April, four years after it was taken over by US health giant UnitedHealth, leaving more than 4500 patients without a doctor.1

The inquiry panel of three councillors—chaired by Labour councillor Angela Mason—said there was an “urgent need” to find a replacement for the closed surgery, adding: “We remain concerned about the remaining two contracts held by The Practice at the Brunswick Centre and King’s Cross, as contracts will end in 2013.”

The …
647 Genetic variants of hepatobiliary transporter and nuclear receptor genes and response to ursodeoxycholic acid in primary biliary cirrhosis
Authors: V. Barbu, C. Ping, C. Corpechot, Y. Chrétien, E. Matsuda, O. Chazouillières, T. Simon, R.E. Poupon, R. Poupon
Journal: Journal of Hepatology (2006)
NEW METHODS FOR THE CULTURE OF BACTERIA
Authors: G. Mann
Journal: BMJ (1912)

<h3>ABSTRACT</h3> <h3>Aims</h3> The aim of this study was to estimate a 48 hour prediction of moderate to severe respiratory failure, requiring mechanical ventilation, in hospitalized patients with COVID-19 pneumonia. <h3>Methods</h3> This was an observational study that comprised consecutive patients with COVID-19 pneumonia admitted to hospital from 21 February to 6 April 2020. The patients’ medical history, demographic, epidemiologic and clinical data were collected in an electronic patient chart. The dataset was used to train predictive models using an established machine learning framework leveraging a hybrid approach where clinical expertise is applied alongside a data-driven analysis. The study outcome was the onset of moderate to severe respiratory failure defined as PaO<sub>2</sub>/FiO<sub>2</sub> ratio &lt;150 mmHg in at least one of two consecutive arterial blood gas analyses in the following 48 hours. Shapley Additive exPlanations values were used to quantify the positive or negative impact of each variable included in each model on the predicted outcome. <h3>Results</h3> A total of 198 patients contributed to generate 1068 usable observations which allowed to build 3 predictive models based respectively on 31-variables signs and symptoms, 39-variables laboratory biomarkers and 91-variables as a composition of the two. A fourth “boosted mixed model” included 20 variables was selected from the model 3, achieved the best predictive performance (AUC=0.84) without worsening the FN rate. Its clinical performance was applied in a narrative case report as an example. <h3>Conclusion</h3> This study developed a machine model with 84% prediction accuracy, which is able to assist clinicians in decision making process and contribute to develop new analytics to improve care at high technology readiness levels.
The Frustrated Reformers
Authors: Daniel S. Greenberg
Journal: New England Journal of Medicine (1979)

Stay in Washington long enough, and you'll see cycles of health-policy "reformers" arrive full of bright ideas and high hopes. And then, a few years later, many of them depart, and when they do, they almost invariably express despair about — as it's often put — "getting anything done."The round trips of these frustrates are along a variety of courses, but the most common starting points are academic institutions and nonprofit research organizations. The major workplaces in Washington are the House and Senate subcommittees concerned with health policy, the Congressional Office of Technology Assessment, the Department of Health, Education, . . .
Teaching on a ward round
Authors: J. Ker, P. Cantillon, L. Ambrose
Journal: BMJ (2008)

A deliberate and planned approach to bedside teaching will make learning more effective 

Teaching on a ward round has been compared to walking a tightrope. A clinical teacher has to balance the differing needs of undergraduate and graduate learners while providing a comprehensive and safe clinical service. Teaching in the presence of patients is an additional tension because the patient plays a central role and also is the most attentive member of the audience. Ward round teaching remains a powerful teaching context in medicine as it provides an authentic experience of the complexity of patient care and professional practice.1 2 The enduring value of the ward round lies in its potential to model professionalism, enhance clinical reasoning,3 and demonstrate the cultural norms of medical practice.4 5 

We have developed six questions that can routinely be used to plan and deliver effective bedside teaching on ward rounds (fig 1⇓). The questions are derived from empirically based theories of experiential and situated learning.6 7 8



Fig 1 Six questions for planning a teaching ward round



Most clinical teaching is done on the hoof, but ward based teaching is more effective if it is planned. This can be difficult on a busy ward. When the senior clinician arrives for a ward round, there is usually a brief conference with team members and then “off we go.” However, taking five minutes at the start to think about the learners, the teaching opportunities, the teaching goals, and the tasks will increase the efficiency and effectiveness of teaching enormously.

It is important to consider what sort of ward round it is. For example, a ward round that follows a night when team members were on call (a post-take ward round) will be longer than usual but may offer more teaching opportunities. …