tbuckley/cabot-search huggingface dataset:
Differentiation between actinic keratoses and disseminated superficial actinic porokeratoses with reflectance confocal microscopy
Authors: M. Ulrich, T. Forschner, J. Röwert-Huber, S. González, E. Stockfleth, W. Sterry, S. Astner
Journal: British Journal of Dermatology (2007)

Summary Background Clinical differentiation between actinic keratosis (AK) and disseminated superficial actinic porokeratosis (DSAP) may pose a significant challenge, and histological evaluation is often also required for diagnosis. Distinct morphological features can be distinguished upon histopathological examination, but the use of non-invasive tools, such as reflectance confocal microscopy (RCM), may be an eligible alternative for confirmation of diagnosis. Objectives The aim of this study was to determine the relevant RCM criteria for the identification of disseminated superficial actinic porokeratoses (DSAPs) and to define distinguishing criteria for DSAPs compared with actinic keratosis (AKs). Patients/methods A total of 20 patients with a clinical diagnosis of AK or DSAP were included in this study. All lesions were evaluated by clinical examination, and RCM and one clinically identified lesion was biopsied for histological confirmation. Results Cellular and nuclear atypia, inflammation, spongiosis, parakeratosis and changes in epidermal architecture were present in both lesion types (i.e. AKs and DSAPs). However, these features were more pronounced in AKs. Whereas AKs exhibited more disseminated parakeratotic changes, parakeratosis was found focally present on the border of DSAP lesions. Most characteristically, a distinct border corresponding to cornoid lamella in RCM can be identified in DSAPs. Conclusions Distinguishing features of DSAPs, such as cornoid lamella, sharp demarcation of the lesion and focal keratinocyte atypia are easily identifiable using RCM, and correlate well with histopathology. Whilst RCM has previously been used in the evaluation of AKs, it has not yet been used to investigate DSAPs. The findings in this study suggest the feasibility of non-invasive tools, such as RCM for the differentiation of AKs and DSAPs. However, further studies are warranted to assess the sensitivity and specificity of RCM in the diagnosis of DSAP.
Root causes of violent conflict in developing countries Commentary: Conflict---from causes to prevention?
Authors: F. Stewart
Journal: BMJ (2002)

Poverty and political, social, and economic inequalities between groups predispose to conflict; policies to tackle them will reduce this risk Eight out of 10 of the world's poorest countries are suffering, or have recently suffered, from large scale violent conflict. Wars in developing countries have heavy human, economic, and social costs and are a major cause of poverty and underdevelopment. The extra infant deaths caused by the war in Cambodia, for example, were estimated to be 3% of the country's 1990 population.1 Most current conflicts, such as in the Sudan or the Congo, are within states, although there is often considerable outside intervention, as in Afghanistan. In the past 30 years Africa has been especially badly affected by war (see fig 1). This article reviews the evidence on the root causes of conflict and suggests some policy responses that should be adopted to reduce the likelihood of future war. #### Summary points Wars are a major cause of poverty, underdevelopment, and ill health in poor countries The incidence of war has been rising since 1950, with most wars being within states Wars often have cultural dimensions related to ethnicity or religion, but there are invariably underlying economic causes too Major root causes include political, economic, and social inequalities; extreme poverty; economic stagnation; poor government services; high unemployment; environmental degradation; and individual (economic) incentives to fight To reduce the likelihood of wars it is essential to promote inclusive development; reduce inequalities between groups; tackle unemployment; and, via national and international control over illicit trade, reduce private incentives to fight Fig 1. Number of armed conflicts by level, 1946-2000. (Adapted from Gleditsch NP, Wallensteen P, Eriksson M, Sollenberg M, Strand H. Armed conflict 1946-2000: a new dataset. www.pcr.uu.se/workpapers.html) Many groups of people who fight together perceive themselves as belonging to a common culture (ethnic … Correspondence to: D Holdstock
All emotions are not created equal: Reaching beyond the traditional disputes
Authors: Patrik N. Juslin, Daniel Västfjäll
Journal: Behavioral and Brain Sciences (2008)

Abstract Most commentators have agreed with our thesis, that musical emotions cannot be studied without regard to underlying mechanisms. However, some commentators have expressed concerns that are addressed in this response. Others have suggested directions for future research. Topics discussed in our response include terminology, elaborations on particular mechanisms, possible additional mechanisms, ways of distinguishing among emotions and mechanisms, the prevalence of musical emotions, the relationship between perceived and felt emotions, developmental issues, and evolutionary perspectives. We end our response with a plea for researchers to reach beyond the traditional disputes in the field to pave the way for more theory-driven studies that can facilitate a deeper understanding of musical emotions.
Trusts need to improve their handling of complaints, commission says
Authors: Adrian O’Dowd
Journal: BMJ (2008)

The NHS in England is getting worse at responding to complaints, according to the largest measure of patients’ grievances, published this week.

The NHS watchdog, the Healthcare Commission, says that overall justified complaints from patients are rising and involve poor communications, hurried consultations with GPs, and a lack of basic nursing care.

The commission has published a report looking in detail at 10 366 complaints lodged between August 2006 and July 2007 and concludes that the NHS has a lot of work to do to improve the way it handles complaints.

The report says that numbers of complaints are …
Classification of human genomic regions based on experimentally determined binding sites of more than 100 transcription-related factors
Authors: Kevin Y Yip, Chao Cheng, Nitin Bhardwaj, James B Brown, Jing Leng, Anshul Kundaje, Joel Rozowsky, Ewan Birney, Peter Bickel, Michael Snyder, Mark Gerstein
Journal: Genome biology (2012)

Transcription factors function by binding different classes of regulatory elements. The Encyclopedia of DNA Elements (ENCODE) project has recently produced binding data for more than 100 transcription factors from about 500 ChIP-seq experiments in multiple cell types. While this large amount of data creates a valuable resource, it is nonetheless overwhelmingly complex and simultaneously incomplete since it covers only a small fraction of all human transcription factors.As part of the consortium effort in providing a concise abstraction of the data for facilitating various types of downstream analyses, we constructed statistical models that capture the genomic features of three paired types of regions by machine-learning methods: firstly, regions with active or inactive binding; secondly, those with extremely high or low degrees of co-binding, termed HOT and LOT regions; and finally, regulatory modules proximal or distal to genes. From the distal regulatory modules, we developed computational pipelines to identify potential enhancers, many of which were validated experimentally. We further associated the predicted enhancers with potential target transcripts and the transcription factors involved. For HOT regions, we found a significant fraction of transcription factor binding without clear sequence motifs and showed that this observation could be related to strong DNA accessibility of these regions.Overall, the three pairs of regions exhibit intricate differences in chromosomal locations, chromatin features, factors that bind them, and cell-type specificity. Our machine learning approach enables us to identify features potentially general to all transcription factors, including those not included in the data.
Effect of educational outreach to nurses on tuberculosis case detection and primary care of respiratory illness: pragmatic cluster randomised controlled trial
Authors: Lara R Fairall, Merrick Zwarenstein, Eric D Bateman, Max Bachmann, Carl Lombard, Bosielo P Majara, Gina Joubert, Rene G English, Angeni Bheekie, Dingie van Rensburg, Pat Mayers, Annatjie C Peters, Ronald D Chapman
Journal: BMJ (2005)

To develop and implement an educational outreach programme for the integrated case management of priority respiratory diseases (practical approach to lung health in South Africa; PALSA) and to evaluate its effects on respiratory care and detection of tuberculosis among adults attending primary care clinics.Pragmatic cluster randomised controlled trial, with clinics as the unit of randomisation.40 primary care clinics, staffed by nurse practitioners, in the Free State province, South Africa.1999 patients aged 15 or over with cough or difficult breathing (1000 in intervention clinics, 999 in control clinics).Between two and six educational outreach sessions delivered to nurse practitioners by usual trainers from the health department. The emphasis was on key messages drawn from the customised clinical practice guideline for the outreach programme, with illustrative support materials.Sputum screening for tuberculosis, tuberculosis case detection, inhaled corticosteroid prescriptions for obstructive lung disease, and antibiotic prescriptions for respiratory tract infections.All clinics and almost all patients (92.8%, 1856/1999) completed the trial. Although sputum testing for tuberculosis was similar between the groups (22.6% in outreach group v 19.3% in control group; odds ratio 1.22, 95% confidence interval 0.83 to 1.80), the case detection of tuberculosis was higher in the outreach group (6.4% v 3.8%; 1.72, 1.04 to 2.85). Prescriptions for inhaled corticosteroids were also higher (13.7% v 7.7%; 1.90, 1.14 to 3.18) but the number of antibiotic prescriptions was similar (39.7% v 39.4%; 1.01, 0.74 to 1.38).Combining educational outreach with integrated case management provides a promising model for improving quality of care and control of priority respiratory diseases, without extra staff, in resource poor settings.Current controlled trials ISRCTN13438073.
Lower limb activity and its determinants in COPD
Authors: P P Walker, A Burnett, P W Flavahan, P M A Calverley
Journal: Thorax (2008)

Patients with chronic obstructive pulmonary disease (COPD) walk less than healthy older people and their self-reported activity predicts exacerbation risk. The relationship between lower limb activity and total daily activity is not known, nor are there any data which relate objectively assessed daily activity to laboratory assessments made before and after rehabilitation.Lower limb activity was measured by leg actigraphy over 3 days in 45 patients with moderate to severe COPD and 18 controls of similar age. Thirty-three patients with COPD entered an 8-week rehabilitation programme in which the change in leg activity was measured and related to other outcomes.In patients with COPD the mean level of activity measured by whole body and leg activity monitors was closely related (r = 0.92; p<0.001), but leg activity was consistently reduced compared with controls of similar age (p = 0.001). Mean leg activity, mean intensity of leg activity and the time that patients spent mobile at home were all related to forced expiratory volume in 1 s (FEV(1)) (r = 0.57, p = 0.001; r = 0.5, p = 0.003; and r = 0.51, p = 0.002, respectively), but intensity of activity and time spent mobile were not related. Subjects completing pulmonary rehabilitation showed significant improvements in mean activity (p = 0.001) and spent more time moving (p = 0.014). These changes were unrelated to improvement in muscle strength or walking distance but correlated with baseline FEV(1) (r = 0.8, p<0.001).Total daily activity in patients with COPD is closely related to leg activity which is reduced compared with controls of similar age. Individuals differ in the time spent mobile during the day, but subjective and objectively assessed activity improves after rehabilitation and is predicted by FEV(1). The change in activity is unrelated to improvements in corridor walking and health status.
Significance of specific antibody assay for genotyping of hepatitis C virus
Authors: Takeshi Tanaka, Kyoko Tsukiyama-Kohara, Kenjiro Yamaguchi, Shintaro Yagi, Satoshi Tanaka, Akira Hasegawa, Yohsuke Ohta, Nobu Hattori, Michinori Kohara
Journal: Hepatology (1994)

Group I and II hepatitis C virus genotypes were determined by a newly developed serological genotyping assay. This assay detected antibodies against group-specific recombinant proteins in the putative NS4 protein region (amino acid no. 1676–1760) by an enzyme-linked immunosorbent assay. This region of the hepatitis C virus peptide has many group-specific amino acids; fewer than 50% of these amino acids are identical between groups I and II. Genotypes determined by the serological genotyping assay were compared with those determined by a method in which the polymerase chain reaction was used in 91 chronic hepatitis patients. The group-specific polymerase chain reaction was performed within the genome region corresponding to the putative NS5 protein, where the group II hepatitis C virus genome is 57 nucleotides longer than that of group I. Among 91 chronic hepatitis C patients who had positive results in the second-generation hepatitis C virus antibody (core and NS3 region) assay, hepatitis C virus RNA was detected in 80 patients by polymerase chain reaction in the 5′ untranslated region and in 78 patients by this group-specific polymerase chain reaction. As a result, in 76 of 91 patients (84%) genotypes determined by the serological genotyping assay showed complete agreement with those determined by the group-specific polymerase chain reaction, and none of the patients revealed a group opposite to that of hepatitis C virus genotype. The detection rate of the serological genotyping assay (89 of 91; 98%) was even higher than that of the polymerase chain reaction assay (78 of 91; 86%). Thus, serological genotyping assay is specific and sensitive for the determination of hepatitis C virus genotypes, and this enzyme-linked immunosorbent assay may be useful for epidemiological studies of hepatitis C virus genotypes. (HEPATOLOGY 1994;19:1347–1353.)
Thrombospondin-1 Associated with Tumor Microenvironment Contributes to Low-Dose Cyclophosphamide-Mediated Endothelial Cell Apoptosis and Tumor Growth Suppression
Authors: Yuki Hamano, Hikaru Sugimoto, Mary A. Soubasakos, Mark Kieran, Bjorn R. Olsen, Jack Lawler, Akulapalli Sudhakar, Raghu Kalluri
Journal: Cancer Research (2004)

Abstract Low-dose cyclophosphamide (LDC) induces selective apoptosis of endothelial cells within the vascular bed of tumors. Here, we investigated a hypothesis that the effect of LDC is mediated by the pro-apoptotic action of endogenous inhibitors of angiogenesis. Tumors treated with LDC demonstrate similar expression of matrix metalloproteinases and also basement membrane-derived angiogenesis inhibitors when compared with wild-type tumors, whereas the expression of thrombospondin-1 (TSP-1) is significantly elevated in LDC-treated tumors. We used mice with an absence of type XVIII collagen (endostatin) or type IV collagen α3 chain (tumstatin) or TSP-1 to assess the contribution of these endogenous inhibitors of angiogenesis on LDC-mediated tumor suppression. Lack of TSP-1 in the host in addition to tumor cells leads to diminished capacity of LDC to suppress tumor growth, whereas the absence of endostatin and tumstatin did not alter the effect of LDC. LDC treatment predominantly induces selective expression of TSP-1 in tumor cells and peri-vascular cells and facilitates apoptosis of proliferating endothelial cells, with minimal direct effect on tumor cells and peri-vascular cells. These studies indicate that TSP-1 contributes to tumor growth suppression induced by LDC and suggest that tumors that express high basal level of TSP-1 may be more susceptible to tumor suppression by such a regimen. This study also makes a strong case for TSP-1 expression levels as a potential predictive marker for the successful use of LDC in cancer patients.
Survival among women with triple receptor-negative breast cancer and brain metastases
Authors: S. Dawood, K. Broglio, F.J. Esteva, W. Yang, S.-W. Kau, R. Islam, C. Albarracin, T.K. Yu, M. Green, G.N. Hortobagyi, A.M. Gonzalez-Angulo
Journal: Annals of Oncology (2009)
Can Granulocyte-Colony Stimulating Factor Worsen Anemia?
Authors: Chau Dang, Clifford Hudis
Journal: Journal of Clinical Oncology (2006)

Neutropenia is the major dose-limiting toxicity in patients with cancer who are treated with myelosuppressive chemotherapy.The incidence of chemotherapy dose reductions or treatment delays, which can impact overall dose intensity and compromise treatment outcomes, may be reduced by the prophylactic use of granulocyte colony-stimulating factor (G-CSF).In this issue, Papaldo et al 1 report on the effects of G-CSF on hemoglobin in 506 patients with stage I-II breast cancer who received adjuvant epirubicin and cyclophosphamide (EC) at 120 mg/m 2 and 600 mg/m 2 , respectively.This study utilized a 2 ϫ 2 factorial design in which patients were randomly assigned to receive EC alone or with lonidamine to enhance the activity of anthracyclines and were also randomly assigned to receive G-CSF or not, thereby yielding four treatment assignments.Another aspect of the trial was that they tested five schedules of G-CSF.It was given as (1) 480 g days 8 to 14; (2) 480 g days 8, 10, 12, and 14; (3) 300 g days 8 to 14; (4) 300 g days 8, 10, 12, and 14; and (5) 300 g days 8 and 12.Specifically with regard to G-CSF, the study aims were to compare the mean hemoglobin level in patients assigned to receive G-CSF compared with those in the control group and also to compare the mean hemoglobin levels in patients on the five different schedules of G-CSF.These G-CSF schedules were not randomly assigned but were accrued sequentially in cohorts.The authors report that from the third cycle of EC onward, the mean hemoglobin value was statistically significantly lower in the G-CSF treatment group (overall) when compared with controls at each weekly time point of each cycle (P Ͻ .0001).Exploratory analysis showed no difference in the hemoglobin level in patients who received no G-CSF when compared with those receiving just two doses of G-CSF (schedule 5).However, from the second cycle onward, the mean hemoglobin level was lower in patients receiving more than two doses of G-CSF (schedules 1-4) compared with those who received just two doses of G-CSF (schedule 5).Again, overall the study showed that the rate of grade 2 or worse anemia was higher in the G-CSF group than in the controls (38.8% v 26.2%, P ϭ .005).Thus, Papaldo et al concluded that G-CSF dose-related effect may play a role in the worsening of anemia in patients receiving adjuvant EC.The potential effect of G-CSF on erythropoiesis is not clearly understood.Papaldo et al address several of the theoretical ways by which G-CSF might have an impact on erythropoiesis, including the hypotheses that the granulopoietic and erythropoietic lineages may compete for differentiating stem cells, that G-CSF may induce stem cells to differentiate into more committed hematopoietic cells, thereby directly leading to a decline in erythropoiesis, or that the inhibition of erythropoiesis may occur at a late level of differ-
Medication Errors Among Adults and Children With Cancer in the Outpatient Setting
Authors: Kathleen E. Walsh, Katherine S. Dodd, Kala Seetharaman, Douglas W. Roblin, Lisa J. Herrinton, Ann Von Worley, G. Naheed Usmani, David Baer, Jerry H. Gurwitz
Journal: Journal of Clinical Oncology (2008)

Outpatients with cancer receive complicated medication regimens in the clinic and home. Medication errors in this setting are not well described. We aimed to determine rates and types of medication errors and systems factors associated with error in outpatients with cancer.We retrospectively reviewed records from visits to three adult and one pediatric oncology clinic in the Southeast, Southwest, Northeast, and Northwest for medication errors using established methods. Two physicians independently judged whether an error occurred (kappa = 0.65), identified its severity (kappa = 0.76), and listed possible interventions.Of 1,262 adult patient visits involving 10,995 medications, 7.1% (n = 90; 95% CI, 5.7% to 8.6%) were associated with a medication error. Of 117 pediatric visits involving 913 medications, 18.8% (n = 22; 95% CI, 12.5% to 26.9%) were associated with a medication error. Among all visits, 64 of the 112 errors had the potential to cause harm, and 15 errors resulted in injury. There was a range in the rates of chemotherapy errors (0.3 to 5.8 per 100 visits) and home medication errors (0 to 14.5 per 100 visits in children) at different sites. Errors most commonly occurred in administration (56%). Administration errors were often due to confusion over two sets of orders, one written at diagnosis and another adjusted dose on the day of administration. Physician reviewers selected improved communication most often to prevent error.Medication error rates are high among adult and pediatric outpatients with cancer. Our findings suggest some practical targets for intervention, including improved communication about medication administration in the clinic and home.
Palmoplantar pustulotic arthro-osteitis of the peripheral joints with no sternocostoclavicular lesions.
Authors: M Takagi, J Oda, N Tsuzuki, H Sonozaki
Journal: Annals of the Rheumatic Diseases (1992)

A 45 year old woman presented with swelling and pain on joint movement of her knees, although joint movement was relatively well maintained. Five years previously the patient had been diagnosed as having pustulosis palmoplantaris by a dermatologist. Treatment with non-steroidal anti-inflammatory drugs (NSAIDs) had no effect, but treatment with 5 mg/day prednisolone caused remission of both the joint pain and swelling and the pustulosis palmoplantaris. There were no sternocostoclavicular lesions at any time during treatment. Clinical findings in this patient were different from previous reports and she was diagnosed as having palmoplantar pustulotic arthro-osteitis affecting the peripheral joints.