tbuckley/cabot-search huggingface dataset:
PTU-012 Endoscopy Training using Simulators: what Factors affect Trainee Motivation to Learn?
Authors: R E Swann, A Renwick
Journal: Gut (2013)

<h3>Introduction</h3> Simulation is increasingly being advocated to enhance training in complex technical skills such as endoscopy. While a growing body of evidence suggests simulation use within a study context can improve technical and non-technical skills [1], little attention has been paid to the learning experiences of trainee doctors using simulators to learn such skills. Motivation is an important component of effective learning but anecdotal evidence suggests some trainees may be less motivated to learn in a simulated environment than in traditional training. <h3>Aim</h3> To determine which factors trainee doctors identified as positively and negatively affecting levels of motivation during endoscopy training using a simulator. <h3>Methods</h3> We invited a cohort of surgical and medical gastroenterology trainees to participate in semi-structured interviews. 6 trainees who had used an endoscopy simulator as part of their regular training were purposively selected to include a range of stages of training. We analysed the recorded interviews in an inductive fashion from an interpretivist perspective concentrating on key themes, outlying cases and use of language to develop insight into factors affecting motivation. <h3>Results</h3> Major emergent themes specific to simulator use included: Context of simulator use including: Physical environment, professional and educational Positive impact of intermittent rather than continuous supervisor presence and feedback Recognising limitations of utility Differences in individual preferences relating to the above issues was also emphasised suggesting, where possible, a tailored approach would maximise motivation. The limitations of simulator based learning was repeatedly mentioned by senior trainees, with a suggestion that being forced to learn on simulators beyond a point where they were perceived useful could have a detrimental impact on motivation. However, several trainees identified alternative uses such as team training exercises which could provide motivating simulator based learning at more senior levels. <h3>Conclusion</h3> The above issues should be considered in all units using simulators in training for endoscopy or similar complex technical skills. The impact of the physical environment, altered role of the supervisor and optimum methods of delivering feedback in simulator based endoscopy training merit further exploration. As simulator based learning becomes more widely available, careful consideration of how it is used at different stages of the endoscopy curriculum is required. <h3>Disclosure of Interest</h3> None Declared <h3>Reference</h3> Cochrane Database Syst Rev. 2012 Jun 13; 6:CD008237
AB1214 Juvenile idiopathic arthritis: Attitude of parents to the child’s disease
Authors: V. Malievsky, G. Gareeva
Journal: Annals of the Rheumatic Diseases (2013)

<h3>Background</h3> Juvenile idiopathicarthritis affect essentially the quality of life of sick children. In the social and psychological adaptation of a sick child, of a great importance are intrafamily relations, including the parents' psychological reaction to the child's disease. <h3>Objectives</h3> There were questionnaired mothers of 108 patients (46 boys and 62 girls) with juvenile arthritides at the age from 7 to 16 years. <h3>Methods</h3> To study psychological reaction of parents to the child's disease, the "Procedure of diagnostics of parents' attitude to the child's disease" (V.E. Kagan, I.P. Zhuravleva) were used. The questionnaire consisted of 40 points-assertions, agreement with which was estimated by the 6-score scale (from "absolutely do not agree" to "agree completely"). The questionnaire structure was represented by 5 scales: internality, anxiety, nosognosia, control of activity, and the total stress. Positive values indicated expression of this sign, while negative values – its absence. <h3>Results</h3> The highest values are obtained in the scale of anxiety, which indicates the parents' anxious reaction to the child's disease. In rare cases (15.7%) there were recorded negative values on this scale due to the neutral attitude to the disease. The nosognosia scale was characterized by low positive values, which on the whole indicates an adequate perception of the child's disease. In a quarter of parents (30 persons, 27.8%), negative values reflecting underestimation of seriousness of the disease were observed. In parents' opinion, their child needs no serious treatment. Positive values on the internality scale indicate a parents' external control, i.e., the cause of the disease is perceived as independent of them. Such parents think that they cannot prevent development of the disease, are unable to control the course of disease and to affect somehow its outcome. Negative scale values of control of activity indicate the absence of restrictions of physical activity in children with juvenile arthritides. With increase of the degree of activity, the parents' anxiety rose (<i>r</i> =0.2, <i>d</i> =0.037), whereas with rising functional insufficiency there was increasing the nosognosia parameter (<i>r</i> =0.2, <i>d</i> =0.034). <h3>Conclusions</h3> Psychological reaction of parents to the child's disease is characterized by increased anxiety on the background of the adequate perception of the disease. At the same time, not infrequent are the cases of anosognosia (denial of seriousness of disease), negation of a possibility of affecting the course of disease. The psychological peculiarities of the parents' attitude to the child's disease can affect negatively the parents' compliance of adherence to physician's recommendations. <h3>Disclosure of Interest</h3> None Declared
MUTANT IDH1 SUPPRESSES APOPTOSIS REGULATOR PAR-4 IN GLIOMAS
Authors: C. Horbinski, Y. Liu, M. R. Gilbert, N. Kyprianou
Journal: Neuro-Oncology (2014)

BACKGROUND: Glioma-associated mutations in isocitrate dehydrogenase 1 (IDH1) alter its catalytic properties, leading to the production of D-2-hydroxyglutarate (D-2-HG). This promotes hypermethylation and inhibits differentiation, but its full range of effects remains unclear. In pediatric acute myeloid leukemias, the presence of mutant IDH1 is associated with upregulation of Prostate apoptosis response-4 (Par-4), which promotes cancer-selective apoptosis. Because of this, and because very little work has been done studying Par-4 in gliomas, we tested the effect of mutant IDH1 on Par-4 in these tumors. METHODS: Par-4 expression was measured via western immunoblots in cell cultures and immunohistochemistry in paraffin-embedded tumor tissue microarrays. Par-4 mRNA levels and stability were measured using RT-PCR, cycloheximide, and actinomycin D assays.Par-4 promoter activity was studied with a luciferase reporter assay. Glioblastoma (GBM) cell lines and patient-derived stem cells were infected via lentivirus with either the Selective for Apoptosis induction in Cancer cells (SAC) domain of Par-4 or with control plasmid, for in vitro studies as well as prior to intracerebral injection in nude mice. External validation datasets included The Cancer Genome Atlas (TCGA) and the REpository for Molecular BRAin Neoplasia DaTa (REMBRANDT). RESULTS: In vitro treatment with exogenous unmodified D-2-HG or expression of R132H IDH1 downregulates Par-4 in GBM cells. This occurs by inhibition of Par-4 promoter activity as well as by acceleration of Par-4 mRNA degradation, but not direct promoter hypermethylation. In patients, Par-4 expression is markedly lower in IDH1-mutant high grade gliomas, both in our cohort (P = 0.003) as well as in GBMs from TCGA (P = 0.008). Expression of the SAC domain of Par-4 induces apoptosis in GBM cells. When GBM stem cell intracranial xenografts express SAC, mice have longer median survival compared to controls (30 vs 23 days, P = 0.016). Among high-grade gliomas that are IDH1 wild-type, those that express Par-4 have significantly longer median survival (18.4 versus 8.0 months, P = 0.002), a finding confirmed in external GBM cohorts. CONCLUSIONS: These data suggest that a.) Mutant IDH1 and D-2-HG can affect protein expression independent of direct gene hypermethylation, b.) Suppression of Par-4 may contribute to IDH1-mutant tumorigenesis; c.) While this might seem to be a paradoxical effect of mutant IDH1 given its association with better prognosis, not all its activities will be “favorable” or the mutation would not be so prevalent in gliomas; d.) Regardless of IDH1 status, Par-4 may be an effective sensitizer of gliomas to apoptosis. SECONDARY CATEGORY: Tumor Biology.
Case 9-2015
Authors: Bruce L. Miller, Bradford C. Dickerson, Diane E. Lucente, Mykol Larvie, Matthew P. Frosch
Journal: New England Journal of Medicine (2015)

A 31-year-old man was seen in the neurology clinic because of personality changes and neurologic decline of 3 years' duration. Previous imaging studies showed mild atrophy in the frontal lobes. He could not speak or follow commands. Additional diagnostic testing was performed.
Thinking about kinship and thinking
Authors: Doug Jones
Journal: Behavioral and Brain Sciences (2010)

Abstract The target article proposes a theory uniting the anthropological study of kin terminology with recent developments in linguistics and cognitive science. The response to comments reaches two broad conclusions. First, the theory may be relevant to several current areas of research, including (a) the nature and scope of the regular, “grammatical” side of language, (b) the organization of different domains of conceptual structure, including parallels across domains, their taxonomic distribution and implications for evolution, and (c) the influence of conceptual structure on social structure. Second, the theory compares favorably with alternatives, including (a) the theory that kin terminology is not really that complicated, (b) the theory that kin terms mirror social categories, (c) componential analysis, and (d) kinship algebra. If further research in anthropology, linguistics, and other fields supports the theory, and confirms the psychological reality of proposed mechanisms, then kinship may emerge as a model system for the study of important issues in cognition and social organization.
P204 Fractionated Carboplatin and Vinorebine For Elderly and Poor Performance Status Patients with NSCLC
Authors: J Maguire, S Datta, V Kelly, P Mbanu
Journal: Thorax (2012)

Patients with advanced NSCLC who are elderly and/or have poor Performance Status are generally considered unsuitable for chemotherapy and usually excluded from the possible benefits of systemic treatment. The outlook for this group of patients is poor, with typical survival times of four months or less. If a tolerable form of systemic chemotherapy could be identified for elderly and poor PS patients, this would enable consideration of active rather than supportive care, and might improve overall survival rates. We have treated 110 patients who were either aged over 70; (16%, n=18), PS 2 or greater (36%, n=40) or both; (46%, n=52) with systemic chemotherapy using fractionated Carboplatin and Vinorelbine. Carboplatin was administered at AUC 2.5 on day 1 and day 8, with oral Vinorelbine 60 mg/m2 on a 21 day cycle. 40 patients had Stage III and 68 had Stage IV disease. Prophylactic levofloxacin 500 mg daily was given from day 9 to 20 of each treatment cycle. Renal function for Carboplatin dosage was measured using EDTA clearance. 67 patients were aged 70 or greater, and 22 more than 80 years. 90 patients were PS 2 or 3 and 51 patients were both over 70 and had poor PS. The average number of cycles given to each patient was 3. 7% of patients died within 30 days of receiving chemotherapy treatment. The median survival for the whole patient group was 7.5 months. 72% percent of patients lived for 6 months or longer from commencement of chemotherapy. 40% of patients lived 9 months or longer and 22% of patients lived for a year or longer after starting chemotherapy. There was a strong statistical correlation between response to chemotherapy and survival. In conclusion, systemic chemotherapy using fractionated Carboplatin and Vinorelbine should be considered as a possible treatment option for patients with advanced NSCLC who are elderly or have moderate to poor PS.
Adjusted Subcutaneous Heparin versus Warfarin Sodium in the Long-Term Treatment of Venous Thrombosis
Authors: Russell Hull, Terry Delmore, Cedric Carter, Jack Hirsh, Edward Genton, Michael Gent, Graham Turpie, Dermot McLaughlin
Journal: New England Journal of Medicine (1982)

Previously, we compared fixed low doses of heparin with adjusted doses of warfarin for the long-term treatment of venous thrombosis; in that study low-dose heparin was ineffective in preventing recurrence in patients with proximal-vein thrombosis. We have now completed a randomized trial comparing adjusted doses of heparin and of warfarin for prevention of recurrent venous thromboembolism in patients with proximal-vein thrombosis. One hundred six consecutive patients with acute proximal-vein thrombosis confirmed by venography were treated with intravenous heparin and then randomized to secondary prophylaxis. Two of 53 patients receiving heparin, as compared with one of 53 receiving warfarin, had new episodes of objectively documented venous thromboembolism. Nine patients taking warfarin had bleeding complications (which were major in three patients), as compared with one patient taking heparin (P = 0.008). Our data indicate that adjusted-dose subcutaneous heparin therapy provides an effective alternative to warfarin sodium and is associated with a lower risk of bleeding.
Abstract 1380: <i>In vivo</i> evidence for prior manipulation therapy-induced metastasis of primary osteosarcoma.
Authors: Jir-You Wang, Po-Kuei Wu, Chih-Hsueh Chen, Chuen-Chuan Yen, Giun-Yi Hung, Shih-Chieh Hung, Wei-Ming Chen, Chien-Lin Liu, Tain-Hsiung Chen
Journal: Cancer Research (2013)

Abstract Our previous clinical study demonstrated that manipulation therapy (MT) on osteosarcoma (OS) patients prior to diagnosis resulted in poor prognosis after surgical treatment. This study was aimed to provide in vivo evidence of MT-induced metastasis in primary osterosarcoma. Eight-week-old male GFP-labeled human OS cells-transferred nude mice were randomly allocated into 2 groups, namely, MT (+) and MT (-) groups. MT was conducted with repeated massage on tumor site twice a week for 7 or 15 weeks. The parameters evaluated were x-ray diagnosis, micro-PET/CT scan, histopathology and serum metalloproteinase 9 (MMP9) level. The results showed that MT (+) mice showed a decreased body weight (30.5±0.65g) and an increased tumor volume (8.3±1.18 mm3) compared to MT (-) group with body weight (35.8±0.40g, p&amp;lt;0.0001) and tumor volume (3.9±1.34mm3, p=0.038), respectively. There was an increased signal intensity over lymph node region of hind limb by micro-PET/CT and the GFP-labeled human OS cells were detected in the lung and bilateral lymph nodes in MT (+) group, while there were no such findings in MT (-) group. The serum MMP9 level was higher in MT (+) group (27.1±1.29 ng/ml) than in MT (-) group (17.8±1.97 ng/ml, p=0.048). Taken previous clinical observation and the present in vivo evidence together, we conclude that physicians should pay more attention on those patients who seek MT before diagnosis or during treatment for osteosarcoma. Citation Format: Jir-You Wang, Po-Kuei Wu, Chih-Hsueh Chen, Chuen-Chuan Yen, Giun-Yi Hung, Shih-Chieh Hung, Wei-Ming Chen, Chien-Lin Liu, Tain-Hsiung Chen. In vivo evidence for prior manipulation therapy-induced metastasis of primary osteosarcoma. [abstract]. In: Proceedings of the 104th Annual Meeting of the American Association for Cancer Research; 2013 Apr 6-10; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2013;73(8 Suppl):Abstract nr 1380. doi:10.1158/1538-7445.AM2013-1380
Abstract 3010: IL-6 enhances migration and ICAM-1 expression of human oral squamous cell carcinoma involves IL-6 receptor signaling pathway
Authors: Wei-Lin Yen, Jing-Yuan Chuang, Chih-Hsin Tang
Journal: Cancer Research (2012)

Abstract Oral squamous cell carcinoma(SCC) has a striking tendency to migration and metastasize. Interleukin-6(IL-6) has been implicated in the promotion of many cancers proliferation and migration. Intercellular adhesion molecule-1(ICAM-1), a member of the immunoglobulin supergene family, is an inducible surface glycoprotein that mediates adhesion-dependent cell-to-cell interactions. However, the effects of IL-6 in migration and ICAM-1 expression in human oral cancer cells are largely unknown. We found that IL-6 increased migration and ICAM-1 expression in human oral cancer cells. Using a specific inhibitor and genetic inhibition of IL-6 receptor, we discovered that the IL-6 receptor is involved in migration and ICAM-1 expression of human oral cancer cells. IL-6-mediated migration and ICAM-1 up-regulation were attenuated by inhibitor of Syk, JNK and AP-1. Activation of the Syk, JNK and AP-1 signaling pathway occurred after IL-6 stimulation. IL-6 induced AP-1 activity was inhibited by Syk and JNK inhibitor. Our results indicated that IL-6 enhances the migration of human oral cancer cells by increasing ICAM-1 expression through the IL-6 receptor, Syk, JNK and AP-1 signal transduction pathway. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 3010. doi:1538-7445.AM2012-3010
Commentary: Additional Thoughts on the Review of Epidemiologic Studies Related to Ingested Asbestos
Authors: Gary M. Marsh
Journal: Environmental Health Perspectives (1983)

Following my presentation (1), a number of very interesting questions were raised. I am happy to be able to discuss some of these issues in this commentary. One question dealt with the fact that the concentration of fibers in Connecticut (2,3) was very low. Could any positive result really be expected? Since a dose-response relationship between ingested asbestos and related cancers has not been established, it is not possible to characterize any exposure level as insufficient for increasing cancer incidence or mortality above background levels. In fact, this basic uncertainty has probably provided much of the motivating force behind the ecological studies that have been conducted to date. If one subscribes, however, to the notion of the existence of a positive dose-response relationship between ingested asbestos and cancer, then, of course, the probability of detecting an elevated risk would be enhanced by studying populations that are exposed to higher levels of waterborne asbestos. Another question concerned the use of multiple regression in the Connecticut study: How well did the data fit the normal assumptions for multiple regression? The questioner felt that a perfect fit cannot be expected, and that these kinds of data are usually fraught with outliers. He also suggested that the variance of observations is also probably not constant. I have found that it is not uncommon to be faced with interpreting the results of a statistical procedure in the absence of information regarding the adherence of the data to the assumptions underlying the procedure. The assumptions noted by the questioner (normality
Open Remarks on Artificial Openings
Authors: Marvin M. Schuster
Journal: New England Journal of Medicine (1972)

IN the United States and Canada there are approximately one million ostomates – men, women, and children who live their daily lives with colonic, ileal or ureteral stomas. It is noteworthy that these patients generally view their operation as "ostomy surgery" rather than colonic or bladder resection. The missing organ is of less concern to them than the stoma with which they must live for the rest of their days. One of the reasons for this attitude is that, unlike laryngectomy or limb resection, colectomy does not impose a vocational disability or require learning new physical skills. Yet, even when . . .
PHS Cancels Availability of Medicinal Marijuana
Authors: J. Bowersox
Journal: JNCI Journal of the National Cancer Institute (1992)

Journal Article PHS Cancels Availability of Medicinal Marijuana Get access John Bowersox John Bowersox Search for other works by this author on: Oxford Academic PubMed Google Scholar JNCI: Journal of the National Cancer Institute, Volume 84, Issue 7, April 1992, Pages 475–476, https://doi.org/10.1093/jnci/84.7.475 Published: 01 April 1992
EUS-guided High-Intensity Focused Ultrasound
Authors: Hwang Joo Ha, K Morrison, N Farr, T Khokhlova, Wang Yak-Nam, Ko Bong-Min, Jang Hyun-Joo, G Keilman
Journal: Endoscopy (2011)

Background/Rationale: High-intensity focused ultrasound (HIFU) is a rapidly developing technology that is becoming more widely used for non-invasive and minimally invasive ablation of benign and malignant tumors. In addition, recent studies suggest that unique mechanical effects of HIFU may help to enhance targeted drug delivery and stimulate an anti-tumor immune response in many tumors including pancreatic tumors. However, targeting of pancreatic tumors using an extracorporeal source is often not possible due to the lack of an adequate acoustic window because of the presence of overlying bowel gas. The development of an EUS-guided HIFU transducer has many potential benefits including improved targeting, decreased energy requirements and decreased potential for injury to intervening structures.
370 WHOLE RECOMBINANT YEAST THERAPEUTIC VACCINE GENERATES HBV X, S, AND CORE ANTIGEN-SPECIFIC RESPONSES IN MURINE AND HUMAN T CELLS
Authors: T.H. King, A.J. Gehring, A. Bertoletti, Z.Z. Ho, W.E. Delaney, M. Subramanian, J. McHutchison, Z. Guo, Y. Lu, L. U'Ren, D.L. Mann, D. Bellgrau, D. Apelian
Journal: Journal of Hepatology (2013)