tbuckley/cabot-search huggingface dataset:
THU0625-HPR Succes- and Fail Factors in the Implementation of a Rheumatology Network: What Does Work out Well and What Doesn't?
Authors: H. Muijen-Drop
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Background</h3> From 2010 to 2012, in two regions in the Netherlands rheumatology networks are developed. The purpose of both networks was to improve the care for patients with rheumatic diseases. The design of the networks was similar and the working teams were comparable They consisted both of a collaboration between the health professionals of rheumatology in two local hospitals, physiotherapists in primary care and the local patient associations of rheumatology. After two years one network (A) was successfully implemented and one network (B) was not. <h3>Objectives</h3> The purpose of the current project is to determine which factors affected the implementation processes. <h3>Methods</h3> In the Pubmed database articles were searched which described succes- and fail factors affecting the implementation of a professional network in health care. The results of this search in literature were compared with factors, that influenced the development process in the two networks. These factors were investigated by questionnaires, filled in by the people of the working teams. Both working teams consisted of one rheumatology nurse, one physiotherapist from the hospital, three physiotherapists in primary care and one or two people from the local rheumatology association. <h3>Results</h3> There is poor evidence about success- and fail factors (table 1). The succes factors of network A were “good confidence”, “good collaboration”, and “thinking in patient view point”. The fail factors of network B consisted of “lack of communication”, “bad collaboration” and “competitive feelings”. <h3>Conclusions</h3> It is necessary to have a good preparation during the development of a rheumatology network. It is also important to keep the success- and fail factors in mind during the process. Thinking from the patient9s point of view is recommended in the decision making process. Thereby bridges can be built between several partners! <h3>References</h3> Manasse HR Jr. 2009 Rho Chi Lecture: interdisciplinary health professions education: a systems approach to bridging the gaps Am J Pharm Educ. 2009 Aug 28;73(5):90. Daly G. Understanding the barriers to multiprofessional collaboration. Nurs Times. 2004 Mar 2-8;100(9):78-9. Minkman M, et al., 2005, De beste zorg bij CVA, Handreiking voor het verbeteren van de CVA-zorgketen, Van Zuiden Communications B.V., ISBN 90-8523-08307. Grol R, Wensing M. Implementatie, effectieve verbetering van de patiëntenzorg. 3<sup>e</sup> druk, Elsevier Gezondheidszorg, Amsterdam, 2010. Calsbeek H, Rosendal H. Waarom ketenzorg zo moeizaam van de grond komt: de slaag- en faalfactoren. Nederlands Tijdschrift voor EBP 2007; 5: 4-7. <h3>Acknowledgements</h3> Author: Hanneke Muijen-Drop, MPT Master fysiotherapie bij mensen met chronische ziekten Projectmanager: Hanneke Muijen-Drop <h3>Disclosure of Interest</h3> None declared
Preconditioning the heart by repeated stunning improves myocardial salvage.
Authors: Flack Je rd, Kimura Y, Engelman Rm, Rousou Ja, Iyengar J, Jones R, Das Dk
Journal: Circulation (1991)

Repeated regional ischemia of short duration followed by reperfusion leads to preconditioning of the myocardium. Left anterior descending coronary artery (LAD) occlusion was applied for 5 minutes and then released for 10 minutes. This was repeated four times by using an intact pig model. LAD occlusion was then continuously applied for 1 hour. Myocardial function, high energy phosphates, and membrane phospholipids were compared with a control (nonstunned) group over a 6-hour reperfusion period. Stunning itself produced no significant change in regional function, total phospholipids, or free fatty acids (FFA). However, regional function, adenosine triphosphate, and creatine phosphate were significantly (p less than 0.05) reduced over control. After 60 minutes of ischemia, regional function was significantly improved by preconditioning that persisted throughout reperfusion (p less than 0.01). This was associated with an 11% mean decrease in infarct size (p less than 0.05). Adenosine triphosphate was significantly preserved during ischemia in the preconditioned hearts, and this preservation persisted throughout reperfusion (p less than 0.05). Total phospholipids were not affected by ischemia in either group. However, during reperfusion both groups demonstrated a 15-20% decrease in phospholipid levels at 1 hour, with only the stunned group showing a progressive increase at 3 and 6 hours (p less than 0.05). Examination of FFA during reperfusion demonstrated a profound increase in only the unstunned animals (p less than 0.05), correlating with the decreased level of membrane phospholipids noted in this group. In conclusion, repeated stunning predisposes the heart to recovery after regional ischemia. This results in improved mechanical function, increased high-energy phosphate stores, and decreased infarct size.(ABSTRACT TRUNCATED AT 250 WORDS)
Neurobiology of Depression
Authors: D F Braus
Journal: New England Journal of Medicine (1989)

Basic and clinical neurosciences have effectively advanced research on aetiology, pathogenesis and therapy options of psychiatric disorders. The objectives of the present short review were to summarise the key findings regarding the neurobiology of major depressive disorder (MDD) on the gene, cell as well as system level. Consistent with structural findings, which report alterations in regions of emotionally relevant networks of the brain in depressive disorders, findings of functional studies point to changes in an ordered interaction of ventral-limbic and dorsal-neocortical regions of the brain. Genetic and stress vulnerabilities as well as social rhythm disrupting interact to initiate a cascade of neurobiological alterations that disrupt this dynamic system. On the cellular level, monoamine as well as glutamate neurotransmission, circadian rhythm disturbance, glucocorticoids, inflammatory cytokines and brain-derived growth factors are relevant mediators of these pathological alterations. Progressive effects of recurrent and chronic MDD may then lead to further structural and functional abnormalities. Thus, treatment providers are directed to recog-nise that the factors that may initiate an MDD episode and those that maintain the illness are likely to be different. Given these long-term consequences, an essential objective of treatment must be to restore as early as possible normative functioning and prevent further neurobiological structural alterations.
Attitudes toward parenting in dual-career families
Authors: C L Johnson, F A Johnson
Journal: American Journal of Psychiatry (1977)

The authors interviewed 28 dual-career families with young children and found that the wives and mothers in particular experience difficulties in respect to the proliferation of role demands in both home and job situations. The greatest strain was in the maternal role; guilt and anxiety were prominent. The literature is reviewed, techniques used by dual-career families to resolve role strain are discussed, and suggestions are made for the clinician's role as facilitator for reducing role strain among career mothers.
Feasibility of Affibody Molecule-Based PNA-Mediated Radionuclide Pretargeting of Malignant Tumors
Authors: Hadis Honarvar, Kristina Westerlund, Mohamed Altai, Mattias Sandström, Anna Orlova, Vladimir Tolmachev, Amelie Eriksson Karlström
Journal: Theranostics (2015)

Affibody molecules are small (7 kDa), non-immunoglobulin scaffold proteins with a potential as targeting agents for radionuclide imaging of cancer.However, high renal re-absorption of Affibody molecules prevents their use for radionuclide therapy with residualizing radiometals.We hypothesized that the use of Affibody-based peptide nucleic acid (PNA)-mediated pretargeting would enable higher accumulation of radiometals in tumors than in kidneys.To test this hypothesis, we designed an Affibody-PNA chimera Z HER2:342 -SR-HP1 containing a 15-mer HP1 PNA recognition tag and a complementary HP2 hybridization probe permitting labeling with both 125 I and 111 In. 111 In-Z HER2:342 -SR-HP1 bound specifically to HER2-expressing BT474 and SKOV-3 cancer cells in vitro, with a K D of 6±2 pM for binding to SKOV-3 cells.Specific high affinity binding of the radiolabeled complementary PNA probe 111 In-/ 125 I-HP2 to Z HER2:342 -SR-HP1 pre-treated cells was demonstrated. 111In-Z HER2:342 -SR-HP1 demonstrated specific accumulation in SKOV-3 xenografts in BALB/C nu/nu mice and rapid clearance from blood.Pre-saturation of SKOV-3 with non-labeled anti-HER2 Affibody or the use of HER2-negative Ramos xenografts resulted in significantly lower tumor uptake of 111 In-Z HER2:342 -SR-HP1.The complementary PNA probe 111 In/ 125 I-HP2 accumulated in SKOV-3 xenografts when Z HER2:342 -SR-HP1 was injected 4 h earlier.The tumor accumulation of 111 In/ 125 I-HP2 was negligible without Z HER2:342 -SR-HP1 pre-injection.The uptake of 111 In-HP2 in SKOV-3 xenografts was 19±2 %ID/g at 1 h after injection.The uptake in blood and kidneys was approximately 50-and 2-fold lower, respectively.In conclusion, we have shown that the use of Affibody-based PNA-mediated pretargeting enables specific delivery of radiometals to tumors and provides higher radiometal concentration in tumors than in kidneys.
PWE-409 Colorectal cancer care apps for patient and staff education – bringing medical education into the 21st century
Authors: P Shah, M Rees, D Brown, P Haray
Journal: Gut (2015)

<h3>Introduction</h3> Advancing technology has led to the opening of new channels for communication and access to information. Accordingly healthcare must keep pace with our increasing desire for choice in how we receive, interact and learn if we are to continue to strive for higher standards of care. In 2008, our group launched the first interactive DVD for patients with colorectal cancer, which described the diagnosis, treatment and follow-up of patients at our unit. This project won several awards within the UK for innovation and has led to the creation of a series of four titles which have played an important role in patient counselling/staff education within our centre. Following the feedback from this series, we were inspired to find avenues to widen the availability of these resources worldwide. This has led to the series being digitally enhanced and adapted as four interactive iOS apps currently available for worldwide download on tablet platform. <h3>Method</h3> The online applications designed as part of this initiative are: - 1. Patient Journey – the diagnosis, treatment and follow-up when diagnosed with a bowel tumour’: An educational app designed to inform, demystify and prepare patients and carers with bowel cancer for the journey ahead. 2. ‘Enhanced Recovery after Surgery (ERAS) for major bowel surgery’: An app designed to explain the concepts and benefits of ERAS to patients prior to major bowel surgery. 3. ‘Colorectal’: An educational app designed to give exposure to students/junior trainees regarding the anatomical/surgical principles of common colorectal procedures. 4. ‘Stepwise Approach for Laparoscopic Colorectal Surgery’: An interactive app to assist colorectal consultants/trainee surgeons who wish to gain proficiency in laparoscopic colorectal surgery <h3>Results</h3> Since our product launch in July 2014, there have been more than 5000 downloads worldwide. Downloads were noted across all world regions with 58% in the Asia-Pacific region, 26% in Europe and 12% in the USA and Canada. These applications are unique in that they contain extensive footage of real-life events coupled with surgical technique. This level of realism in the digital medium means the viewer can have many questions answered before their next consultation, resulting in a better informed patient ready for surgery. <h3>Conclusion</h3> These applications exemplify how utilising technology can advance practice and improve patient experience by providing an interactive format where patients can explore and understand their condition. Our vision is that this model can be used/adapted for widespread use to supplement current methods of patient/staff education, bringing the way we communicate, counsel and train into the 21<sup>st</sup>century. <h3>Disclosure of interest</h3> None Declared.
The use of ECT in the treatment of schizophrenia
Authors: C Salzman
Journal: American Journal of Psychiatry (1980)

ECT has been replaced by neuroleptics for the treatment of schizophrenia. The production of serious drug-related side effects, particularly tardive dyskinesia, raises the question of the efficacy and toxicity of ECT versus neuroleptics. Most of the studies in the English literature on the use of ECT in the treatment of schizophrenia are unacceptable according to contemporary criteria: the question of ECT versus neuroleptic drugs thus remains unanswered. In the few acceptable published studies, clinical response to ECT was inversely proportional to duration of schizophrenic symptoms. Schizophrenic patients with affective and catatonic symptoms responded best: those with chronic symptoms rarely responded. ECT does not alter the fundamental psychopathology of schizophrenia.
Combinatorial Gene Regulatory Functions Underlie Ultraconserved Elements in Drosophila
Authors: Maria Warnefors, Britta Hartmann, Stefan Thomsen, Claudio R. Alonso
Journal: Molecular Biology and Evolution (2016)

Ultraconserved elements (UCEs) are discrete genomic elements conserved across large evolutionary distances. Although UCEs have been linked to multiple facets of mammalian gene regulation their extreme evolutionary conservation remains largely unexplained. Here, we apply a computational approach to investigate this question in Drosophila, exploring the molecular functions of more than 1,500 UCEs shared across the genomes of 12 Drosophila species. Our data indicate that Drosophila UCEs are hubs for gene regulatory functions and suggest that UCE sequence invariance originates from their combinatorial roles in gene control. We also note that the gene regulatory roles of intronic and intergenic UCEs (iUCEs) are distinct from those found in exonic UCEs (eUCEs). In iUCEs, transcription factor (TF) and epigenetic factor binding data strongly support iUCE roles in transcriptional and epigenetic regulation. In contrast, analyses of eUCEs indicate that they are two orders of magnitude more likely than the expected to simultaneously include protein-coding sequence, TF-binding sites, splice sites, and RNA editing sites but have reduced roles in transcriptional or epigenetic regulation. Furthermore, we use a Drosophila cell culture system and transgenic Drosophila embryos to validate the notion of UCE combinatorial regulatory roles using an eUCE within the Hox gene Ultrabithorax and show that its protein-coding region also contains alternative splicing regulatory information. Taken together our experiments indicate that UCEs emerge as a result of combinatorial gene regulatory roles and highlight common features in mammalian and insect UCEs implying that similar processes might underlie ultraconservation in diverse animal taxa.
Development of Adenocarcinoma of the Breast in the Wistar Rat Following the Gastric Instillation of Methylcholanthrene&lt;xref ref-type="fn" rid="fn1"&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/xref&gt;
Authors: Harry Shay, Ernest A. Aegerter, Margot Gruenstein, S. A. Komarov
Journal: JNCI Journal of the National Cancer Institute (1949)

Development of Adenocarcinoma of the Breast in the Wistar Rat Following the Gastric Instillation of Methylcholanthrene Harry Shay, Harry Shay Search for other works by this author on: Oxford Academic PubMed Google Scholar Ernest A. Aegerter, Ernest A. Aegerter Search for other works by this author on: Oxford Academic PubMed Google Scholar Margot Gruenstein, Margot Gruenstein Search for other works by this author on: Oxford Academic PubMed Google Scholar S. A. Komarov S. A. Komarov Samuel S. Fels Research Institute and the Department of Pathology, Temple University School of Medicine, Philadelphia Search for other works by this author on: Oxford Academic PubMed Google Scholar JNCI: Journal of the National Cancer Institute, Volume 10, Issue 2, October 1949, Pages 255–266, https://doi.org/10.1093/jnci/10.2.255 Published: 01 October 1949 Article history Received: 07 July 1949 Published: 01 October 1949
Autologous Followed By Allogeneic Versus Tandem-Autologous Stem Cell Transplant in Newly Diagnosed FISH-del13q Myeloma
Authors: Stefan Knop, Peter Liebisch, Holger Hebart, Ernst Holler, Monika Engelhardt, Bernd Metzner, Dietrich Peest, Walter Aulitzky, Donald W. Bunjes, Christian Straka, Thomas Fischer, Hannes Wandt, Orhan Sezer, Markus Hentrich, Helmut Ostermann, Christian Peschel, Georg Hess, Bernd Hertenstein, Mathias Freund, Martin H Kropff, Hans-Heinrich Wolf, Wolfram E Jung, Norbert Frickhofen, Ralf C. Bargou, Georg Maschmeyer, Else Heidemann, Christian Langer, Lothar Kanz, Christoph Meisner, Hermann Einsele
Journal: Blood (2014)
Cardiac Arrest and Temperature of Bank Blood
Authors: C. Paul Boyan, William S. Howland
Journal: JAMA (1963)

MASSIVE TRANSFUSION of cold bank blood will significantly lower the body temperature. The heart is the first organ to receive the stream of cold blood infused into an antecubital vein. Esophageal temperatures behind the heart, as low as 27.5° to 29° C. (81.5° to 84.2° F.) have been recorded at the time of cardiac arrest in patients receiving large amounts of cold bank blood.<sup>1, 2</sup>Rapid cooling of the heart by perfusion could be an important factor in the development of cardiovascular complications during massive blood replacement. To avoid the effects of cardiac and general hypothermia during massive hemorrhage, it was decided to warm cold bank blood to body temperature when it is administered rapidly and in large amounts. For this purpose, a mechanism was devised for warming bank blood during administration. In essence, this apparatus consists of 24 ft. of sterile plastic tubing, 4.5 mm. in diameter, wrapped
Real world treatment patterns, healthcare resource utilization (HRU), and costs among Waldenstrom macroglobulinemia (WM) patients initiating therapy.
Authors: Lorie Ellis, Stacey DaCosta Byfield, Stephanie Korrer, Brad Schenkel
Journal: Journal of Clinical Oncology (2015)

e19519 Background: WM is a rare, indolent B-cell lymphoma with 1000 to 1500 new cases diagnosed annually in the US. The disease is incurable with current therapy. Prior to January 2015 when ibrutinib was approved by the US FDA for WM, there were no therapies approved in this indication. This study describes initial systemic anti-cancer therapy (SACT) and HRU among WM patients (pts). Methods: A retrospective study using a large, national US claims database from 1/2007-10/2013 was conducted. Adult WM pts ( ≥ 2 claims for WM) with ≥ 1 claim for SACT were identified; the first SACT claim date was the index date. Pts were required to have a WM diagnosis within 3 months (m) prior to the index date and be continuously enrolled (CE) in the health plan for 12m pre- and ≥ 6m post-index date. Pregnant pts and those with SACT in the pre-index period were excluded. The first line of therapy (LOT1) period was examined; the LOT started at index date and the regimen included all drugs received within 60 days. The LOT ended at the earliest of, start of a new drug, ≥ 60-day gap in receipt of initial drug regimen, death or CE end. All-cause HRU and costs during LOT1 were examined. Results: There were 161 WM pts identified. 66% of pts were ≥ 65 yrs (mean age 69), 55% were male, and by insurance type, 49% were Medicare Advantage pts vs. 51% commercially insured. Mean total follow-up time was 23m, and mean duration of LOT1 was 4.7m. The top 4 most common LOT1 regimens accounted for 71% of patients: Rituximab (R) only (39%); bortezomib+ R (14%); bendamustine+ R (9%) and cyclophosphamide+ R (9%). No other regimens identified accounted for more than 4% of pts. Overall, 96% and 81% of pts had ≥ 1 office or hospital outpatient visit with mean per patient per month (PPPM) visits of 3.55 (standard deviation, SD = 2.41) and 2.60 (SD = 3.06), respectively. Approximately 25% and 21% had ≥ 1 ER visit or inpatient stay with mean PPPM visits of 0.11 (SD = 0.24) and 0.06 (SD = 0.16), respectively. Total mean PPPM healthcare costs during LOT1 was $13,589 (SD = $13,404). Conclusions: HRU and costs were high among WM pts initiating SACT. Future studies should examine whether differences in LOT1 regimen choice are associated with differences in cost and outcomes.
How primary care physicians treat psychiatric disorders: a national survey of family practitioners
Authors: C T Orleans, L K George, J L Houpt, H K Brodie
Journal: American Journal of Psychiatry (1985)

A survey of 350 family practice physicians nationwide showed that 22.6% of their patients had significant psychiatric disorders. Physicians reported treating most psychiatric problems themselves, usually through a combination of psychotropic drugs, advice, and reassurance. The results suggest that anxiolytics are more conservatively used and referrals for mental health care more often made than past studies indicate. Physicians cited patient resistance and time limitations as the most important barriers to primary care mental health treatment, followed by limited third-party payment for mental health services, poor coordination between the primary care and mental health care sectors, and insufficient training to treat psychiatric disorders.
The Italian registry of cystic echinococcosis (RIEC): the first prospective registry with a European future
Authors: F Tamarozzi, P Rossi, F Galati, M Mariconti, G J Nicoletti, F Rinaldi, A Casulli, E Pozio, E Brunetti
Journal: Eurosurveillance (2015)

Cystic echinococcosis (CE), a worldwide zoonosis, is highly endemic in southern and eastern Europe. Its actual prevalence is unknown due to the lack of efficient reporting systems designed to take into account the particular features of the disease. Neglect of CE makes diagnosis and clinical management difficult outside referral centres, with inconsistencies in clinical practice and often unnecessary procedures carried out that have associated risks and costs. The Italian registry of CE (RIEC) is a prospective multicentre registry of CE patients seen from January 2012 in Italian health centres; data are voluntarily submitted to the registry. Its aims are to show the prevalence of CE in Italy, bring the importance of this infection to the attention of health authorities, encourage public health policies towards its control, and stimulate biological, epidemiological and clinical research on CE. From January 2012 to February 2014, a total 346 patients were enrolled in 11 centres, outnumbering national reports of many CE-endemic European countries. We discuss preliminary data and challenges of the RIEC, template for the European registry of CE, which has been implemented within the Seventh Framework Programme project HERACLES (Human cystic Echinococcosis ReseArch in CentraL and Eastern Societies) since September 2014.