tbuckley/cabot-search huggingface dataset:
Women and people living alone are more likely to choose assisted suicide, Swiss study finds
Authors: M. Limb
Journal: BMJ (2014)

People who opt for assisted suicide are most likely to live alone, have no religious affiliation, and be female, a study in Switzerland has shown.

The study, published last week in the International Journal of Epidemiology, said that other characteristics linked to a higher likelihood of choosing assisted dying included a higher level of education and living in wealthier and urban areas.1

The researchers looked at the mortality records of 1301 cases of suicide during 2003-08 that were assisted by right-to-die organisations in Switzerland, where assisted suicide is legal. They compared them with national census records to examine the characteristics of people who had opted for assisted suicide. 

They found that …
UK based neuroscientist wins Nobel Prize for work on the brain's "inner GPS"
Authors: E. Parish
Journal: BMJ (2014)

The 2014 Nobel Prize in Physiology or Medicine has been awarded jointly to UK based John O’Keefe and Norwegian husband and wife team May-Britt Moser and Edvard Moser for their work in cognitive neuroscience.

O’Keefe discovered cells in the rat hippocampus that constitute a positioning system in the brain. These “place cells,” described by many as an “inner GPS,” allow animals to build spatial memory to navigate their environment. The Mosers’ finding of “grid cells” during their time working with O’Keefe at University College London further explains the coordination and accuracy of positioning.

O’Keefe’s success was met with great enthusiasm across the country, including …
Tc-99m MIBI Uptake and Its Relation to the Proliferative Potential of Brain Tumors
Authors: Ilknur Ak, Zafer Gulbas, Faruk Altinel, Erkan Vardareli
Journal: Clinical Nuclear Medicine (2003)

Many studies have shown that the S-phase fraction is a reflection of the proliferation potential of tumors, and DNA aneuploidy is more common in malignant tumors. In this preliminary study, the authors assessed the Tc-99m MIBI uptake of brain tumors and its relation to tumor grade and DNA content of the tumor cells.Ten patients (eight male, two female; mean age, 53.2 +/- 6.11 years) with untreated brain tumors were included in the study. SPECT imaging was performed 20 minutes after injection of 740 MBq (20 mCi) Tc-99m MIBI. A single detector camera with a low-energy high-resolution collimator was used for image acquisition. A region of interest was drawn in the tumor area under magnetic resonance guidance. A Tc-99m MIBI uptake index was computed as the mean tumor-to-background ratio. Flow cytometric analysis of fresh tumor tissue specimens was performed immediately. The percentages of cells in the G0/G1, S, and G2/M phases were determined for each patient.DNA aneuploidy was found in 4 (49%) patients, whereas diploidy was found in 6 (60%) patients. There was a significant positive correlation between the Tc-99m MIBI uptake and the percentage of the S-phase fraction of the cell cycle ( = 0.000, r = 0.95). The Tc-99m MIBI index was significantly greater in aneuploid tumors than in diploid tumors ( < 0.01).High-grade brain tumors have increased Tc-99m MIBI uptake compared with that of low-grade tumors. Tc-99m MIBI uptake is correlated with the percentage of the S-phase fraction of the cell and the aneuploidy level of the brain tumor. This preliminary report suggests that Tc-99m MIBI imaging may be useful in the evaluation of the biologic characteristics of brain tumors.
Deaths from work related illness are rising, show latest figures
Authors: J. Zarocostas
Journal: BMJ (2011)

Although the number of fatal work related accidents worldwide continues to fall, more people are dying from work related diseases, says a report by the International Labour Organization.

From 2003 to 2008 deaths from accidents in the workplace fell by 10% (from 358 000 to 321 000), while the number of people who died from work related diseases rose by nearly 4% (from 1.95 million to 2.02 million). 

The fall in deaths from workplace accidents is a result of stronger policies on health and safety at work introduced by many governments, including bringing legislation in line with international standards, says the report, together with better inspection services and increased prevention and …
SAT0136 Predictive factors of efficacy of anti TNF therapy in real practice: Experience from the national registry of biological therapy attra
Authors: K. Pavelka, K. Chroust, P. Nemec
Journal: Annals of the Rheumatic Diseases (2013)

<h3>Background</h3> The efficacy of biological therapy has been proven in a number of randomized clinical trials. The important data are however provided by registries of the biological therapies that reflect the biological therapy in real clinical practice. Adherence to T2T principals in clinical practice was not established yet. <h3>Objectives</h3> To evaluate predictive factors for achievement of remission or low disease activity of first anti TNF therapy. <h3>Methods</h3> Efficacy of the first anti-TNF drug in rheumatoid arthritis (RA) treatment was evaluated during the first year of therapy. This evaluation included all patients receiving biological therapy in centres within the national registry of the biological therapy ATTRA in Czech Republic. This therapy was indicated in case of at least 1 DMARD failure and disease activity higher than DAS28 5.1. <h3>Results</h3> There were 1945 patients enrolled in the study, 518 of which were treated with etanercept, 655 with infliximab, 747 with adalimumab, and 25 with golimumab. For analysis purposes, the monoclonal antibodies were amalgamated in one group consisting of 1427 patients. The average duration of the disease exceeded 10 years and the average number of DMARDs failed was 3. Disease activity at baseline was high; the mean DAS28 was 6.4 and mean CRP was about 29 mg/l. There were no significant differences between both groups by the initiation of therapy. In both groups, DAS28 decreased significantly. Mean values in etanercept (ETA) were significantly lower in Week 10 than in monoclonal antibodies (p&lt;0.001). Remission was achieved in 35% of patients treated with ETA and in 24.1% of patients treated with monoclonal antibodies in Week 54. Low disease activity was achieved in 51.6% of patients with ETA and in 40.5% of patients with monoclonal antibodies in Week 54. Significant factors to predict remission were the following: ETA therapy against monoclonal antibodies (HR 1.41 95% CI 1.167 – 1.708, p&lt;0.001), age under 35 years (HR 2.086 95% CI 1.688 – 2.578, p&lt;0.001), a duration of the disease less than 10 years (HR 1.438 95% CI 1.193 – 1.733, p&lt;0.001), baseline DAS28 &lt;4.5 and medical history with less than 3 DMARDs failed. No effect on the prediction of remission was found for neither gender, rheumatoid factors positivity and for concomitant treatment with methotrexate. <h3>Conclusions</h3> Remission or LDA was achieved in about 50% of patients after 1 year of therapy. Predictive factors of the therapeutic response were the use of etanercept, lower age, short duration of the disease and lower baseline DAS28. Results reflect treatment before introduction of T2T principals. Its introduction should improve patients outcomes. Supported by grant of Ministry of health Nr. MZO 00023728 <h3>Disclosure of Interest</h3> None Declared
CARDIAC OUTPUT IS ALTERED IN FETUSES WITH HYPOPLASTIC LEFT HEART SYNDROME AND TRANSPOSITION OF THE GREAT ARTERIES COMPARED TO NORMAL CONTROLS; LESSONS LEARNED FROM FETAL ECHOCARDIOGRAM
Authors: Tarek Alsaied, Eileen King, Stephanie Tseng, Allison Divanovic, Eunice Hahn, Mounira Habli, James Cnota
Journal: Journal of the American College of Cardiology (2016)
Abstract 5006: Pdcd4 as a prognostic factor and a modulator of cell proliferation, migration and invasion in ovarian cancer
Authors: Na Wei, Stephanie S. Liu, Thomas HL Leung, Kar-Fai Tam, Xiao-yun Liao, Annie NY Cheung, Karen KL Chan, Hextan YS Ngan
Journal: Cancer Research (2010)

Abstract Programmed cell death 4 (Pdcd4), a novel gene and originally identified as the neoplastic transformation inhibitor, is down regulated in human colon, breast and lung cancer cells and considered as a diagnostic and prognostic marker in lung cancer. It has been shown to have tumor suppressor properties such as inhibition of cell invasion and proliferation, as well as induction of apoptosis. However, those properties of Pdcd4 are tissue specific. The mechanisms of function of Pdcd4 are largely unknown and its function and modulation in ovarian cancer is still elusive. The objectives of our present study are firstly to investigate the expression of Pdcd4 in normal and malignant ovarian tissues and the role of Pdcd4 in ovarian carcinogenesis; and secondly, to study the function of Pdcd4 in the regulation of cell proliferation, migration and invasion and modulation of Pdcd4 in ovarian cancer. Using both western blot and real-time quantitative PCR analyses, we demonstrated that Pdcd4 expression was continuously down-regulated in the sequence of normal-borderline-malignant ovarian tissue samples. Higher Pdcd4 expression was found to be associated with longer disease-free survival (p=0.037). Using immunohistochemical staining approach, we found the subcellular localization of Pdcd4 differed in the way that, normal ovarian tissues showed distinctive nuclear localization while malignant ovarian tissues showed mainly cytoplasmic staining. To further explore the function of Pdcd4 in ovarian cancer cells, we developed Pdcd4 over-expression stable clones in ovarian cancer cell lines. Our in vitro studies demonstrated that ectopic Pdcd4 expression significantly inhibited ovarian cancer cell proliferation by inducing cell cycle arrest at G0/G1 stage and the upregulation of cell cycle regulators p27 and p21. The induction of p21 by Pdcd4 was not mediated through p53. Using wound healing, transwell migration and invasion assay, we demonstrated Pdcd4 significantly inhibited ovarian cancer cell migration and invasion. In conclusion, loss of Pdcd4 was a common abnormality at molecular level in ovarian cancer and it might be a potential prognostic factor in ovarian cancer patients. In addition, our results also provided first evidence for the tumor suppressor properties of Pdcd4 in inhibition of cell proliferation by inducing cell cycle arrest and modulating cell cycle regulators, as well as inhibition of cell migration and invasion in ovarian cancer cells. Note: This abstract was not presented at the AACR 101st Annual Meeting 2010 because the presenter was unable to attend. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 5006.
Paris court attacks abortion law
Authors: A. Dorozynski
Journal: BMJ (1995)

A Paris court last week challenged a 1993 law that makes it a criminal offense to obstruct abortions. The court acquitted nine anti-abortion protestors who had broken into the maternity ward of the public hospital Pitie-Salpetriere last November and prayed at the entrance of a ward where patients are admitted for abortions. The judges ruled that the protestors had not interfered with abortions being carried out because none were taking place at the time of the demonstration; furthermore, the judges stated, because the fetus could be considered a person (child), the protestors were protected by other laws which give immunity to those breaking a law in order to protect another person's life, or to defend a child that had been abandoned. The court continued to say that a fetus should be protected, whether or not it was considered a person, because it was definitely more than nothing. The Syndicat de la Magistrature, the association of French magistrates, believes the tribunal has denied the right to abortion guaranteed in the 1975 law. Veronique Neietz, who drafted the 1993 law, was "scandalized" by the decision and believes the decision of the court was made in retribution for a recent parliamentary decision to exclude anti-abortion protestors from the general amnesty given after presidential elections to minor offenders. During the same week of this court decision, two tribunals, in Lyons and in Bourg-en-Bresse, sentenced 45 anti-abortionists to suspended prison terms with fines.
P16.13 * UNCERTAINTY AND VARIABILITY IN SURVEILLANCE IMAGING AFTER COMPLETION OF PRIMARY TREATMENT IN GLIOBLASTOMA MULTIFORME
Authors: A. Hamdan, P. Kane
Journal: Neuro-Oncology (2014)

INTRODUCTION: Clear and evidence-based follow up imaging guideline after the completion of primary therapy in glioblastoma multiforme (GBM) is lacking. Here we provide the first report analysing international, national and local guidelines in GBM imaging surveillance. METHODS: First we performed a systematic review of GBM management guidelines indexed in PUBMED and EMBASE databases up until October 2013. We then searched for GBM guidelines on websites of the relevant international and national societies. Next, to ascertain local recommendations within the UK, we reviewed guideline documents produced by the local neuro-oncology multidisciplinary teams (MDTs; n = 28) in the UK accessed via the Care Quality Improvement Network (CQuIN) database. For all the relevant guidelines identified, we extracted imaging recommendations for the period following completion of primary therapy. RESULTS: Of identified guidelines produced by international and national societies, only 6 had follow up imaging guidelines with variability in imaging frequency ranging from 1-2 monthly (1 guideline), 2-4 monthly (1), 2-3 monthly (2), to 3-4 monthly (2). Twenty out of the 28 neuro-oncology MDTs had imaging guidelines. Of these, 18 had guidelines on imaging after completion of primary therapy, with also a wide variability in imaging frequency from 2 monthly (2 guidelines), 2-4 monthly (1), 3 monthly (6), 3-4 monthly (1), 3-6 monthly (2), 6 monthly (4), and yearly (2). Most guidelines did not include references to any evidence base to inform the recommendations. CONCLUSIONS: The guidelines and recommendations for follow up imaging after the completion of primary therapy in GBM are variable and uncertain. Future studies should assess effectiveness of these guidelines in detecting assymptomatic GBM recurrence.
PMO-253 Impact of inflammatory bowel disease nurse specialist on quality of patient care and meeting strategic national aims: Abstract PMO-253 Table 1
Authors: E Fernandez, K Kemp
Journal: Gut (2012)

<h3>Introduction</h3> The UK IBD Audit has now completed its 3rd round with continued marked variation in the resource and quality of care for IBD patients. This analysis of the national data aims to measure the quality of care for patients in centres with: a IBD nurse &gt;1 WTE, IBD nurse &lt;1 WTE and those with no IBD nurse; to demonstrate the impact of the IBD nurse in terms of quality of care; and how the role assists in meeting specific aims of the White Paper (Equity and excellence: Liberating the NHS, 2010). <h3>Methods</h3> A comparison was carried out of the 2010 audit results of hospitals with no IBD nurse, &lt;1 WTE nurse and those with ≥1 nurses. It cannot directly be inferred that the IBD nurse is the causative factor in the reduction in hospital admissions or improvements in care. The results also do not reflect the number of nurse sessions per week dedicated to IBD care or long the IBD nurse had been in post. <h3>Results</h3> There was a significant reduction in the number of patients admitted to hospital with an IBD nurse in post and a difference in the range and choice of care delivery. More patient education was offered in the presence of the IBD nurse (28%, 60%, 74%, p&lt;0.001), more patient involvement in service development (12%, 20%, 39%, p&lt;0.001), clearer guidance for patients to seek a 2nd opinion (93%, 20%, 45%, p&lt;0.009) and clinical data more likely to be captured (23%, 50%, 61%, p&lt;0.001). <h3>Conclusion</h3> The NHS White paper states reducing avoidable hospital admissions, increasing the proportion of people with a long term condition to self care and the ability to offer choice of care are High Level Outcomes which lead to commissionable services. The presence of an IBD nurse, within the IBD team, correlates with fewer admissions, the availability of self management programmes and greater overall choice in care provision and new modes of care delivery. <h3>Competing interests</h3> None declared.
<i>Sall4</i> in “Stemness”-Driven Hepatocarcinogenesis
Authors: Jens U. Marquardt, Snorri S. Thorgeirsson
Journal: New England Journal of Medicine (2013)

Hepatocellular carcinoma is the most common and deadly cause of primary liver cancer. Although the incidence of hepatocellular carcinoma is highest in Asia and sub-Saharan Africa, the steadily increasing incidence in traditionally low-incidence regions such as northern Europe and the United States is a considerable public health problem.1 Despite implementation of surveillance programs, the majority of patients still present with advanced stages of the disease, for which curative options are limited.Currently, the standard-of-care treatment for advanced liver cancer is limited to the multiple receptor tyrosine kinase inhibitor sorafenib.2 Furthermore, development of new therapies is often hampered by the molecular . . .
Scintimammographic Findings of In Situ Ductal Breast Carcinoma in a Double-Phase Study With Tc-99m(V) DMSA and Tc-99m MIBI
Authors: V Papantoniou, M Sotiropoulou, E Stipsaneli, A Louvrou, H Feda, J Christodoulidou, G Pampouras, C Zerva, A Keramopoulos, S Michalas
Journal: Clinical Nuclear Medicine (2000)

The authors present a case of in situ ductal carcinoma of the breast (DCIS) with no associated mass in a 46-year-old woman examined with Tc-99m MIBI and Tc-99m(V) DMSA scans, which were acquired in separate sessions 10 minutes and 60 minutes after injection. Histologic analysis revealed a small (<1 cm) infiltrating ductal carcinoma located within the DCIS. Mammography showed a cluster of microcalcifications on a very dense parenchymal background. Tc-99m(V) DMSA was characterized as positive for DCIS, especially in the delayed image. Tc-99m MIBI failed to identify the lesions previously noted. In conclusion, Tc-99m(V) DMSA scintimammography seems to have an advantage and could improve the detection of nonpalpable in situ breast carcinomas.
Abstract 1973: Tumor suppressor p15Ink4b determines cell fate of hematopoietic progenitors: Implications for development of human blood disorders.
Authors: Rita Humeniuk, Michael Rosu-Myles, Linda Wolff
Journal: Cancer Research (2013)

Abstract Red blood cells (RBCs) are a vital component of mammalian blood. Since they are short lived, they must be continuously replenished by erythropoiesis, a stepwise commitment of blood stem and progenitor cells to mature erythrocytes. The anemia due to the loss of RBC is a life threatening condition, often accompanying blood diseases such as leukemias and myelodysplastic syndromes (MDS). A striking 60-80% of these diseases have deleted or silenced expression of p15INK4B. An increased understanding of the factors that drive erythroid lineage commitment in progenitor cells is critical for developing new treatments for blood disorders. Previous examination of p15Ink4b knock-out mouse models, revealed skewing of hematopoietic progenitor differentiation towards myeloid lineage (granulocytes, macrophages). Here, we demonstrate a novel function for p15Ink4b in driving commitment to the erythroid lineage. Mice lacking p15Ink4b have lower numbers of primitive RBC progenitors and died shortly after induction of hemolytic anemia by phenylhydrazine injection. Expression of p15Ink4b in blood progenitors induced dynamic changes at the molecular level that rendered multi-lineage cells more permissive to erythroid commitment and less permissive to myeloid commitment. Noticeably, we found that p15Ink4b regulates a switch that controls the balance between myeloid and erythroid differentiation through activation of MEK/ERK signaling. In a time-coordinated manner expression of p15Ink4b induced rapid phosphorylation of MEK/ERK that led to rapid degradation of GATA-2 and activation of the GATA-1 transcription factors. Subsequently, the active GATA-1 executed lineage commitment through activation of the Erythropoietin receptor (EpoR), the “master regulator” of erythroid differentiation. The p15Ink4b mediated increase in GATA-1 expression, also resulted in decreased expression of the myeloid specific transcription factor PU.1, suppressing myeloid differentiation. In summary, we have defined a framework that determines how multipotent progenitors coordinate the balance between myeloid and erythroid differentiation. Central to this activity is p15Ink4b, which promotes erythroid fate while suppressing myeloid cell formation, a function that is particularly important in rapid RBC replenishment following stress. Our finding has implications not only for MDS and myeloid leukemia, where loss of tumor suppressor p15INK4B is a common event, but also for other forms of human refractory anemia. Citation Format: Rita Humeniuk, Michael Rosu-Myles, Linda Wolff. Tumor suppressor p15Ink4b determines cell fate of hematopoietic progenitors: Implications for development of human blood disorders. [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 1973. doi:10.1158/1538-7445.AM2013-1973
Data re-entry overload: time for a paradigm shift in maternity information technology?
Authors: Paul J Curley
Journal: Journal of the Royal Society of Medicine (2012)

I read with interest the comprehensive review by Fawdry et al.1 Many of the issues resonate with management of general hospital notes, while some are specific to maternity notes. Recent advances in management of records offer some glimmer of hope.

The authors say “paperless” offices benefit only those “logged on in one place for most of the time”. Session mobility is now being delivered in the clinical environment – this allows a session to be suspended on a given PC (free to be used by others) and to be opened again seamlessly on another PC.2

Secondly, many believe that a slavish transition to fully electronic data will lose some of the narrative and richness inherent in the paper record. We have scanned 750,000 volumes of general hospital and 70,000 maternity records, and both are now available to view electronically. Although not structured, this allows colleagues to view records simultaneously across sites and to seamlessly view data from other specialties relevant to the care of the patient. Finally, Portsmouth have implemented a digital pen solution allowing hand written forms to be completed at the ante-natal contact, data to be transferred securely via Blackberry and then entered into the maternity system at the hospital Trust.3

The ability to continue to produce and store images of paper using Document Management Systems appears to be gathering traction for preserving the richness of complex records. Fawdry et al. clearly speak with authority on the absence of standardization in maternity records. Standards for records in secondary care have been produced, but these are not widely implemented.4 In their absence, a more pragmatic approach to electronic patient records is developing using scanned records, session mobility and novel data collection.

Informed discussion on these issues is more crucial than ever.