tbuckley/cabot-search huggingface dataset:
Outdoor pollen is a trigger of child and adolescent asthma emergency department presentations: A systematic review and meta‐analysis
Authors: B. Erbas, M. Jazayeri, K. A. Lambert, C. H. Katelaris, L. A. Prendergast, R. Tham, M. J. Parrodi, J. Davies, E. Newbigin, M. J. Abramson, S. C. Dharmage
Journal: Allergy (2018)

In the context of increased asthma exacerbations associated with climatic changes such as thunderstorm asthma, interest in establishing the link between pollen exposure and asthma hospital admissions has intensified. Here, we systematically reviewed and performed a meta-analysis of studies on pollen and emergency department (ED) attendance.A search for studies with appropriate search strategy in MEDLINE, EMBASE, Web of Science and CINAHL was conducted. Each study was assessed for quality and risk of bias. The available evidence was summarized both qualitatively and meta-analysed using random-effects models when moderate heterogeneity was observed.Fourteen studies were included. The pollen taxa investigated differed between studies, allowing meta-analysis only of the effect of grass pollen. A statistically significant increase in the percentage change in the mean number of asthma ED presentations (MPC) (pooled results from 3 studies) was observed for an increase in 10 grass pollen grains per cubic metre of exposure 1.88% (95% CI = 0.94%, 2.82%). Time series studies showed positive correlations between pollen concentrations and ED presentations. Age-stratified studies found strongest associations in children aged 5-17 years old.Exposure to ambient grass pollen is an important trigger for childhood asthma exacerbations requiring ED attendance. As pollen exposure is increasingly a problem especially in relation to thunderstorm asthma, studies with uniform measures of pollen and similar analytical methods are necessary to fully understand its impact on human health.
IMPACT OF LARGE FOCAL INTIMAL DISRUPTION ON DISEASE PROGRESSION IN PATIENTS WITH TYPE B AORTIC INTRAMURAL HEMATOMA
Authors: Kenichi Ishizu, Shuichiro Kaji, Yasuhiro Sasaki, Mitsuhiko Ota, Kitae Kim, Takeshi Kitai, Takafumi Yamane, Natsuhiko Ehara, Atsushi Kobori, Makoto Kinoshita, Yutaka Furukawa
Journal: Journal of the American College of Cardiology (2018)
Abiraterone acetate (AA) or docetaxel (D) in metastatic castration-sensitive prostate cancer (mCSPC): A systematic review and network meta-analysis of randomized clinical trials (RCTs).
Authors: Irbaz Bin Riaz, Abdulaali Almutairi, Zeeshan Ali, Abdullah Alhifany, Sandipan Bhattacharjee, Ivo Abraham, Manish Kohli
Journal: Journal of Clinical Oncology (2018)

243 Background: AA and D have been shown in separate trials to increase overall survival in patients with mCSPC compared to Androgen Derivation Therapy (ADT). In the absence of head to head clinical trials and to provide clinical guidance, we performed an indirect comparison of AA and D using network meta-analysis. Methods: We performed a search of MEDLINE, EMBASE, Cochrane Library, and Cochrane Central Register of Controlled Trials to identify relevant clinical trials. Collected data included hazard ratio and confidence interval (CI) for Overall Survival (OS) and number of adverse events in each study arm. Risk for bias was assessed using the Cochrane Collaboration’s tool. Bayesian network meta-analysis was conducted using WinBUGS 1.4.3 software (MRC Biostatistics Unit, Cambridge, UK) to perform an indirect comparison of D and AA. Results: Five clinical trials were included in this analysis. Two trials (LATITUDE, STAMPEDE) compared AA to ADT and three trials (CHAARTED,STAMPEDE, GETUG-AFU 15 study) compared D to ADT. Results from both fixed effect and random effect network meta-analyses for the primary outcome (OS) revealed no statistical significance between AA and D (HR 0.81,95%CI 0.65-1.01; HR 0.81, 95%CI 0.40-1.82) respectively. Comparatively, abiraterone had statistically significant fewer events of anemia (OR 0.14,95%CI 0.08-0.23), neutropenia (OR 0.06,95%CI 0.03-0.12), peripheral edema (OR 0.21,95%CI 0.09-0.44), dyspnea (OR 0.22,95%CI 0.08-0.51), nausea (OR 0.09,95%CI 0.02-0.24), diarrhea (OR 0.06,95%CI 0.02-0.15), constipation (OR 0.25,95%CI 0.11-0.53), and fatigue (OR 0.12,95%CI 0.07-0.20). AA had statistically significant more events of hot flashes (OR 3.85, 95% CI2.33-6.25). For other adverse events, both drugs were statistically similar. Conclusions: There is no difference in OS using AA for longer periods in CSPC than a regimen of a limited number of cycles of D. There are significant differences in side effect profile of these drugs. Further analyses are needed to determine cost effectiveness of AA vs D under consideration of comparative efficacy and safety.
Hepatitis A outbreak since November 2016 affecting men who have sex with men (MSM) in Chile connected to the current outbreak in MSM in Europe, situation up to October 2017
Authors: Violeta Rivas, Aldo Barrera, Karla Pino, Ruth Núñez, C. Joaquin Caceres, Marcelo Lopez-Lastra, Alejandro Soza
Journal: Eurosurveillance (2018)

A hepatitis A outbreak has occurred in Chile since November 2016. Men are predominantly affected, with a large proportion of men who have sex with men (MSM). We describe 12 consecutive unrelated confirmed cases who presented at our healthcare institution in Santiago Metropolitan Area. Nine were men, all reporting having had sex with men. Ten viral sequences, genotyped as IA, clustered with the V16-25801 strain causing outbreaks mostly in MSM in Europe since mid-2016.
Junior doctors' welfare officer—to be recommended for all hospitals
Authors: Richard Charity, Aeneas O'Kelly
Journal: BMJ (2007)

A new species has been discovered in Wales. Andalat Jayakumar Shyam Kumar , Richard Charity , and Aeneas O'Kelly discuss how the junior doctors' welfare officer at his hospital helped to take away the stress of starting work, and explain why they believe that all trusts would benefit from such a post
CORRELATION OF ANTEROSEPTAL ST-ELEVATIONS WITH MYOCARDIAL INFARCTION TERRITORIES THROUGH CARDIOVASCULAR MAGNETIC RESONANCE IMAGING
Authors: Joseph Allencherril, Yama Fakhri, Henrik Engblom, Einar Heiberg, Marcus Carlsson, Jean-Luc Dubois-Rande, Sigrun Halvorsen, Trygve Hall, Alf Inge Larsen, Svend Eggert Jensen, Hakan Arheden, Dan Atar, Peter Clemmensen, Maria Ripa, Yochai Birnbaum
Journal: Journal of the American College of Cardiology (2018)
Reduction in medical academics threatens medical education
Authors: Helen Jaques
Journal: BMJ (2011)

The ongoing decrease in the number of medical academics has dramatically altered the ratio of students to teachers in universities and could destabilise undergraduate medical education, the BMA’s Medical Academic Staff Committee has said.

Speaking at the Conference of Medical Academic Representatives, Michael Rees, co-chairman of the committee, warned that a reduced medical academic workforce would struggle to cope with the number of medical students and to meet the high expectations of students paying up to £9000 a year in fees. 

“In the past 15 years the number of medical academics …
UNSUPERVISED MACHINE LEARNING ALGORITHM TO IDENTIFY HIGH AND LOW RISK PATIENTS FOLLOWING CRT IMPLANTATION
Authors: Marton Tokodi, Walter Schwertner, Peter Perge, Annamaria Kosztin, Balint Lakatos, Sirish Shrestha, Attila Kovacs, Bela Merkely
Journal: Journal of the American College of Cardiology (2018)
What should I do if I want to pursue an academic career in emergency medicine?
Authors: Colin A Graham
Journal: BMJ (2005)

Have a career or related problem that needs answering? Can9t find the right person to point you in the right direction? Log on to the Advice Zone (www.bmjcareers.com/advicezone) for reliable medical careers advice. You can post a question or see if one of our 300 advisers has already answered a similar question. Here is a selection of questions and answers posted on the site.
Concurrent Inhibition of Neurosphere and Monolayer Cells of Pediatric Glioblastoma by Aurora A Inhibitor MLN8237 Predicted Survival Extension in PDOX Models
Authors: Mari Kogiso, Lin Qi, Frank K. Braun, Sarah G. Injac, Linna Zhang, Yuchen Du, Huiyuan Zhang, Frank Y. Lin, Sibo Zhao, Holly Lindsay, Jack M. Su, Patricia A. Baxter, Adekunle M. Adesina, Debra Liao, Mark G. Qian, Stacey Berg, Jodi A. Muscal, Xiao-Nan Li
Journal: Clinical Cancer Research (2018)

Purpose: Pediatric glioblastoma multiforme (pGBM) is a highly aggressive tumor in need of novel therapies. Our objective was to demonstrate the therapeutic efficacy of MLN8237 (alisertib), an orally available selective inhibitor of Aurora A kinase (AURKA), and to evaluate which in vitro model system (monolayer or neurosphere) can predict therapeutic efficacy in vivoExperimental Design: AURKA mRNA expressions were screened with qRT-PCR. In vitro antitumor effects were examined in three matching pairs of monolayer and neurosphere lines established from patient-derived orthotopic xenograft (PDOX) models of the untreated (IC-4687GBM), recurrent (IC-3752GBM), and terminal (IC-R0315GBM) tumors, and in vivo therapeutic efficacy through log rank analysis of survival times in two models (IC-4687GBM and IC-R0315GBM) following MLN8237 treatment (30 mg/kg/day, orally, 12 days). Drug concentrations in vivo and mechanism of action and resistance were also investigated.Results: AURKA mRNA overexpression was detected in 14 pGBM tumors, 10 PDOX models, and 6 cultured pGBM lines as compared with 11 low-grade gliomas and normal brains. MLN8237 penetrated into pGBM xenografts in mouse brains. Significant extension of survival times were achieved in IC-4687GBM of which both neurosphere and monolayer were inhibited in vitro, but not in IC-R0315GBM of which only neurosphere cells responded (similar to IC-3752GBM). Apoptosis-mediated MLN8237 induced cell death, and the presence of AURKA-negative and CD133+ cells appears to have contributed to in vivo therapy resistance.Conclusions: MLN8237 successfully targeted AURKA in a subset of pGBMs. Our data suggest that combination therapy should aim at AURKA-negative and/or CD133+ pGBM cells to prevent tumor recurrence. Clin Cancer Res; 24(9); 2159-70. ©2018 AACR.
GALECTIN-3 IN PATIENTS WITH OBSTRUCTIVE HYPERTROPHIC CARDIOMYOPATHY
Authors: Ying Guo, Xi Wu, Changpeng Song, Xinxin Zheng, Jie Lu, Bing Tang, Hao Cui, Xiaonan Fang, Shuiyun Wang, Xiaohong Huang
Journal: Journal of the American College of Cardiology (2018)
Cybersecurity for Cardiac Implantable Electronic Devices
Authors: Adrian Baranchuk, Marwan M. Refaat, Kristen K. Patton, Mina K. Chung, Kousik Krishnan, Valentina Kutyifa, Gaurav Upadhyay, John D. Fisher, Dhanunjaya R. Lakkireddy
Journal: Journal of the American College of Cardiology (2018)
China’s “new” silk road
Authors: Lawrence O Gostin
Journal: BMJ (2018)

The New Silk Road - the Belt and Road Initiative (BRI) - is China's grand idea for the 21st century, promising to transform international development assistance for health. Named after the ancient network of terrestrial and maritime routes, BRI represents a massive USD $1 trillion investment in trade and cultural exchange, stretching through Eurasia and connecting to Africa, the Middle East, and Europe. Flynn Murphy's Feature reveals glaring global tensions about BRIs impact-will China forge a new paradigm for global health or is BRI a modern form of colonialism? What are BRI's promises and perils, and how could China reform BRI to genuinely advance the right to health?
Medicare Accountable Care Organization Enrollment and Appropriateness of Cancer Screening
Authors: Matthew J. Resnick, Amy J. Graves, Sunita Thapa, Robert Gambrel, Mark D. Tyson, Daniel Lee, Melinda B. Buntin, David F. Penson
Journal: JAMA Internal Medicine (2018)

Despite rapid diffusion of Accountable Care Organizations (ACOs), whether ACO enrollment results in observable changes in cancer screening remains unknown.To determine whether Medicare Shared Savings Program (MSSP) ACO enrollment changes the appropriateness of screening for breast, colorectal, and prostate cancers.For this population-based analysis of Medicare beneficiaries, we used Medicare data from 2007 through 2014 and evaluated changes in screening associated with ACO enrollment using differences-in-differences (DD) analyses. We then performed difference-in-difference-in-differences (DDD) analyses to determine whether observed changes in cancer screening associated with ACO enrollment were different across strata of appropriateness, defined using age (65-74 years vs ≥75 years) and predicted survival (top vs bottom quartile).Rates of breast, colorectal, and prostate cancer screening measured yearly as a proportion of eligible Medicare beneficiaries undergoing relevant screening services.Among Medicare beneficiaries, comprising 39 218 652 person-years before MSSP enrollment and 17 252 345 person-years after MSSP enrollment, breast cancer screening declined among both ACO (42.7% precontract, 38.1% postcontract) and non-ACO (37.3% precontract, 34.1% postcontract) populations. The adjusted rate of decline (DD) in the ACO population exceeded the non-ACO population by 0.79% (P < .001). This decline was most pronounced among elderly women (-2.1%), with minimal observed change among younger women (-0.26%). Baseline colorectal cancer screening rates were lower than those for breast cancer among both ACO (10.1% precontract, 10.3% postcontract) and non-ACO (9.2% precontract, 9.1% postcontract) populations. We observed an adjusted 0.24% (P = .03) increase in screening associated with ACO enrollment, most pronounced among younger Medicare beneficiaries (0.36%). For breast and colorectal cancer, we observed statistically significant differences in estimates of effect between age strata, suggesting that the ACO effect on cancer screening is mediated by age (DDD for both P < .001). Prostate cancer screening declined among ACO (35.1% precontract, 28.5% postcontract) and non-ACO (31.2% precontract, 25.7% postcontract) populations. The adjusted rate of decline in the ACO population exceeded that of the non-ACO population by 1.2%. We observed no difference in estimate of effect between age strata, suggesting that the ACO-mediated changes in prostate cancer screening are similar among younger and elderly men. Results characterizing appropriateness with predicted survival mirrored those when stratified by age.Medicare Shared Savings Program ACO enrollment is associated with more appropriate breast and colorectal screening, although the magnitude of the observed ACO effect is modest in the early ACO experience.
Many SAS doctors face harassment and bullying at work, conference hears
Authors: Abi Rimmer
Journal: BMJ (2014)

A “significant number” of staff, associate specialist, and specialty doctors (SAS doctors) face harassment and bullying at work, a BMA conference has heard.

Representatives at the BMA SAS doctors’ conference voted in favour of a motion that said SAS doctors faced “harassment and bullying in their workplace” and were “gagged” against speaking up “in …
Characterization of the benefit-risk profile of nivolumab + ipilimumab (N+I) <i>v</i> sunitinib (S) for treatment-naïve advanced renal cell carcinoma (aRCC; CheckMate 214).
Authors: Nizar M. Tannir, Hans J. Hammers, Asim Amin, Marc-Oliver Grimm, Brian I. Rini, Sabeen Mekan, M. Brent McHenry, Christian K. Kollmannsberger
Journal: Journal of Clinical Oncology (2018)

686 Background: The phase 3 CheckMate 214 study demonstrated superior efficacy for N+I v S in intermediate/poor-risk aRCC patients (pts), with manageable safety (Escudier, ESMO 2017). Here we report additional data to define benefit-risk. Methods: Pts with clear-cell aRCC were randomized 1:1 to N 3 mg/kg + I 1 mg/kg every 3 wk for 4 doses followed by N 3 mg/kg every 2 wk, or S 50 mg daily orally for 4 wk (6-wk cycles). Primary endpoints were efficacy parameters in intermediate/poor-risk pts. Secondary endpoints included adverse event (AE) incidence in all treated pts. Select AEs were defined as AEs pooled by organ category that may differ from AEs caused by non-immunotherapies, may require immunosuppression, and whose early recognition may mitigate severe toxicity. Results: 1096 pts were randomized (pts treated: N+I: n = 547; S: n = 535). N+I showed statistically significant OS benefit, significantly higher ORR, numerically longer PFS, and better symptom control v S. 79% of N+I pts received all 4 I doses. Drug-related grade 3-5 AEs occurred in 46% with N+I v 63% with S; drug-related AEs leading to discontinuation occurred in 22% v 12%. Drug-related select AEs resolved in 72%-92% of N+I pts, except endocrinopathies (43%; Table). An analysis of the relationship between safety and efficacy will be presented. Conclusions: Drug-related select AEs with N+I were manageable, with the vast majority resolving except endocrinopathies. These additional data further support the favorable benefit-risk profile of N+I v S in CheckMate 214. Clinical trial information: NCT02231749. [Table: see text]
Suppress orthotopic colon cancer and its metastasis through exact targeting and highly selective drug release by a smart nanomicelle
Authors: Chunqi Zhu, Hanbo Zhang, Wei Li, Lihua Luo, Xiaomeng Guo, Zuhua Wang, Fenfen Kong, Qingpo Li, Jie Yang, Yongzhong Du, Jian You
Journal: Biomaterials (2018)
HIGH-DENSITY LIPOPROTEIN SUBFRACTIONS ARE NOT INDEPENDENTLY ASSOCIATED WITH CORONARY ARTERY CALCIUM: A CROSS-SECTION ANALYSIS
Authors: Marcio Bittencourt, Giuliano Generoso, Isabela Bensenor, Itamar S. Santos, Raul D. Santos, Alessandra C. Goulart, Henrique L. Staniak, Rodolfo Sharovsky, Steven Jones, Krishnaji R. Kulkarni, Michael J. Blaha, Peter P. Toth, Paulo A. Lotufo
Journal: Journal of the American College of Cardiology (2018)
NHS bodies should work to improve relations between junior doctors and government, Keogh says
Authors: Adrian O’Dowd
Journal: BMJ (2016)

NHS organisations should improve junior doctors’ working and training conditions to try to repair relations between the profession and the government, NHS England’s national medical director has said.

Speaking at an evidence session of the parliamentary health committee on 19 July, Bruce Keogh told MPs that he wanted to help change the bad feeling between the two parties.

Relations have been strained because of the recent industrial dispute over a new contract for junior doctors in England, which led to a full strike by BMA junior doctor members in April.1

The new contract, which will be imposed …
Research in health and social care: a practical introduction course
Authors: Mark Gorman
Journal: BMJ (2011)

This course is intended to demystify clinical research for frontline clinical staff. Delivered by the research and development department attached to Calderdale and Huddersfield NHS Foundation Trust, together with external trainers, the course has been run successfully for more than a decade.

The course runs at the Field House Teaching Centre at Bradford Royal Infirmary from March to May each year. It is aimed at anyone interested in developing an understanding of research concepts and their practical application. Twenty places are available on a first come, first served basis (closing date 21 February), and although it is open to all qualified NHS and social care staff, the course leaders require candidates to show how they will benefit and apply their learning at work. The full course is fairly extensive and is recommended if you are seeking a good overall grasp of the subject.

Support from the Yorkshire and Humber Strategic Health Authority means that the course is free of …
Comment on Edelman and Polonsky. Type 2 Diabetes in the Real World: The Elusive Nature of Glycemic Control. Diabetes Care 2017;40:1425–1432
Authors: Dario Giugliano, Maria Ida Maiorino, Giuseppe Bellastella, Katherine Esposito
Journal: Diabetes Care (2018)

Edelman and Polonsky (1) suggest that poor adherence to pharmacotherapy is largely (∼75%) responsible for the gap between clinical efficacy from randomized controlled trials and real-world effectiveness of antihyperglycemic drugs. As no single strategy can be applied successfully to all patients with type 2 diabetes in order to improve medication adherence, other approaches are suggested, including innovation in delivery methods and reduction of the number of daily pills, shared strategies between clinicians and patients, and easier access to medications.

Only 11 years ago, the first newer diabetes drug (sitagliptin) was …
Surgical training in the developing world
Authors: Steve Payne
Journal: BMJ (2005)

Urological trainees <b>John McGrath</b> and <b>Danny Painter</b> spent some time last year working and training at the Kilimanjaro Christian Medical Centre in Tanzania through the charity UROLINK. Here, with <b>Steve Payne</b>, they explain what it entailed and offer advice to others wanting to work abroad
EVALUATION OF THE ASSOCIATION OF SINGLE NUCLEOTIDE POLYMORPHISMS IN THE SODIUM GLUCOSE CO-TRANSPORTER 2 GENE WITH GLUCOSE HOMEOSTASIS AND TYPE 2 DIABETES
Authors: Axel Muendlein, Janine Ebner, Andreas Leiherer, Christoph Saely, Kathrin Geiger, Eva-Maria Brandtner, Daniela Zanolin, Alexander Vonbank, Peter Fraunberger, Heinz Drexel
Journal: Journal of the American College of Cardiology (2018)
RCGP partners with MSF to send GPs around the world
Authors: Abi Rimmer
Journal: BMJ (2015)

The Royal College of General Practitioners (RCGP) has partnered with Medecins Sans Frontieres (MSF; Doctors Without Borders) in a scheme to send GPs around the world.

The partnership will run for three years and will place RCGP members in projects in sub-Saharan Africa and the Middle East. The first posting will be in Swaziland, where MSF provides free healthcare for patients with conditions such as tuberculosis, HIV, and diabetes. Teams also …
Non-invasive Prenatal Diagnosis of Chromosomal Aneuploidies and Microdeletion Syndrome Using Fetal Nucleated Red Blood Cells Isolated by Nanostructure Microchips
Authors: Chun Feng, Zhaobo He, Bo Cai, Jianhong Peng, Jieping Song, Xuechen Yu, Yue Sun, Jing Yuan, Xingzhong Zhao, Yuanzhen Zhang
Journal: Theranostics (2018)

Detection of detached fetal nucleated red blood cells (fNRBCs) in the maternal peripheral blood may serve as a prospective testing method competing with the cell-free DNA, in non-invasive prenatal testing (NIPT).Methods: Herein, we introduce a facile and effective lab-on-a-chip method of fNRBCs detection using a capture-releasing material that is composed of biotin-doped polypyrrole nanoparticles.To enhance local topographic interactions between the nano-components and fNRBC, a specific antibody, CD147, coated on the nanostructured substrate led to the isolation of fNRBCs from maternal peripheral blood.Subsequently, an electrical system was employed to release the captured cells using 0.8 V for 15 s.The diagnostic application of fNRBCs for fetal chromosomal disorders (Trisomy 13/21/18/X syndrome, microdeletion syndrome) was demonstrated.Results: Cells captured by nanostructured microchips were identified as fNRBCs.Twelve cases of chromosomal aneuploidies and one case of 18q21 microdeletion syndrome were diagnosed using the fNRBCs released from the microchips.Conclusion: Our method offers effective and accurate analysis of fNRBCs for comprehensive NIPT to monitor fetal cell development.
COMPARATIVE EFFECTIVENESS OF DIFFERENT CONTEMPORARY DRUG-ELUTING STENTS IN ROUTINE CLINICAL PRACTICE: MULTIGROUP PROPENSITY-SCORE ANALYSIS USING DATA FROM THE STENT-SPECIFIC, MULTI-CENTER, PROSPECTIVE REGISTRIES
Authors: Duk-Woo Park, Osung Kwon, Se Hun Kang, Jung-Bok Lee, Jung-Min Ahn, Cheol Hyun Lee, Do-Yoon Kang, Pil Hyung Lee, Soo-Jin Kang, Young-Hak Kim, Cheol Whan Lee, Seong-Wook Park, Seung-Jung Park
Journal: Journal of the American College of Cardiology (2018)