tbuckley/cabot-search huggingface dataset:
We need better interview methods to recruit junior doctors
Authors: N R Chenthil Kumar
Journal: BMJ (2004)

Having recently gained a management qualification in personnel practice (CIPD-CPP), I now realise that we use an inappropriate method of recruiting and selecting junior doctors in the NHS.

Interviews play a valuable part in making sure that we recruit the right people for the right job. In all the job interviews I have attended in various NHS trusts, the consultants and human resources staff were conducting face to face interviews. Later discussions have revealed that most consultants were not able to go through the curriculum vitae (CVs) of the shortlisted candidates before the interview because of lack of time. In my experience, human resources staff were not interested in going through the CVs of shortlisted candidates as they felt that the final decision was made by the consultants and so they had no say in it. The discussions also revealed that most of the consultants and human resources staff were not aware of the different …
The transgenic chicken derived anti-CD20 monoclonal antibodies exhibits greater anti-cancer therapeutic potential with enhanced Fc effector functions
Authors: Young Min Kim, Jin Se Park, Sang Kyung Kim, Kyung Min Jung, Young Sun Hwang, Mookyoung Han, Hong Jo Lee, Hee Won Seo, Jeong-Yong Suh, Beom Ku Han, Jae Yong Han
Journal: Biomaterials (2018)
Efficacy of ferumoxytol as a lymphatic contrast agent in prostate cancer.
Authors: Michael J. Dattoli, Stephen M Bravo, Daniel Kaplon, Matt Hayes, Alexandria Osorio, Patricia M Dycus, David G. Bostwick, Joseph Kaminski
Journal: Journal of Clinical Oncology (2018)

186 Background: Ferumoxytol (Feraheme) is a ferromagnetic nanoparticle with lymphotrophic biokinetics, delivered to lymph nodes by normal macrophages. MRI suppresses normal lymph nodes containing Feraheme. Objective is to validate safety and efficacy in finding lymph node positivity in prostate cancer (PCa). Methods: Nonrandomized prospective evaluation of 178 consecutive PCa patients (pts) at high risk for lymph node spread enrolled 2/13-3/15. All received IV Feraheme. 177 received 6/mg/kg over 20 min. One pt received 3 mg/kg infusion. T2 MEDIC and T2* sequence imaging of abdomen and pelvis, given 24 hours later. Images reviewed by 2 board certified radiologists with same interpretations, blinded to clinical and histo-path info (pre-MRI TNM stage/PSA/Gleason). Nodes were deemed abnormal if they did not suppress after Feraheme infusion (group 1, 94 patients). Nodes were deemed suspicious if suppressed and met usual size criteria with high signal intensity on DWI and decreased ADC map values and morphologic features (group 2, 84 pts). 83 group 1 pts had CT biopsies (77 pelvis, 6 retroperitoneum);11 pts had open PLND. 382 lymph nodes sampled. 76 group 2 patients had CT biopsies (73 pelvis, 3 retroperitoneum); 9 pts had open PLND. 340 lymph nodes sampled. Rad-path correlation was performed. Nodes were stained; reviewed by a single pathologist with no knowledge of MRI findings. Histo-path results for each node were cataloged for later MRI comparison. Results: 90 group 1 pts (96%) proved metastatic PCa; 4 pts (4%) were normal. 68 group 1 pts (77%) had malignant lymph nodes not meeting usual imaging criteria. 39 group 2 pts (47%) showed metastatic PCa; 46 pts (53%) were normal. One group 2 pt had an allergic reaction with hives; infusion ceased at 3mg/kg; pt treated to full resolution with 50 mg IV Benadryl. Conclusions: Feraheme can evaluate lymphatic dissemination of metastatic disease in PCa patients, with a lower limit of resolution of focal lymph node metastases of 2-3 mm. Better resolution gives implications for therapeutic radiation planning of newly diagnosed or recurrent/metastatic PCa. Toxicity was very acceptable at 6mg/kg. Feraheme may play a significant role as a lymphatic contrast agent in the early dissemination of lymphatic metastatic disease.
Industry must cut calories in savoury food products by 20%, says Public Health England
Authors: Abi Rimmer
Journal: BMJ (2018)

Public Health England has challenged manufacturers and restaurants to reduce the calorie content of food products that contribute significantly to children’s energy intake by 20% by 2024. It said that meeting the target would save the NHS £4.5bn (€5bn; $6.2bn) and social care £4.48bn.

PHE’s calorie reduction programme, announced on 6 March, aims to cut calories in foods that are not already covered by restrictions that were placed on sugar in 2016 and is part of the government’s childhood obesity strategy.12 Products covered by the programme include pizza, ready meals, readymade sandwiches, processed meat products, and savoury snacks.

Alison Tedstone, chief nutritionist at PHE, said, “We know that we need to get to these foods because they …
IDO1 Inhibition Synergizes with Radiation and PD-1 Blockade to Durably Increase Survival Against Advanced Glioblastoma
Authors: Erik Ladomersky, Lijie Zhai, Alicia Lenzen, Kristen L. Lauing, Jun Qian, Denise M. Scholtens, Galina Gritsina, Xuebing Sun, Ye Liu, Fenglong Yu, Wenfeng Gong, Yong Liu, Beibei Jiang, Tristin Tang, Ricky Patel, Leonidas C. Platanias, C. David James, Roger Stupp, Rimas V. Lukas, David C. Binder, Derek A. Wainwright
Journal: Clinical Cancer Research (2018)

Abstract Purpose: Glioblastoma is the most aggressive primary brain tumor in adults with a median survival of 15–20 months. Numerous approaches and novel therapeutics for treating glioblastoma have been investigated in the setting of phase III clinical trials, including a recent analysis of the immune checkpoint inhibitor, nivolumab (anti-PD-1), which failed to improve recurrent glioblastoma patient survival. However, rather than abandoning immune checkpoint inhibitor treatment for glioblastoma, which has shown promise in other types of cancer, ongoing studies are currently evaluating this therapeutic class when combined with other agents. Experimental Design: Here, we investigated immunocompetent orthotopic mouse models of glioblastoma treated with the potent CNS-penetrating IDO1 enzyme inhibitor, BGB-5777, combined with anti-PD1 mAb, as well as radiotherapy, based on our recent observation that tumor-infiltrating T cells directly increase immunosuppressive IDO1 levels in human glioblastoma, the previously described reinvigoration of immune cell functions after PD-1 blockade, as well as the proinflammatory effects of radiation. Results: Our results demonstrate a durable survival benefit from this novel three-agent treatment, but not for any single- or dual-agent combination. Unexpectedly, treatment efficacy required IDO1 enzyme inhibition in non-glioblastoma cells, rather than tumor cells. Timing of effector T-cell infiltration, animal subject age, and usage of systemic chemotherapy, all directly impacted therapy-mediated survival benefit. Conclusions: These data highlight a novel and clinically relevant immunotherapeutic approach with associated mechanistic considerations that have formed the basis of a newly initiated phase I/II trial for glioblastoma patients. Clin Cancer Res; 24(11); 2559–73. ©2018 AACR.
Dyslipidaemia and cardiovascular risk
Authors: Aidan Ryan, Simon Heath, Paul Cook
Journal: BMJ (2018)

### What you need to know

A 40 year old man visits his general practitioner for annual antipsychotic monitoring. He is taking risperidone and sertraline for a previous diagnosis of psychotic depression. Recent blood tests showed a total cholesterol of 6.0, low density lipoprotein (calculated) (LDLc) 3.8, high density lipoprotein (HDL) 0.8, non-HDL 5.2, and triglyceride of 3.0 mmol/L; other blood tests were within the reference range. 



Patients may require consideration of dyslipidaemia and cardiovascular risk for a number of reasons, including pre-existing physical health conditions such as chronic kidney disease; medications such as antipsychotics; family history such as hypercholesterolaemia or ischaemic heart disease; or due to age thresholds, such as cardiovascular disease (CVD) screening in over-40s.

This article provides a framework for diagnosing and managing dyslipidaemia, with the aim of reducing patients’ CVD risk.

History 

Ask about



Fig 1 
Approach to diagnosis and management of hypercholesterolaemia (based on guidance from the National Institute of Health and Care Excellence)



The patient advice leaflet, included as a supplementary file with this …
What are the criteria for being awarded discretionary pay awards for staff grades and associate specialists?
Authors: Romeh Gupta
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 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. <b>www.bmjcareers.com/advicezone</b>
Biological and psychosocial predictors of job performance following a first episode of psychosis
Authors: M Beiser, G Bean, D Erickson, J Zhang, W G Iacono, N A Rector
Journal: American Journal of Psychiatry (1994)

The purposes of this study were 1) to evaluate occupational functioning 18 months after a first episode of psychosis and 2) to determine predictors of differential outcome.Using a variety of sociodemographic, clinical, and psychophysiological measures, the project team assessed adults experiencing a first episode of schizophrenia (N = 33) or affective psychosis (N = 31). Identical measures were obtained from a comparison group (N = 46) who had no history of psychiatric disorder. Work performance was rated at entry into the study and 18 months later.At entry into the study, the schizophrenic subjects displayed the worst job performance, the asymptomatic individuals the best. The subjects with affective psychosis fell in between. Each of the two diagnostic groups evidenced postmorbid occupational decline. Three factors predicted good outcome in the schizophrenic group--good premorbid job performance, female gender, and scores on putative markers of biological vulnerability for the illness. For the affective disorder group, positive labeling by a significant other proved the only predictor of good outcome.These findings suggest that post-morbid occupational decline is common to both schizophrenia and affective psychosis. Past accomplishment and biological vulnerability predicted short-term course for these schizophrenic patients; psychosocial factors played a more prominent role in affective psychosis.
Abstract 15624: Surgery Characteristic and Incidence of Post-operative Atrial Fibrillation, In-hospital Major Adverse Cardiovascular Event (MACE), and Mortality in the OPERATrial
Authors: Emmanuel Akintoye, Frank Sellke, Roberto Marchioli, Luigi Tavazzi, Dariush Mozaffarian
Journal: Circulation (2016)

Background: Postoperative atrial fibrillation (PoAF) complicates about 1/3rd of the cases of cardiac surgery and it has been associated with major adverse consequences. However, there is very scant...
PREVALENCE AND CHARACTERISTICS OF HIV/AIDS PATIENTS UNDERGOING AORTIC VALVE REPLACEMENT IN THE UNITED STATES: A POPULATION BASED STUDY
Authors: David Song, Richard Hajjar, Pratik Agrawal, Ayush Arora, Adamantios Tsangaris, Akhtar Amin, Alfonso Waller, James Maher
Journal: Journal of the American College of Cardiology (2018)
NIH/Kennedy Center Workshop on Music and the Brain: Finding Harmony
Authors: Thomas Cheever, Anna Taylor, Robert Finkelstein, Emmeline Edwards, Laura Thomas, Joke Bradt, Steven J. Holochwost, Julene K. Johnson, Charles Limb, Aniruddh D. Patel, Nim Tottenham, Sunil Iyengar, Deborah Rutter, Renée Fleming, Francis S. Collins
Journal: Neuron (2018)
Abstract 19287: Renal Sympathetic Denervation Preconditions the Myocardium by Inhibiting G Protein-Coupled Receptor Kinase 2 Signaling
Authors: David J Polhemus, Juan Gao, Rishi Trivedi, Amy Scarborough, Traci Goodchild, Frank Smart, Daniel Kapusta, David J Lefer
Journal: Circulation (2016)

Introduction:  Renal denervation (RDN) is currently under clinical investigation for the treatment of resistant hypertension. G Protein-Coupled receptor Kinase 2 (GRK2) is classically recognized as a GPCR desensitizing agent, but also elicits non-canonical signaling pathways that promote cell death. We hypothesize that inhibition of the sympathetic nervous system, via RDN, will attenuate myocardial GRK2 signaling and attenuate subsequent myocardial ischemia-reperfusion (MI/R) injury in the setting of hypertension.   Methods:  Spontaneously hypertensive rats (SHR) at 20 weeks of age received either bilateral RF-RDN or sham RDN (Biosense Webster Stockert 70 RF generator) of the renal arteries (4 sides x 20 sec at 10 or 0 watts). After 4 wks, SHR were subjected to 30 min. of left coronary artery occlusion + 24 hr. Rep. and myocardial infarct size (INF)/area-at-risk (AAR) was determined. Left ventricle (LV) was collected 4 weeks following RDN for molecular determinations.   Results:  RDN produced a significant decrease in LV GRK2 mRNA to 60% of Sham-RDN levels. Although we did not observe a difference in whole cell GRK2 protein levels between groups, phosphorylation at residue Ser670 was significantly down regulated following RF-RDN. Phosphorylation at this residue results in GRK2 mitochondrial translocation and cell death. RF-RDN rats displayed a significant reduction in myocardial INF size per AAR (26.8 vs. 43.9%, p    Conclusion:  RDN protects against myocardial I/R injury in the setting of established hypertension, in part, by inhibiting pro-death GRK2 signaling pathways associated with increased sympathetic nerve activity. Our data suggest that RF-RDN may exert therapeutic benefits that extend beyond blood pressure reduction in the setting of hypertension and acute myocardial infarction.
Can Infection Prevention Programs in Hospitals and Nursing Facilities Be Integrated?
Authors: Lona Mody, Laraine Washer, Scott Flanders
Journal: JAMA (2018)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
Review: In primary prevention, BP-lowering treatment reduces major CV events in patients with SBP ≥ 140 mm Hg
Authors: Peter Rudd
Journal: Annals of Internal Medicine (2018)

Source Citation Brunström M, Carlberg B. Association of blood pressure lowering with mortality and cardiovascular disease across blood pressure levels: a systematic review and meta-analysis. JAMA Intern Med. 2018;178:28-36. 29131895
Accelerated Progression to Type 1 Diabetes in the Presence of <i>HLA-A*24</i> and <i>-B*18</i> Is Restricted to Multiple Islet Autoantibody–Positive Individuals With Distinct <i>HLA-DQ</i> and Autoantibody Risk Profiles
Authors: Else M. Balke, Eric V. Balti, Bart Van der Auwera, Ilse Weets, Olivier Costa, Simke Demeester, Pascale Abrams, Kristina Casteels, Marina Coeckelberghs, Sylvie Tenoutasse, Bart Keymeulen, Daniel G. Pipeleers, Frans K. Gorus
Journal: Diabetes Care (2018)

We investigated the effect of HLA class I risk alleles on disease progression in various phases of subclinical islet autoimmunity in first-degree relatives of patients with type 1 diabetes.A registry-based group of siblings/offspring (aged 0-39 years) was monitored from single- to multiple-autoantibody positivity (n = 267) and from multiple-autoantibody positivity to clinical onset (n = 252) according to HLA-DQ, -A*24, -B*18, and -B*39 status. Genetic markers were determined by PCR sequence-specific oligotyping.Unlike HLA-B*18 or -B*39, HLA-A*24 was associated with delayed progression from single- to multiple-autoantibody positivity (P = 0.009) but not to type 1 diabetes. This occurred independently from older age (P < 0.001) and absence of HLA-DQ2/DQ8 or -DQ8 (P < 0.001 and P = 0.003, respectively), and only in the presence of GAD autoantibodies. In contrast, HLA-A*24 was associated with accelerated progression from multiple-autoantibody positivity to clinical onset (P = 0.006), but its effects were restricted to HLA-DQ8+ relatives with IA-2 or zinc transporter 8 autoantibodies (P = 0.002). HLA-B*18, but not -B*39, was also associated with more rapid progression, but only in HLA-DQ2 carriers with double positivity for GAD and insulin autoantibodies (P = 0.004).HLA-A*24 predisposes to a delayed antigen spreading of humoral autoimmunity, whereas HLA-A*24 and -B*18 are associated with accelerated progression of advanced subclinical autoimmunity in distinct risk groups. The relation of these alleles to the underlying disease process requires further investigation. Their typing should be relevant for the preparation and interpretation of observational and interventional studies in asymptomatic type 1 diabetes.
Impact of a colorectal enhanced recovery program implementation on clinical outcomes and institutional costs: A prospective cohort study with retrospective control
Authors: Mattia Portinari, Simona Ascanelli, Simone Targa, Elisabete Maria Dos Santos Valgode, Barbara Bonvento, Emidia Vagnoni, Stefano Camerani, Marco Verri, Carlo Alberto Volta, Carlo V. Feo
Journal: International Journal of Surgery (2018)
VALVE IN VALVE TRANSCATHETER AORTIC VALVE IMPLANTATION VERSUS REDO SURGICAL AORTIC VALVE REPLACEMENT IN FAILING BIOPROSTHETIC VALVES: AN UPDATED META-ANALYSIS
Authors: Nikhil Nalluri, Varunsiri Atti, Varun Kumar, Abdullah B. Munir, Deepak Asti, Samer Saouma, Sainath Gaddam, Mandeep Randhawa, Mohammad Zgheib, Boutros Karam, Jonathan Spagnola, Roman Royzman, Ruben Kandov, Frank Tamburrino, Gregory Maniatis, James Lafferty, Chad Kliger
Journal: Journal of the American College of Cardiology (2018)
The Real Cost of the US Health Care System
Authors: Ezekiel J. Emanuel
Journal: JAMA (2018)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
REAL-WORLD EVALUATION OF HOSPITAL LENGTH OF STAY AND COST FOR APIXABAN VERSUS WARFARIN TREATMENT OF HOSPITALIZED VENOUS THROMBOEMBOLISM PATIENTS IN THE US
Authors: Jay Lin, Lien Vo, Gail Wygant, Patrick Hlavacek, Lisa Rosenblatt, Anu Gupta, Xianying Pan, Jack Mardekian, Melissa Lingohr-Smith, Brandy Menges, Kenneth Tuell, Jennifer Guo
Journal: Journal of the American College of Cardiology (2018)
Genetic ablation of dynactin p150Glued in postnatal neurons causes preferential degeneration of spinal motor neurons in aged mice
Authors: Jia Yu, Chen Lai, Hoon Shim, Chengsong Xie, Lixin Sun, Cai-Xia Long, Jinhui Ding, Yan Li, Huaibin Cai
Journal: Molecular Neurodegeneration (2018)

Dynactin p150Glued, the largest subunit of the dynactin macromolecular complex, binds to both microtubules and tubulin dimers through the N-terminal cytoskeleton-associated protein and glycine-rich (CAP-Gly) and basic domains, and serves as an anti-catastrophe factor in stabilizing microtubules in neurons. P150Glued also initiates dynein-mediated axonal retrograde transport. Multiple missense mutations at the CAP-Gly domain of p150Glued are associated with motor neuron diseases and other neurodegenerative disorders, further supporting the importance of microtubule domains (MTBDs) in p150Glued functions. However, most functional studies were performed in vitro. Whether p150Glued is required for neuronal function and survival in vivo is unknown.Using Cre-loxP genetic manipulation, we first generated a line of p150Glued knock-in mice by inserting two LoxP sites flanking the MTBD-coding exons 2 to 4 of p150Glued-encoding Dctn1 gene (Dctn1LoxP/), and then crossbred the resulting Dctn1LoxP/ mice with Thy1-Cre mice to generate the bigenic p150Glued (Dctn1LoxP/LoxP; Thy1-Cre) conditional knockout (cKO) mice for the downstream motor behavioral and neuropathological studies.P150Glued expression was completely abolished in Cre-expressing postnatal neurons, including corticospinal motor neurons (CSMNs) and spinal motor neurons (SMNs), while the MTBD-truncated forms remained. P150Glued ablation did not affect the formation of dynein/dynactin complex in neurons. The p150Glued cKO mice did not show any obvious developmental phenotypes, but exhibited impairments in motor coordination and rearing after 12 months of age. Around 20% loss of SMNs was found in the lumbar spinal cord of 18-month-old cKO mice, in company with increased gliosis, neuromuscular junction (NMJ) disintegration and muscle atrophy. By contrast, no obvious degeneration of CSMNs, striatal neurons, midbrain dopaminergic neurons, cerebellar granule cells or Purkinje cells was observed. Abnormal accumulation of acetylated α-tubulin, and autophagosome/lysosome proteins was found in the SMNs of aged cKO mice. Additionally, the total and cell surface levels of glutamate receptors were also substantially elevated in the p150Glued-depleted spinal neurons, in correlation with increased vulnerability to excitotoxicity.Overall, our findings demonstrate that p150Glued is particularly required to maintain the function and survival of SMNs during aging. P150Glued may exert its protective function through regulating the transportation of autophagosomes, lysosomes, and postsynaptic glutamate receptors in neurons.