tbuckley/cabot-search huggingface dataset:
Association of Body Mass Index With Lifetime Risk of Cardiovascular Disease and Compression of Morbidity
Authors: Sadiya S. Khan, Hongyan Ning, John T. Wilkins, Norrina Allen, Mercedes Carnethon, Jarett D. Berry, Ranya N. Sweis, Donald M. Lloyd-Jones
Journal: JAMA Cardiology (2018)

Prior studies have demonstrated lower all-cause mortality in individuals who are overweight compared with those with normal body mass index (BMI), but whether this may come at the cost of greater burden of cardiovascular disease (CVD) is unknown.To calculate lifetime risk estimates of incident CVD and subtypes of CVD and to estimate years lived with and without CVD by weight status.In this population-based study, we used pooled individual-level data from adults (baseline age, 20-39, 40-59, and 60-79 years) across 10 large US prospective cohorts, with 3.2 million person-years of follow-up from 1964 to 2015. All participants were free of clinical CVD at baseline with available BMI index and CVD outcomes data. Data were analyzed from October 2016 to July 2017.World Health Organization-standardized BMI categories.Total CVD and CVD subtype, including fatal and nonfatal coronary heart disease, stroke, congestive heart failure, and other CVD deaths. Heights and weights were measured directly by investigators in each study, and BMI was calculated as weight in kilograms divided by height in meters squared. We performed (1) modified Kaplan-Meier analysis to estimate lifetime risks, (2) adjusted competing Cox models to estimate joint cumulative risks for CVD or noncardiovascular death, and (3) the Irwin restricted mean to estimate years lived free of and with CVD.Of the 190 672 in-person examinations included in this study, the mean (SD) age was 46.0 (15.0) years for men and 58.7 (12.9) years for women, and 140 835 patients (73.9%) were female. Compared with individuals with a normal BMI (defined as a BMI of 18.5 to 24.9), lifetime risks for incident CVD were higher in middle-aged adults in the overweight and obese groups. Compared with normal weight, among middle-aged men and women, competing hazard ratios for incident CVD were 1.21 (95% CI, 1.14-1.28) and 1.32 (95% CI, 1.24-1.40), respectively, for overweight (BMI, 25.0-29.9), 1.67 (95% CI, 1.55-1.79) and 1.85 (95% CI, 1.72-1.99) for obesity (BMI, 30.0-39.9), and 3.14 (95% CI, 2.48-3.97) and 2.53 (95% CI, 2.20-2.91) for morbid obesity (BMI, ≥40.0). Higher BMI had the strongest association with incident heart failure among CVD subtypes. Average years lived with CVD were longer for middle-aged adults in the overweight and obese groups compared with adults in the normal BMI group. Similar patterns were observed in younger and older adults.In this study, obesity was associated with shorter longevity and significantly increased risk of cardiovascular morbidity and mortality compared with normal BMI. Despite similar longevity compared with normal BMI, overweight was associated with significantly increased risk of developing CVD at an earlier age, resulting in a greater proportion of life lived with CVD morbidity.
Review of trainees’ welfare and morale is needed, says contract negotiator
Authors: Abi Rimmer
Journal: BMJ (2016)

The government should commission a review into the issues affecting the welfare and morale of junior doctors, David Dalton has said.

In a letter sent to all doctors in training Dalton, the government’s lead negotiator over the junior doctor contract, said that given the “high level of unhappiness” the government, along with other stakeholders, should “commission a review of the longstanding concerns with recommendations to all parties for action which can improve the welfare and morale of trainees.”

The BMA announced on 2 February that junior doctors would go ahead …
N-TERMINAL PRO-B-TYPE NATRIURETIC PEPTIDE VERSUS CLINICAL RISK SCORES FOR PROGNOSTIC STRATIFICATION IN HEART FAILURE PATIENTS
Authors: Chiara Arzilli, Alberto Aimo, Giuseppe Vergaro, Alessandra Gabutti, Andrea Ripoli, Michele Senni, Michele Emdin, Claudio Passino
Journal: Journal of the American College of Cardiology (2018)
Re: De Moraes et al.: 24-2 Visual fields miss central defects shown on 10-2 tests in glaucoma suspects, ocular hypertensives, and early glaucoma ( Ophthalmology . 2017;124:1449-1456)
Authors: Piergiacomo Grassi, Henrietta Ho, Kin Sheng Lim
Journal: Ophthalmology (2018)
ANTHRACYCLINE-INDUCED CARDIO-AND VASO-TOXICITY IN PATIENTS RECEIVING CHEMOTHERAPY FOR BREAST CANCER
Authors: Evangelos Oikonomou, Maria Anastasiou, Flora Zagouri, Gerasimos Siasos, Alexios Antonopoulos, Sotirios Tsalamandris, Athina Goliopoulou, George-Angelo Papamikroulis, Vasiliki Tsigkou, Theodora Psaltopoulou, Aristotelis Bamias, Meletis Dimopoulos, Dimitris Tousoulis
Journal: Journal of the American College of Cardiology (2018)
Postgraduate Diploma in Epidemiology: Principles and Practice (PGDipEpid)
Authors: Alia Rafey Faruqui
Journal: BMJ (2005)

This course is suitable for doctors and other health professionals aiming for a career in epidemiological research. It is also of interest to people requiring an understanding of epidemiology, such as statisticians, medical journalists, and scientific officers in government and industry.

I completed my postgraduate diploma in 2001-3 as a part time external student from the University of London/London School of Hygiene and Tropical Medicine.

I am interested in epidemiology and I hoped that it would help me establish my evidence based practice and an understanding of research methods in a career in either community paediatrics or general practice. The course design and timetable are quite flexible to meet …
Junior doctor contract and equality analysis published
Authors: Abi Rimmer
Journal: BMJ (2016)

A new contract for junior doctors in England has been published by NHS Employers.

The Department of Health has also published an equality analysis of the contract, which found that it was “fair and justified.”

Following a breakdown of negotiations with the BMA, health secretary Jeremy Hunt announced in February that the government would impose a new contract on junior doctors from August this year.1

The new contract, published on Thursday 31 March, sets out the terms and conditions for junior doctors.2 NHS Employers, which developed the contract on behalf of the health department, said that implementation of the contract would be phased.

It said that most doctors in training would be moved on to the 2016 contract over an 18 month period, starting in August 2016. This would be linked to when their current …
eHealth interventions for family carers of people with long term illness: A promising approach?
Authors: Jacqueline Sin, Claire Henderson, Debbie Spain, Victoria Cornelius, Tao Chen, Steve Gillard
Journal: Clinical Psychology Review (2018)

Family carers of people who have long term illness often experience physical and mental health morbidities, and burden. While there is good evidence to suggest that carers benefit from psychosocial interventions, these have primarily been delivered via face-to-face individual or group-formats. eHealth interventions offer a novel, accessible and self-paced approach to care delivery. Whether these are effective for carers' wellbeing has been little explored. This paper reports the first comprehensive systematic review in this area. A total of 78 studies, describing 62 discrete interventions, were identified. Interventions commonly aimed to promote carers' knowledge, self-efficacy, caregiving appraisal, and reduce global health morbidities. Interventions were offered to carers of people with a wide range of long term illness; dementia has been the most researched area, as reported in 40% of studies. Clinical and methodological heterogeneity in interventions precluded meta-analyses, and so data were analysed narratively. The most popular approach has comprised psychoeducational interventions delivered via an enriched online environment with supplementary modes of communication, such as network support with professionals and peers. Overall, carers appreciate the flexibility and self-paced nature of eHealth interventions, with high rates of satisfaction and acceptability. More studies using robust designs are needed to extend the evidence base.
How do you become an adviser in a medical defence organisation. Do you need a law qualification? If not, would it help?
Authors: Matthew Lee
Journal: BMJ (2004)

<i>Got 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:</i>
Salivary factor LTRIN from Aedes aegypti facilitates the transmission of Zika virus by interfering with the lymphotoxin-β receptor
Authors: Lin Jin, Xiaomin Guo, Chuanbin Shen, Xue Hao, Peng Sun, Pengpeng Li, Tao Xu, Chunmiao Hu, Ombati Rose, Hongning Zhou, Mingdong Yang, Cheng-Feng Qin, Jingya Guo, Hua Peng, Mingzhao Zhu, Gong Cheng, Xiaopeng Qi, Ren Lai
Journal: Nature Immunology (2018)
STAT3/HOTAIR Signaling Axis Regulates HNSCC Growth in an EZH2-dependent Manner
Authors: Shanshan Sun, Yansheng Wu, Wenyu Guo, Feng Yu, Lingping Kong, Yu Ren, Yu Wang, Xiaofeng Yao, Chao Jing, Chao Zhang, Mingyang Liu, Yuqing Zhang, Minghui Zhao, Zhaoqing Li, Chuanqiang Wu, Yu Qiao, Jingxuan Yang, Xudong Wang, Lun Zhang, Min Li, Xuan Zhou
Journal: Clinical Cancer Research (2018)

Abstract Purpose: PI3K and STAT3 are frequently activated in cancer progression. However, little is known about the underlying mechanisms by which PI3K and STAT3 regulate head and neck squamous cell cancer (HNSCC) growth. The lncRNA HOX transcript antisense RNA (HOTAIR) was found to modulate the progression of HNSCC. In this study, we attempted to establish the correlation of PI3K/STAT3/HOTAIR signaling with the progression of HNSCC and its sensitivity toward platinum-based and targeted anti-EGFR combination therapy. Experimental Design: We first analyzed the STAT3/HOTAIR and PI3K/AKT level in human HNSCC samples. We then activated or suppressed STAT3/HOTAIR and determined the effects on HNSCC cell proliferation in vitro and the growth of UM1 xenograft tumor, an orthotopic model of HNSCC. The sensitivity of HNSCC cells toward cisplatin and cetuximab was determined by in vitro assays. Results: HNSCC samples showed significantly robust expression/activation of STAT3, HOTAIR, PI3K, and AKT, compared with normal squamous epithelium. STAT3 inhibition with WP1066 decreased HOTAIR level and sensitized HNSCC to cisplatin or cetuximab. STAT3 promoted HOTAIR transcription and its interaction with pEZH2-S21, resulting in enhanced growth of HNSCC cells. In addition, overexpression of HOTAIR promoted the growth of UM1 xenograft tumors in vivo. Conclusions: Our results suggest that STAT3 signaling promotes HNSCC progression via regulating HOTAIR and pEZH2-S21 in HNSCC with PI3K overexpression/activation. These findings provide a rationale to target the STAT3/HOTAIR/pEZH2-S21 regulatory axis for treating patients with HNSCC. Clin Cancer Res; 24(11); 2665–77. ©2018 AACR.
Glucosylated nanomicelles target glucose-avid pediatric patient-derived sarcomas
Authors: Alexandra Bukchin, Guillem Pascual-Pasto, Maria Cuadrado-Vilanova, Helena Castillo-Ecija, Carles Monterrubio, Nagore G. Olaciregui, Monica Vila-Ubach, Laia Ordeix, Jaume Mora, Angel M. Carcaboso, Alejandro Sosnik
Journal: Journal of Controlled Release (2018)
Nanoscaled Metal‐Organic Frameworks for Biosensing, Imaging, and Cancer Therapy
Authors: Jingrong Zhou, Gan Tian, Lijuan Zeng, Xueer Song, Xiu‐wu Bian
Journal: Advanced Healthcare Materials (2018)

Abstract Owing to the progressive development of metal‐organic frameworks (MOFs) synthetic processes and their unique characters associated with the excellent performance‐selectable composition, tunable pore scale, large surface area, and good thermal stability, MOFs have captured the interest and the imagination of an increasing number of scientists working in different fields. In the area of biomedical applications, MOFs are especially involved in sensing, molecular imaging, and drug delivery, with strong contributions to the whole nanomedicine area. Recently, these materials have been scaled down to nanometer sizes with the advancement of chemical synthesis gradually reaching an adjustable level. This review mainly discusses and summarizes the general synthesis, properties, and biomedical applications of nanoscaled MOFs and their composites in biosensing, imaging, and cancer therapy within the latest three years. The remaining challenges and future opportunities in this field, in terms of processing techniques, maximizing composite properties, and prospects for clinical applications, are also indicated.
Movement on pain
Authors: Tom Moberly
Journal: BMJ (2018)

Doctors face the challenge of treating more people living more of their lives in ill health, and there is not a lot of good news around. For many people, current treatments for their long term conditions may not do much to relieve symptoms or improve their quality of life.

Fibromyalgia is one important example, featuring in The BMJ this week. At present, aerobic exercise is the most commonly prescribed non-drug treatment. Drug interventions, such …
Effect of psoriatic arthritis on ixekizumab clinical outcomes in moderate-to-severe psoriasis patients: A post hoc analysis
Authors: Alice B. Gottlieb, Kim A. Papp, Charles A. Birbara, Catherine L. Shuler, Russel Burge, Janelle Erickson, Lisa Kerr, Philip J. Mease
Journal: Journal of the American Academy of Dermatology (2018)
Biomaterial scaffolds for non-invasive focal hyperthermia as a potential tool to ablate metastatic cancer cells
Authors: Francisco Pelaez, Navid Manuchehrabadi, Priyatanu Roy, Harishankar Natesan, Yiru Wang, Emilian Racila, Heather Fong, Kevin Zeng, Abby M. Silbaugh, John C. Bischof, Samira M. Azarin
Journal: Biomaterials (2018)
BMA backs GMC plans to simplify “equivalence” routes to registration
Authors: Emilie Green
Journal: BMJ (2012)

The BMA has supported the GMC’s plans to reform the “equivalence” routes to GP and specialist registration to simplify the system while ensuring that it is sufficiently robust to guarantee that doctors who follow this route are regarded as equal to those with the Certificate of Completion of Training (CCT).

Most graduates of UK medical schools follow the standard training path from the foundation programme to award of the CCT, after which they are eligible to join the medical register and apply for consultant and GP principal posts.

The equivalence routes involve applying for a Certificate of Eligibility for Specialist Registration (CESR) or a Certificate of Eligibility for General Practice Registration (CEGPR). Applicants …
Expression of microRNA‐155 in inflammatory cells modulates liver injury
Authors: Delia Blaya, Beatriz Aguilar‐Bravo, Fengjie Hao, Silvia Casacuberta‐Serra, Mar Coll, Luis Perea, Júlia Vallverdú, Isabel Graupera, Elisa Pose, Laura Llovet, Jordi Barquinero, Francisco Javier Cubero, Juan Caballería, Pere Ginès, Pau Sancho‐Bru
Journal: Hepatology (2018)

MicroRNA 155 (miR-155) is involved in immune and inflammatory diseases and is associated with liver fibrosis and steatohepatitis. However, the mechanisms involved in miR-155 regulation of liver injury are largely unknown. The role of miR-155 in acute liver injury was assessed in wild-type (WT), miR-155-/- , and miR-155-/- mice transplanted with WT bone marrow. Additionally, miR-155 expression was evaluated in liver tissue and peripheral blood mononuclear cells of patients with autoimmune hepatitis. Concanavalin A, but not acetaminophen, treatment increased the expression of miR-155 in liver tissue of WT mice. Concanavalin A induced increases in cell death, liver aminotransferases, and expression of proinflammatory cytokines (chemokine [C-X-C motif] ligands 1, 5, 9, 10, and 11; chemokine [C-C motif] ligands 2 and 20; and intercellular cell adhesion molecule 1) in miR-155-/- compared to WT mice. Importantly, these animals showed a significant decrease in cluster of differentiation 4-positive/chemokine (C-X-C motif) receptor 3-positive and forkhead box p3-positive cell recruitment but no changes in other inflammatory cell populations. Mechanistically, miR-155-deficient regulatory T cells showed increased SH2 domain-containing inositol 5-phosphatase 1 expression, a known target of miR-155. Inhibition of SH2 domain-containing inositol 5-phosphatase 1 in miR-155-/- mice restored forkhead box p3 recruitment and reduced liver cytokine expression. Transplantation of bone marrow from WT animals into miR-155-/- mice partially reversed the effect of concanavalin A on miR-155-/- mice as assessed by proinflammatory cytokines and cell death protein expression. Patients with autoimmune hepatitis showed a marked increase in miR-155 expression in the liver but reduced expression of miR-155 in peripheral blood mononuclear cells.miR-155 expression is altered in both liver tissue and circulating inflammatory cells during liver injury, thus regulating inflammatory cell recruitment and liver damage; these results suggest that maintaining miR-155 expression in inflammatory cells might be a potential strategy to modulate liver injury. (Hepatology 2018).
Development of a rapidly deployable mobile medical unit for emergency disaster settings
Authors: Esther J Kim, Sergio M Navarro, Sarah Michel, Caroline Soyars, David Hilmers, Sharmila Anandasabapathy
Journal: The Lancet Global Health (2018)

BackgroundMobile medical units are essential for rapid delivery of medical care in remote areas during crises. Baylor Global Innovation Center aimed to conceptualise, build, and deploy an Emergency Smart Pod (ESP)—a mobile medical unit customised for global emergencies—with a four-phase approach: human-centred design, development, user testing, and implementation.MethodsAn initial design was created based on the Ebola Grand Challenge Funding requirements granted by USAID in 2015. The design was then vetted using a 37-question survey via in-depth interviews with experts with field experience: logisticians, health-care workers, and Ebola Treatment Unit directors in the USA, Sierra Leone, Liberia, and Guinea. This design focused on addressing direct needs of end users by providing a rapidly deployable clinical solution with tablet-based wireless technologies, disinfectable materials, and appropriate storage for biohazard waste and medical supplies. The aluminium design of the unit optimised the lightweight capability, durability, and expandability. Manufacturers meeting these requirements were investigated for affordability, and technologies were developed for customised needs of infection control and emergency response. Feedback from field workers, NASA engineers, and physicians was continually evaluated throughout the building process.FindingsA prototype equipped with smart applications optimised to protect health-care workers, improve patient care, and prevent disease transmission was built and tested. An ultraviolet C- heating, ventilation, and air conditioning system was implemented to kill 99·7% of pathogens. Medical record and wireless patient monitoring systems were developed for the high patient throughput in disaster situations. Remote video and push-to-talk systems were implemented to facilitate communication between the hot and cold zones. The ESP was built as an expandable aluminium-based box deployable via ships and trucks. A full simulation was initiated in Houston, TX, USA with simulated patients and health-care workers in full personal protective equipment. Improvements were made prior to shipping the unit to Monrovia, Liberia, for infectious disease care. The ESP was then successfully deployed in September, 2017, at the Eternal Love Winning Africa (ELWA) Hospital as a patient isolation unit.InterpretationCorresponding pharmacy and laboratory units are being developed as additions to the ESP. Similar validation will be used for these units for future deployment.FundingVulcan Inc's Paul G Allen Ebola Program USAID Bureau for Global Health—Center for Accelerating Innovation and Impact.
Electrical Stimulation and Bone Healing: A Review of Current Technology and Clinical Applications
Authors: Jawad M. Khalifeh, Zohny Zohny, Matthew MacEwan, Manu Stephen, William Johnston, Paul Gamble, Youchun Zeng, Ying Yan, Wilson Z. Ray
Journal: IEEE Reviews in Biomedical Engineering (2018)

Pseudarthrosis is an exceedingly common, costly, and morbid complication in the treatment of long bone fractures and after spinal fusion surgery. Electrical bone growth stimulation (EBGS) presents a unique approach to accelerate healing and promote fusion success rates. Over the past three decades, increased experience and widespread use of EBGS devices has led to significant improvements in stimulation paradigms and clinical outcomes. In this paper, we comprehensively review the literature and examine the history, scientific evidence, available technology, and clinical applications for EBGS. We summarize indications, limitations, and provide an overview of cost-effectiveness and future directions of EBGS technology. Various models of electrical stimulation have been proposed and marketed as adjuncts for spinal fusions and long bone fractures. Clinical studies show variable safety and efficacy of EBGS under different conditions and clinical scenarios. While the results of clinical trials do not support indiscriminate EBGS utilization for any bone injury, the evidence does suggest that EBGS is desirable and cost efficient for certain orthopedic indications, especially when used in combination with standard, first-line treatments. This review should serve as a reference to inform practicing clinicians of available treatment options, facilitate evidence-based decision making, and provide a platform for further research.
<i>Aspergillus</i>-induced pneumonia in adult without obvious immunodeficiency: test the burst!
Authors: Héloïse Flament, Vanessa Granger, Corinne Vezinet, Viviana Marzaioli, Caroline Kannengiesser, Luc de Chaisemartin, Margarita Hurtado-Nedelec, Elena Litvinova, Jonathan Messika, Nicolas Adam, Marie-Anne Gougerot-Pocidalo, Pham My-Chan Dang, Renato Monteiro, Jamel el Benna, Olivier Langeron, Sylvie Chollet-Martin, Antoine Monsel
Journal: European Respiratory Journal (2018)

Chronic granulomatous disease (CGD) is a rare primary immunodeficiency caused by a germline defect in one of the genes ( CYBB , NCF1 , CYBA , NCF2 ) encoding the NADPH oxidase 2 (NOX2) components responsible for the phagocyte oxidative burst and the production of reactive oxygen species (ROS). An early diagnosis and a prompt treatment are crucial for improving outcomes in affected patients. CGD is usually diagnosed in early childhood, and more than 95% of cases are diagnosed by the age of 5 years [1, 2]. However, CGD can be diagnosed late in adulthood [1–3]. Aside from residual NOX2 activity, factors underlying late diagnosis of CGD remain poorly investigated. Here, we report a case of Aspergillus -induced pneumonia rapidly extending to fatal acute respiratory distress syndrome (ARDS) revealing a late diagnosis of CGD, which was associated with a residual mitochondria-driven neutrophil extracellular trap release (NETosis) counterbalancing the lack of functional NOX2. Written informed consent was obtained from the deceased patient's next-of-kin for publication of this case report and accompanying images. Unusual pathogen-driven sepsis should prompt to screen for chronic granulomatous disease, even in adult patients <http://ow.ly/2FSi30iXUsa> We thank Benoît Noël (Unité mixte de Recherche 996-Inflammation, Chemokines and Immunopathology, Institut National de la Santé et de la Recherche Médicale, Université Paris Sud, Université Paris-Saclay, Châtenay-Malabry, France) and Claire Oudin (AP-HP, Centre Hospitalier Universitaire Xavier Bichat, Service d'Immunologie et d'Hématologie et Service de Biochimie Hormonale et Génétique, CIB Phenogen, Paris F-75018, France) (molecular exploration of CYBB ) for excellent technical help.