tbuckley/cabot-search huggingface dataset:
Teaching and Learning by Example
Authors: Michael A. LaCombe
Journal: Annals of Internal Medicine (2018)

Editorials3 April 2018Teaching and Learning by ExampleMichael A. LaCombe, MDMichael A. LaCombe, MDAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M18-0336 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Those of us who interact with students, residents, and fellows must make a greater effort to teach at the bedside. That is where the action is. Students and trainees learn the most by example. Watching seasoned colleagues is not only how they learn physical diagnosis and procedural skills, but also how to approach a patient with respect and caring. It is where they learn empathy. Thus, we must be good role models. If our students and trainees learn by example, we must teach by example. That is why the American College of Physicians position paper on the hidden curriculum is ...Reference1. Lehmann LS, Snyder Sulmasy L, Desai S; ACP Ethics, Professionalism and Human Rights Committee. Hidden curricula, ethics, and professionalism: optimizing clinical learning environments in becoming and being a physician: a position paper of the American College of Physicians. Ann Intern Med. 2018;168:506-8. doi:10.7326/M17-2058 LinkGoogle Scholar Author, Article, and Disclosure InformationAffiliations: Disclosures: The author has disclosed no conflicts of interest. The form can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M18-0336.Corresponding Author: Michael A. LaCombe, MD, Maine General Medical Center, 35 Medical Center Drive, Augusta, ME 04330; e-mail, [email protected]com.This article was published at Annals.org on 27 February 2018. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoHidden Curricula, Ethics, and Professionalism: Optimizing Clinical Learning Environments in Becoming and Being a Physician: A Position Paper of the American College of Physicians Lisa Soleymani Lehmann , Lois Snyder Sulmasy , Sanjay Desai , and Annals On Call - Hidden Curriculum Robert M. Centor and Jack Ende Metrics 3 April 2018Volume 168, Issue 7Page: 521-522KeywordsEmotionsHearingHeart rateIntensive care unitsLibrariesMedical educationPatient advocacyStenosisTwins ePublished: 27 February 2018 Issue Published: 3 April 2018 Copyright & PermissionsCopyright © 2018 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
PREGNANCY OUTCOMES IN PATIENTS WITH AND WITHOUT CANCER-TREATMENT-RELATED CARDIAC DYSFUNCTION: A SYSTEMATIC REVIEW AND META-ANALYSIS
Authors: Mark T. Nolan, Nazanin Aghel, Eitan Amir, Shiying Liu, Candice Silversides, Cynthia Maxwell, Paaladinesh Thavendiranathan
Journal: Journal of the American College of Cardiology (2018)
Abstract 19194: FUNDC1 Regulates Mitochondrial Dynamics to Participate in High Fat Diet-Induced Cardiomyopathy
Authors: Nan Hu, Shuyi Wang, Yingmei Zhang, Jun Ren
Journal: Circulation (2016)

Introduction:  The outer mitochondrial membrane protein FUNDC1 interacts with LC3 to recruit autophagosomes, although its role in high fat diet intake-induced myopathic changes remains poorly understood. High fat diet intake triggers cardiac geometric and functional anomalies. Given the key role of mitophagy in the maintenance of mitochondrial homeostasis, this study was designed to evaluate the role of FUNDC1 in the regulation of mitophagy and cardiac homeostasis in the face of high fat diet intake.   Methods:  Wild type (WT) and FUNDC1 mutant (FUNDC1-/-) mice were fed low fat diet (LFD) or high fat diet (HFD) for 20 weeks. Metabolic rate, glucose tolerance, Echocardiography, cardiomyocyte mechanical function, aconitase activity, ROS generation and mitochondrial respiration were assessed. Cell signaling pathways were evaluated using Western blot analysis.   Results:  FUNDC1 ablation did not affect HFD-induced adiposity and insulin resistance, as evidenced by body weight gain and glucose intolerance. In addition, there was little difference in metabolic parameters (VO 2 , VCO 2 , RER, energy expenditure and physical activity) between WT and FUNDC1-/- mice fed HFD. However, FUNDC1 ablation accentuated HFD-elicited cardiac contractile dysfunction, as evidenced by echocardiographic, cardiomyocyte contractile and intracellular Ca 2+  properties. HFD-feeding caused more extensive mitochondrial injury and ROS generation with a more pronounced effect in FUNDC1-/- mice. Myocardial autophagy was drastically reduced with a much more pronounced effect in FundC1 deficient mice. Mitochondrial respiration from HFD-FUNDC1-/- mice was reduced during ADP-dependent respiration compared with WT mice. HFD down-regulated phosphorylation of FUNDC1, promoted the dissociation of FUNDC1 from both OPA1 and LC3B while facilitating the association with DNM1L/DRP1, denoting inhibited mitochondrial fission and mitophagy. Furthermore, the effect of HFD on interaction of OPA1, DNM1L/DRP1 and LC3B was exacerbated by FUNDC1 deletion.   Conclusions:  Our work revealed that FUNDC1 ablation exacerbates HFD-induced cardiac dysfunction and mitochondrial injury, possibly in association with inhibition of appropriate mitochondrial fission and thus cardiac autophagy.
Care of the critically ill surgical patient (CCrISP)
Authors: Rajesh Nair
Journal: BMJ (2007)

The CCrISP course is taught by the Royal College of Surgeons of England. Designed to develop skills that are necessary in the management of critically ill patients, it integrates knowledge, practical skills, communication, and leadership. The course aims to instil a system of assessment, institute basic treatment, and recognise when and who to call for help when faced with a critically ill surgical patient.

All surgical trainees are encouraged …
GPs should offer work experience to boost diversity in profession, advises new guidance
Authors: Caroline White
Journal: BMJ (2016)

More GPs should consider offering work experience at their practice, not only to boost recruitment to the profession, but also to widen participation in medicine, new guidance has recommended.

The guidance has been issued jointly by the Medical Schools Council (MSC), Health Education England, and the Royal College of General Practitioners.1

The MSC said that the issues associated with hosting individuals could seem “complex and time consuming” and could deter doctors from offering work placements.

The guidance, which provides a step by step guide to setting up work experience placements, …
Considerations in Assessing Disability Trajectories Before and After Stroke and Myocardial Infarction
Authors: Shivani Sharma, Prasanthi Sivakumaran
Journal: JAMA Neurology (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 Neurology HomeNew OnlineCurrent IssueFor Authors Podcast 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 Neurology journal
Senior trainees will be balloted on new consultant contract, says BMA
Authors: Tom Moberly
Journal: BMJ (2017)

Senior trainees, as well as all consultants, will be balloted on proposals for a new consultant contract, the BMA has said.

Delegates at the BMA’s annual representative meeting (ARM) in Bournemouth on 29 June voted in favour of a motion which said that “all consultants, [BMA] members on the specialist register, and junior doctors of year three specialty training and above should be balloted on the new consultant contract proposals.”

The motion, which was subject to an electronic vote at the conference, was passed by 116 votes to 89 (57% for the motion, 43% against).

Earlier …
Critical medical ecological perspectives on diabetes in the Pacific Islands: colonialism, power, and balance in human-environment interaction over time
Authors: Timothy D V Dye, Angela Sy, Pertina Albert, Haley Cash, John Hadley, Tolina Tomeing, Erin Muir, Becky Robles, Scott McIintosh, Edolem Ikerdeu, Lorne Farovich, Lee Buenconsejo-Lum
Journal: The Lancet Global Health (2018)

BackgroundDiabetes is endemic in Pacific Island jurisdictions where complex colonial relationships arose from the Spanish Empire, Japanese and German occupation in World Wars 1 and 2, and the Pacific Trust Territory era of the USA. Since diabetes reflects a cluster of ecological processes involving sociobehavioural, medical, and environmental constructs, interpretation of the diabetes epidemic requires both an ecological and intervention framework with an economic and political perspective that accounts for historical and contemporary power relations.MethodsWe conducted qualitative interviews with 272 local residents (totalling 3440 h) of seven Pacific Island communities (Majuro, Pohnpei, Palau, Kayangel Atoll, Saipan, Tinian, and Rota). Interviews were recorded and an inductive analytical plan implemented (analysed for themes within and across sites). An ecological interpretive framework that situates humans within their bodily and environmental context—combined with historical socioeconomic power dynamics (and agency)—informed the generation of findings and implications.FindingsCommunities attribute diabetes in their islands to the direct result of rapid shifts in lifestyle brought from the Japanese (World War 2) and US (Trust Territory) periods of colonial history. The replacement of local starches with rice during the Japanese period, combined with the replacement of local protein sources with US canned meats, fish, and instant foods, catalysed a diabetogenic diet. Shifts in food economies replaced local forms of trade, barter, and reciprocity. Local forms of physical activity—procurement of local food (fishing, gardening)—became devalued in the new food environment, further creating metabolic disease. Individuals from more remote locales are more likely to see their way of life as healthier than their counterparts in central population hubs, and attribute this asset to the slower reach of development, the subsequent lower processed food consumption, greater engagement with traditionally meaningful local activities, and a stronger reliance on local medicine, with less access to Western medicine.InterpretationIsland communities are aware of the dynamics historically that led to their present food and health environment. Cultural and community assets—perceived as resilience by community members—could be promoted to support social norms that contribute to growing local pride, traditional thinking and behaviours, and a redefinition of "healthy".FundingUS Centers for Disease Control and Prevention Research Center Program.
Erratum: The RA-MAP Consortium: a working model for academia–industry collaboration
Authors: Andrew P. Cope, Michael R. Barnes, Alexandra Belson, Michael Binks, Sarah Brockbank, Francisco Bonachela-Capdevila, Claudio Carini, Benjamin A. Fisher, Carl S. Goodyear, Paul Emery, Michael R. Ehrenstein, Neil Gozzard, Ray Harris, Sally Hollis, Sarah Keidel, Marc Levesque, Catharina Lindholm, Michael F. McDermott, Iain B. McInnes, Christopher M. Mela, Gerry Parker, Simon Read, Ayako Wakatsuki Pedersen, Frederique Ponchel, Duncan Porter, Ravi Rao, Anthony Rowe, Peter Schulze-Knappe, Matthew A. Sleeman, Deborah Symmons, Peter C. Taylor, Brian Tom, Wayne Tsuji, Denny Verbeeck, John D. Isaacs
Journal: Nature Reviews Rheumatology (2018)
Response to Comment on Ooi and Wong. Twin Pregnancy With Gestational Diabetes Mellitus: A Double Whammy? Diabetes Care 2018;41:e15–e16
Authors: Sara Ooi, Vincent W. Wong
Journal: Diabetes Care (2018)

We appreciate the interest and comments from McGrath et al. (1) relating to our recent article (2). Although singleton pregnancies complicated by gestational diabetes mellitus (GDM) and non-GDM twin pregnancies had been extensively studied, evidence on how GDM twin pregnancies should be optimally managed is still lacking.

We concur with McGrath et al. (1) that the current approach in managing women with GDM twin pregnancies may not confer harm and the risk of macrosomia is …
TRENDS IN UTILIZATION OF MECHANICAL CIRCULATORY SUPPORT IN CARDIAC TRANSPLANTATION
Authors: Yogita Rochlani, Srikanth Yandrapalli, George Jolly, Prakash Harikrishnan, Venkat Lakshmi Kishan Vuddanda, Wilbert Aronow, Masashi Kai, Alan Gass, Gregg Lanier
Journal: Journal of the American College of Cardiology (2018)
Adaptive versus non-adaptive MRI-guided radiation treatments for pancreatic cancer: A dosimetric study.
Authors: Benjamin Oren Spieler, Nancy El Bared, Kyle Padgett, Karen Moya Brown, Lorraine Portelance, Eric Albert Mellon
Journal: Journal of Clinical Oncology (2018)

336 Background: Combination MRI and radiation therapy systems enable magnetic resonance image guided radiation therapy (MR-IGRT). MR-IGRT allows clear visualization of the target and organs at risk (OARs) allowing for dose adaptation. Using adaptive MR-IGRT with Cobalt-60 for stereotactic body radiation therapy (SBRT) in locally advanced pancreatic cancer (LAPC), we hypothesized that MR-IGRT would improve dose to pancreatic tumor without increasing doses to OARs. Methods: Ten LAPC patients received five fraction SBRT with a total dose of 33-40 Gy. For each fraction, the original plan dose was compared to the dose that would be delivered if the original radiotherapy plan was applied to the anatomy that day (non-adaptive). An adaptive plan was then created for each fraction. The plan was re-optimized based on the anatomy as seen on the daily MRI and re-normalized so the volume of the PTV receiving 100% of the prescription (PTV100) would be 90%. Both the non-adaptive and adaptive doses to the target volume and the OARs were recorded to evaluate the value of adaptation. We used a paired t-test to compare PTV100 between the adaptive and non-adaptive techniques and Chi2 tests to compare the probability of dose constraint failures for OARs. Results: Adaptive MR-IGRT improved target coverage. Mean PTV100 for adaptive and non-adaptive techniques was 89.9% [88.4-90.4] and 78.4% [27.3-96.6] respectively, p = 0.0017. There were no statistically significant differences for violations of dose constraints of OARs using adaptive vs. non-adaptive techniques. Point maxima violations above 35 Gy to duodenum occurred in 6 adaptive fractions (renormalized to 90%) vs. 12 non-adaptive fractions (p = 0.118); to stomach in 8 adaptive fractions vs. 9 non-adaptive fractions (p = 0.790), and to bowel in 9 adaptive fractions vs. 6 non-adaptive fractions (p = 0.401). When adapting, attention must be paid to other OARs in the area: Spinal cord point maxima were violated in 4 adaptive fractions. Conclusions: This study demonstrates that adaptive techniques significantly increase SBRT dose delivered to LAPC without significantly increasing dose constraint violations to OARs. Adaptive MR-IGRT may allow for further SBRT dose escalations.
Associations between blood eosinophils and decline in lung function among adults with and without asthma
Authors: Robert J. Hancox, Ian D. Pavord, Malcolm R. Sears
Journal: European Respiratory Journal (2018)

Eosinophilic inflammation and airway remodelling are characteristic features of asthma, but the association between them is unclear. We assessed associations between blood eosinophils and lung function decline in a population-based cohort of young adults. We used linear mixed models to analyse associations between blood eosinophils and spirometry at 21, 26, 32 and 38 years adjusting for sex, smoking, asthma and spirometry at age 18 years. We further analysed associations between mean eosinophil counts and changes in spirometry from ages 21 to 38 years. Higher eosinophils were associated with lower forced expiratory volume in 1 s (FEV 1 )/forced vital capacity (FVC) ratios and lower FEV 1 % predicted values for both pre- and post-bronchodilator spirometry (all p-values ≤0.048). Although eosinophil counts were higher in participants with asthma, the associations between eosinophils and spirometry were similar among participants without asthma or wheeze. Participants with mean eosinophil counts &gt;0.4×10 9 cells·L −1 between 21 and 38 years had greater declines in FEV 1 /FVC ratios (difference 1.8%, 95% CI 0.7–2.9%; p=0.001) and FEV 1 values (difference 3.4% pred, 95% CI 1.5–5.4% pred); p=0.001) than those with lower counts. Blood eosinophils are associated with airflow obstruction and enhanced decline in lung function, independently of asthma and smoking. Eosinophilia is a risk factor for airflow obstruction even in those without symptoms.
CONCOMITANT MITRAL REGURGITATION AS A PREDICTOR OF LONG-TERM OUTCOME IN PATIENTS WITH AORTIC STENOSIS
Authors: Geraldine Ong, Anne-Sophie Zenses, Mohammed Salah Annabi, Ezquiel Guzzetti, Erwan Salaun, Ouhami Toubal, Jonathan Beaudoin, Philippe Pibarot, Marie-Annick Clavel
Journal: Journal of the American College of Cardiology (2018)
The association of an exosomal form of PD-L1 with immunosuppressive activity and gastric cancer prognosis.
Authors: Yibo Fan, Xiaofang Che, Zhi Li, Xiujuan Qu, Yunpeng Liu
Journal: Journal of Clinical Oncology (2018)

47 Background: The greatest challenge in cancer immunotherapy is to identify efficient predictive biomarkers to select patients for treatment. Though tumor cell membrane PD-L1 has been most anticipated, tumor cell membrane PD-L1 does not correlate with higher response rates and predict for clinical benefit. Subsequently studies showed that the prognostic value of tumor cell membrane PD-L1 in cancer patients remains controversial. In addition to membrane-associated PD-L1, tumor cell also secreted extracellular soluble PD-L1 in the microenvironment. However, even if extracellular soluble PD-L1 was detected, it did not solve the problem mentioned above. In the present study, we discovered another form of PD-L1 in extracellular microenvironment in cancer cells, that is exosomal PD-L1. However, the predictive role and the effect of tumor-derived exosomal PD-L1 is unclear. Methods: We evaluated the prognostic value of exosomal PD-L1 in the plasma of gastric cancer patients by ELISA and the effect of exosomal PD-L1-derived from gastric cancer cell lines by Western blot and Flow cytometry analysis. Results: Exosomal PD-L1 was detected in plasma samples from 69 gastric cancer patients, and exosomal PD-L1 content was significantly associated with T stage (P = 0.012). Overall Survival was significantly lower in the high exosomal PD-L1 group (p = 0.021). Additionally, gastric cancer cells also secreted exosomal PD-L1, with the amounts positively associated with PD-L1 amounts in the corresponding gastric cancer cell lines. Besides, exosomal PD-L1 was more stable and showed stronger immunosuppressive effects in the microenvironment compared with soluble PD-L1. Conclusions: Exosomal PD-L1 might predict the survival in gastric cancer, and induces higher T-cell apoptosis levels compared with soluble PD-L1.
LOGISTIC UTILITY OF MANDATORY ROUTINE BASELINE ECHOCARDIOGRAPHY EXAMS PRIOR TO TREATMENT WITH ANTHRACYCLINES FOR BREAST CANCER: CHALLENGING A NON-EVIDENCE-BASED RECOMMENDATION
Authors: Jose A. Banchs, Adrian DaSilva-DeAbreu, Raymundo Quintana Quezada, Daniel Booser, Astrid Serauto, Gabriela Sanchez Petitto
Journal: Journal of the American College of Cardiology (2018)
A Case Series of Molecular Imaging of Glucagonoma After Initial Therapy—68Ga-DOTATATE PET/CT Reveals Similar Results as in Neuroendocrine Tumors of Other Origin in Follow-up and Re-evaluation
Authors: Christof Rottenburger, Dimitrios Papantoniou, Dalvinder Mandair, Martyn Caplin, Shaunak Navalkissoor
Journal: Clinical Nuclear Medicine (2018)

Abstract Glucagonoma is an extremely rare, glucagon-secreting neuroendocrine tumor of the pancreas. Only sparse data are available about the characteristics of this tumor in somatostatin receptor imaging and only for the situation of initial diagnosis. We present a series of 3 glucagonoma patients who underwent at least 1 68 Ga-DOTATATE PET/CT scan. All patients were diagnosed by either histology and/or elevated serum levels of glucagon. The presented cases suggest that somatostatin receptor–based imaging can probably be used for re-evaluation of disease status in patients with glucagonoma in a similar way as it is already established for neuroendocrine tumors of other origin.
Primary ciliary dyskinesia with normal ultrastructure: three-dimensional tomography detects absence of DNAH11
Authors: Amelia Shoemark, Thomas Burgoyne, Robert Kwan, Mellisa Dixon, Mitali P. Patel, Andrew V. Rogers, Alexandros Onoufriadis, Juliet Scully, Farheen Daudvohra, Thomas Cullup, Michael R. Loebinger, Robert Wilson, Eddie M.K. Chung, Andrew Bush, Hannah M. Mitchison, Claire Hogg
Journal: European Respiratory Journal (2018)

In primary ciliary dyskinesia (PCD), motile ciliary dysfunction arises from ciliary defects usually confirmed by transmission electron microscopy (TEM). In 30% of patients, such as those with DNAH11 mutations, apparently normal ultrastructure makes diagnosis difficult. Genetic analysis supports diagnosis, but may not identify definitive causal variants. Electron tomography, an extension of TEM, produces three-dimensional ultrastructural ciliary models with superior resolution to TEM. Our hypothesis is that tomography using existing patient samples will enable visualisation of DNAH11- associated ultrastructural defects. Dual axis tomograms from araldite-embedded nasal cilia were collected in 13 PCD patients with normal ultrastructure ( DNAH11 n=7, HYDIN n=2, CCDC65 n=3 and DRC1 n=1) and six healthy controls, then analysed using IMOD and Chimera software. DNAH11 protein is localised to the proximal ciliary region. Within this region, electron tomography indicated a deficiency of &gt;25% of proximal outer dynein arm volume in all patients with DNAH11 mutations (n=7) compared to other patients with PCD and normal ultrastructure (n=6) and healthy controls (n=6). DNAH11 mutations cause a shared abnormality in ciliary ultrastructure previously undetectable by TEM. Advantageously, electron tomography can be used on existing diagnostic samples and establishes a structural abnormality where ultrastructural studies were previously normal.