tbuckley/cabot-search huggingface dataset:
Heat stress and fetal risk. Environmental limits for exercise and passive heat stress during pregnancy: a systematic review with best evidence synthesis
Authors: Nicholas Ravanelli, William Casasola, Timothy English, Kate M Edwards, Ollie Jay
Journal: British Journal of Sports Medicine (2018)

Objective Pregnant women are advised to avoid heat stress (eg, excessive exercise and/or heat exposure) due to the risk of teratogenicity associated with maternal hyperthermia; defined as a core temperature (T core ) ≥39.0°C. However, guidelines are ambiguous in terms of critical combinations of climate and activity to avoid and may therefore unnecessarily discourage physical activity during pregnancy. Thus, the primary aim was to assess T core elevations with different characteristics defining exercise and passive heat stress (intensity, mode, ambient conditions, duration) during pregnancy relative to the critical maternal T core of ≥39.0°C. Design Systematic review with best evidence synthesis. Data sources EMBASE, MEDLINE, SCOPUS, CINAHL and Web of Science were searched from inception to 12 July 2017. Study eligibility criteria Studies reporting the T core response of pregnant women, at any period of gestation, to exercise or passive heat stress, were included. Results 12 studies satisfied our inclusion criteria (n=347). No woman exceeded a T core of 39.0°C. The highest T core was 38.9°C, reported during land-based exercise. The highest mean end-trial T core was 38.3°C (95% CI 37.7°C to 38.9°C) for land-based exercise, 37.5°C (95% CI 37.3°C to 37.7°C) for water immersion exercise, 36.9°C (95% CI 36.8°C to 37.0°C) for hot water bathing and 37.6°C (95% CI 37.5°C to 37.7°C) for sauna exposure. Conclusion The highest individual core temperature reported was 38.9°C. Immediately after exercise (either land based or water immersion), the highest mean core temperature was 38.3°C; 0.7°C below the proposed teratogenic threshold. Pregnant women can safely engage in: (1) exercise for up to 35 min at 80%–90% of their maximum heart rate in 25°C and 45% relative humidity (RH); (2) water immersion (≤33.4°C) exercise for up to 45 min; and (3) sitting in hot baths (40°C) or hot/dry saunas (70°C; 15% RH) for up to 20 min, irrespective of pregnancy stage, without reaching a core temperature exceeding the teratogenic threshold.
Optimising single cell RNAseq for the analysis of paired primary and recurrent Glioblastoma
Authors: Nora Rippaus, Ruth Morton, Claire Taylor, Alexander-Francisco Bruns, Heiko Wurdak, Aruna Chakrabarty, Azzam Ismail, Susan Short, Lucy Stead
Journal: Neuro-Oncology (2018)

Glioblastoma (GBM) brain tumours are notoriously heterogeneous, constituting numerous subpopulations of cells with distinct genotypes and/or phenotypes. This level of heterogeneity is likely to facilitate Darwinian selection of treatment-resistant subpopulations during standard therapy and, thus, contribute to the inevitable recurrence of GBM tumours. In order to identify and characterise such treatment-resistant cells, with the aim of finding more effective ways of killing them, we are working on optimising the analysis of paired GBM tumours (before and after standard therapy) at single cell resolution using RNAseq.This is challenging for two reasons: 1) it is not possible to know, once a primary GBM is operated on, whether that patient’s recurrence will also be surgically removed, 2) archival pairs of tumours tend to be stored in snap frozen or paraffin-embedded form, thus hindering single cell analysis. To overcome this, we have altered the way that primary GBM tissue is processed in Leeds. Storing single cells of primary GBM tissue in lysis buffer enables subsequent continuation of our optimised single cell RNAseq workflow, if the recurrent tumour is operated on. We have also inspected several routes for performing single cell analysis on archival, paired tumours and found that our workflow can be applied to nuclei extracted from frozen material. Preliminary results show the feasibility of obtaining transcriptome profiling from RNA extracted from the isolated nuclei. Therefore, our research has a strong potential to reveal the cellular subpopulation dynamics promoting treatment resistance during GBM recurrence.
What kind of experience do I need for a specialist registrar rotation in microbiology?
Authors: Andrew Wilson
Journal: BMJ (2004)

Got a career or related problem that needs answering? Can't 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.
Definitive radiation therapy and survival in clinically node-positive prostate cancer.
Authors: Bryant Alex, A. Karim Kader, Rana R. McKay, John Paul Einck, Loren K. Mell, Arno James Mundt, Christopher J. Kane, Jason A. Efstathiou, James Don Murphy, Brent Shane Rose
Journal: Journal of Clinical Oncology (2018)

168 Background: The survival benefit of combined radiation therapy (RT) and androgen deprivation therapy (ADT) compared to ADT alone for clinically lymph node-positive prostate cancer remains controversial. Methods: We identified clinically node-positive, non-metastatic prostate cancer patients diagnosed between 2000-2015 and treated with ADT (n = 450) or ADT/RT (n = 198) from a national Veterans Affairs database. We compared prostate cancer-specific mortality (PCSM) and all-cause mortality (ACM) between treatment groups using multivariable Cox regression, controlling for potential confounders. All tests of statistical significance were two sided. Results: Compared to ADT alone, ADT/RT was associated with improved ACM (hazard ratio [HR]: 0.56, 95% CI 0.41-0.76, p &lt; 0.001) and PCSM overall (HR 0.65, 95% CI 0.43-0.97, p = 0.03). We noted a significant interaction between ADT/RT and pre-treatment PSA for PCSM (p for interaction = 0.005) and ACM (p for interaction &lt; 0.001). ADT/RT was associated with improved PCSM among patients with PSA less than (HR 0.43, 95% CI 0.24-0.78, p = 0.004) but not greater than the median of 26 ng/mL (HR 1.01, 95% CI 0.60-1.71, p = 0.96). ADT/RT was also associated with improved ACM among patients with PSA less than (HR 0.38, 95% CI 0.25-0.57, p &lt; 0.001) but not greater than the median (HR 0.91, 95% CI 0.60-1.38, p = 0.66). Conclusions: Definitive treatment with ADT/RT is associated with improved ACM and PCSM among patients with clinically node-positive prostate cancer. The survival benefit of ADT/RT is only apparent among patients with lower baseline PSA. Patients with clinically node-positive disease appear to be a heterogeneous cohort, with a subset that may achieve long-term survival with combined radiation and androgen deprivation therapy.
Cross cover—an alternative perspective
Authors: Patrick Tansley
Journal: BMJ (2005)

EDITOR—I read with interest the article “Cross cover: learning to change hats.”1 While Abood views cross cover as an “opportunity,” I view it more as confused policy. As a profession, we are told that on the one hand subspecialisation is in the national interest and is to be achieved rapidly despite ever diminishing training time and resources. On the other hand, cross cover commitments to satisfy the European Working Time Directive (EWTD) and Hospital at Night scheme demand a much broader set of skills …
Which research degree should I do—MSc, MD, or PhD?
Authors: Shehan Hettiaratchy
Journal: BMJ (2004)

Got a career or related problem that needs answering? Can't 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.
Surgeons take as long as 15 years to reach peak performance, study shows
Authors: Anne Gulland
Journal: BMJ (2015)

Surgeons hit a plateau in their performance of 1-15 years depending on the procedure they are performing, a study in the Annals of Surgery has shown.1

A systematic review of 57 studies looking at the influence that experience and the number of procedures carried out have on individual surgeons’ performance found that, after an initial learning phase, surgeons hit a plateau in performance.

This level is reached at any time from one to 15 years, or 25 to 750 cases, depending on the complexity of the procedure, the authors found. For example, single port laparoscopic cholecystectomy can be learned in eight cases, whereas it takes at least five years to learn septomeatoplasty, the authors found.

They wrote that the presence …
Alopecia areata is a medical disease
Authors: Dorota Z. Korta, Angela M. Christiano, Wilma Bergfeld, Madeleine Duvic, Abby Ellison, Jennifer Fu, John E. Harris, Maria K. Hordinsky, Brett King, Dory Kranz, Julian Mackay-Wiggan, Amy McMichael, David A. Norris, Vera Price, Jerry Shapiro, Natasha Atanaskova Mesinkovska
Journal: Journal of the American Academy of Dermatology (2018)
Ever-Pregnant Female Blood Donors and Mortality Risk in Male Recipients
Authors: Omer Ali, Mohamed Fawzi Wasfi, Chika Edward Uzoigwe
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
Emotional competence may help trainees cope in emergencies, study says
Authors: Matthew Limb
Journal: BMJ (2015)

Inexperienced doctors who have a high level of “emotional competence” are “significantly more successful” in an emergency care simulation than those with low emotional competence, a study has found.1

Researchers working in France said that doctors with high emotional competence can manage better when a patient suddenly and unexpectedly deteriorates and use their knowledge to explore alternative diagnoses. They believe that training in emotional management training, based on teaching how to control emotions that impede activity, could be “beneficial” in simulation exercises.

Studies of doctors’ “affective state” during medical practice show that it has an important …
Efficacy, safety, and immune activation with pegylated human IL-10 (AM0010) in combination with an anti-PD1 in advanced NSCLC.
Authors: Deborah Jean Lee Wong, Jeffrey Gary Schneider, Raid Aljumaily, Wolfgang Michael Korn, Jeffrey R. Infante, Manish R. Patel, Karen A. Autio, Kyriakos P. Papadopoulos, Aung Naing, Nashat Y. Gabrail, Pamela N. Munster, Jonathan Wade Goldman, Peter Van Vlasselaer, Gail Linda Brown, Annie Hung, Martin Oft, Edward B. Garon
Journal: Journal of Clinical Oncology (2017)

9091 Background: Although IL-10 has anti-inflammatory properties, it stimulates cytotoxicity and proliferation of intratumoral antigen activated CD8+ T cell at higher concentrations. AM0010 is anticipated to activate antigen stimulated, intratumoral CD8 T cells while PD-1 inhibits them, providing the rationale for combining AM0010 and anti-PD-1 antibody. Methods: We treated a cohort of 34 NSCLC pts with AM0010 (10-20mg/kg QD, SC) and a PD-1 inhibitor [pembrolizumab (2mg/kg, q3wk IV; n=5) or nivolumab (3mg/kg, q2wk IV; n=29)]. Tumor responses were assessed by irRC every 8 weeks. Immune responses were measured by analysis of serum cytokines (Luminex), activation of blood derived T cells (FACS) and peripheral T cell clonality (TCR sequencing). Tumor PD-L1 expression was confirmed by IHC (22C3). Results: Pts had a median of 2 prior therapies. Median follow-up is 9.6 mo (range 0.5-77.3) in this fully enrolled cohort. AM0010 plus anti-PD-1 was well-tolerated. TrAEs were reversible and transient, with most being low grade, most commonly fatigue and pyrexia. G3/4 TrAEs were thrombocytopenia (7), anemia (6), fatigue (4), rash (3), pyrexia (2), hypertriglyceridemia (1) and pneumonitis (1). As of Jan. 31 2017, 22 pts had at least 1 tumor assessment. Partial responses (PRs) were observed in 8 pts (36.4%). 17 of these 22 pts had tissue for analysis of percent of tumor cells with PD-L1 expression (22C3): 58.8% had &lt;1%, 17.7% had 1-49% and 23.5% had &gt;50%. Best response data stratified for PD-L1 are shown in the table. Median PFS and OS for the entire cohort have not been reached. Updated outcome data that includes all enrolled pts will be available at the meeting. AM0010 plus anti-PD1 increased serum Th1 cytokines (IL-18, IFNγ), the number and proliferation of PD1+ Lag3+ activated CD8+ T cells and a de-novo oligoclonal expansion of T cell clones in the blood while decreasing TGFβ. Conclusions: AM0010 in combination with anti-PD1 is well-tolerated in advanced NSCLC pts. The efficacy and the observed CD8+ T cell activation is promising. Clinical trial information: NCT02009449. [Table: see text]
Inflammasome biology, molecular pathology and therapeutic implications
Authors: Fawaz Awad, Eman Assrawi, Camille Louvrier, Claire Jumeau, Sophie Georgin-Lavialle, Gilles Grateau, Serge Amselem, Irina Giurgea, Sonia-Athina Karabina
Journal: Pharmacology & Therapeutics (2018)
CCGs must do more to engage GP members, finds survey
Authors: Caroline White
Journal: BMJ (2013)

Leaders of clinical commissioning groups need to work much harder to reach out to their GP members if they are to prove that these new organisations are not just a rehash of primary care trusts, concludes a joint report from the Nuffield Trust and the King’s Fund.1

The report—which is based on interviews and surveys with GPs at six representative sites in England—highlights a considerable gap between the views of those in charge of these GP led member organisations and GPs without formal roles.

Many GPs don’t have a strong sense of ownership of their local CCG …
3D cell printing of in vitro stabilized skin model and in vivo pre-vascularized skin patch using tissue-specific extracellular matrix bioink: A step towards advanced skin tissue engineering
Authors: Byoung Soo Kim, Yang Woo Kwon, Jeong-Sik Kong, Gyu Tae Park, Ge Gao, Wonil Han, Moon-Bum Kim, Hyungseok Lee, Jae Ho Kim, Dong-Woo Cho
Journal: Biomaterials (2018)
Masters in Public Health (MPH)
Authors: Amitava Banerjee
Journal: BMJ (2006)

Any doctor or medical student with an interest in public health at any point in their career. Medical qualifications are not required—international students from all backgrounds enrol, including those from nursing, management consultancy, and non-governmental organisations, also government officials and computer scientists.

September 2004 to June 2005 at Harvard University School of Public Health, Boston, USA. I had completed my preregistration house officer year and done six months as an accident and emergency senior house officer and six months as an SHO in cardiothoracic surgery in the United Kingdom.

It is a nine month course over one academic year. An intensive eight week summer session is also held each year, so you can begin your studies earlier or spread the degree over three consecutive summer sessions.

Both cardiology and public health greatly interest me. Much work needs to be done in public health terms in the field of cardiology, and both interests can be combined in a single career. The Masters in Public Health (MPH) has given me …
Targeted next-generation sequencing for differential diagnosis of neurofibromatosis type 2, schwannomatosis, and meningiomatosis
Authors: Camille Louvrier, Eric Pasmant, Audrey Briand-Suleau, Joëlle Cohen, Patrick Nitschké, Juliette Nectoux, Lucie Orhant, Cécile Zordan, Cyril Goizet, Stéphane Goutagny, Dominique Lallemand, Michel Vidaud, Dominique Vidaud, Michel Kalamarides, Béatrice Parfait
Journal: Neuro-Oncology (2018)

Clinical overlap between neurofibromatosis type 2 (NF2), schwannomatosis, and meningiomatosis can make clinical diagnosis difficult. Hence, molecular investigation of germline and tumor tissues may improve the diagnosis. We present the targeted next-generation sequencing (NGS) of NF2, SMARCB1, LZTR1, SMARCE1, and SUFU tumor suppressor genes, using an amplicon-based approach. We analyzed blood DNA from a cohort of 196 patients, including patients with NF2 (N = 79), schwannomatosis (N = 40), meningiomatosis (N = 12), and no clearly established diagnosis (N = 65). Matched tumor DNA was analyzed when available. Forty-seven NF2-/SMARCB1-negative schwannomatosis patients and 27 NF2-negative meningiomatosis patients were also evaluated. A NF2 variant was found in 41/79 (52%) NF2 patients. SMARCB1 or LZTR1 variants were identified in 5/40 (12.5%) and 13/40 (∼32%) patients in the schwannomatosis cohort. Potentially pathogenic variants were found in 12/65 (18.5%) patients with no clearly established diagnosis. A LZTR1 variant was identified in 16/47 (34%) NF2/SMARCB1-negative schwannomatosis patients. A SMARCE1 variant was found in 3/39 (∼8%) meningiomatosis patients. No SUFU variant was found in the cohort. NGS was an effective and sensitive method to detect mutant alleles in blood or tumor DNA of mosaic NF2 patients. Interestingly, we identified a 4-hit mechanism resulting in the complete NF2 loss-of-function combined with SMARCB1 and LZTR1 haploinsufficiency in two-thirds of tumors from NF2 patients. Simultaneous investigation of NF2, SMARCB1, LZTR1, and SMARCE1 is a key element in the differential diagnosis of NF2, schwannomatosis, and meningiomatosis. The targeted NGS strategy is suitable for the identification of NF2 mosaicism in blood and for the investigation of tumors from these patients.
I am in the middle of the traditional preregistration house officer year, but would like to apply for an F2 post to commence in August this year—is this possible?
Authors: Anne Hastie
Journal: BMJ (2005)

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USE OF DRUG-ELUTING STENTS VERSUS STANDARD NITINOL STENTS AFTER DRUG-COATED BALLOON ANGIOPLASTY OF THE SUPERFICIAL FEMORAL ARTERY: INSIGHTS FROM THE MULTICENTER EXCELLENCE IN PERIPHERAL ARTERY DISEASE (XLPAD) REGISTRY
Authors: Omar Jawaid, Haekyung Jeon-Slaughter, Damianos Kokkinidis, Subhash Banerjee, Ehrin J. Armstrong
Journal: Journal of the American College of Cardiology (2018)
IMPACT OF ACUTE ADMINISTRATION OF CORTICOSTEROIDS PRIOR TO PERCUTANEOUS CORONARY ANGIOGRAPHY IN DIABETIC PATIENTS WITH CONTRAST ALLERGY
Authors: Bashar Amr, Matthew Lippman, Nilay Patel, Patrick Tobbia, Michael Pierpoline, Tyler Buechler, Tarun Dalia, Nicholas Isom, Peter Tadros, Eric Hockstad, Mathew Earnest, Ashwani Mehta, Mark Wiley, John Chen, Kamal Gupta
Journal: Journal of the American College of Cardiology (2018)
IMPACT AND PREDICTORS OF PARAVALVULAR REGURGITATION FOLLOWING IMPLANTATION OF THE FULLY REPOSITIONABLE AND RETRIEVABLE LOTUS TRANSCATHETER AORTIC VALVE: RESULTS FROM THE REPRISE III RANDOMIZED CONTROLLED TRIAL
Authors: Daniel O’Hair, Vivek Rajagopal, Axel Linke, Dean Kereiakes, Ron Waksman, Vinod H. Thourani, Nicolas Dumonteil, Robert Hodson, Jeffrey Southard, John Harrison, Samir Kapadia, Dominic Allocco, Ian Meredith, Michael Reardon, Ted Feldman
Journal: Journal of the American College of Cardiology (2018)
Developing career resilience in medicine
Authors: Helen Grote, Mazn Raouf, Caroline Elton
Journal: BMJ (2012)

The insecurity inherent in working in a rapidly changing workplace, together with personal demands such as caring for children, coping with illness, and moving to new parts of the country, require trainees to develop “career resilience” or “self reliance” to cope. <b>Helen Grote</b> (together with <b>Mazn Raouf</b> and <b>Caroline Elton</b>) explores what this means in practice
Experience of 1,000 patients.
Authors: Julieta Iorio, Martin Eleta, Florencia Bambacci, Lucrecia Cuneo, David Polillo
Journal: Journal of Clinical Oncology (2018)

294 Background: The aim of this study is to present our experience between the correlation of 18 fluorocholine (FCH) positron emission tomography (PET)/computed tomography (CT) findings and PSA levels in detecting local recurrence, lymphatic/haematogenous involvement in patients with prostate carcinoma. Methods: 1075 patients with prostate cancer were enrolled between July 2012 and August 2017. Patients were separated in two main groups: biochemical progression 913 (85%) and 162 (15%) staging. Each group was divided in three subgroups according to PSA levels: ≤1 ng/ml; ≥ 1-5ng/ml and &gt; 5 ng/ml. All of them underwent “Dual phase” PET-CT consisting of intial pelvis starting 20 minutes after the injection of 18 F-Choline followed by 1 hour delayed PET-CT of the whole body. Results: 1641 lesions showed increased uptake on FCH-PET and were interpretated as local recurrence or metastases .According to biochemical progression we identified for each subgroup: 118 patients (13%) (≤1 ng/ml); 265 patients (29%) (≥ 1-5ng/ml); 530 patients (58%) ( &gt; 5 ng/ml) and for staging we identified for each subgroup: 81 patients (50%) (≤1 ng/ml); 47 patients (29%) (≥ 1-5ng/ml); 20 patients (34%) ( &gt; 5 ng/ml). The results are shown on table 1: Patients presenting biochemical progression the majority of them have PSA levels of 5 ng/ml or more and the most frequent site of metastases were pelvic lymph nodes, on the other hand, for staging patients we have found that most of them have PSA levels of ≤1 ng/ml and we detected that they most commonly have local compromise. Conclusions: In our experience 18 FCH PET/CT is a useful tool to detect lesions in patients with biochemical progression but it seems to have limited value for staging. [Table: see text]