tbuckley/cabot-search huggingface dataset:
Identifying Educational Needs and Practice Gaps of European Hematologists and Hematology Nurses in the Treatment and Management of Multiple Myeloma
Authors: Suzanne Murray, Mohamad Mohty, Sophie Peloquin, Niels W. Van de Donk, Sara Leitão, Sara Labbé, Sharon West, Eva Hofstädter‐Thalmann, Pieter Sonneveld
Journal: HemaSphere (2018)

This needs-assessment aimed to identify clinical challenges faced by hematologists and hematology nurses in the diagnosis, treatment, and management of multiple myeloma, as well as contextual barriers hindering optimal care of patients with multiple myeloma. This manuscript focuses on key findings in relation to decision-making regarding new treatment options. A mixed methods study consisting of qualitative (from semistructured interviews) and quantitative data (from an online survey) was conducted in 8 European countries among hematologists and hematology nurses. The triangulated data led to the identification of 3 key findings related to decision-making: (1) Educational needs regarding mechanisms of action and side effect profiles of new therapies, (2) educational needs regarding the sequencing and combination of new agents with current therapies, and (3) contextual barriers to the integration of new agents. Specific knowledge and skill gaps were identified as causalities of the educational needs, providing information to guide future educational programs. Of note, 34% of hematologists and 69% of nurses reported suboptimal knowledge of the mechanisms of action of new agents and 30% of hematologists reported suboptimal skills integrating new agents in combination with current treatments. This needs-assessment highlighted the importance to address the educational needs and their underlying causes through medical education activities to ensure hematologists and hematology nurses are up-to-date with the latest treatments in the field as they become available. The contextual barriers identified should be considered when designing the educational programs to ensure content is applicable to the clinical reality of learners.
Specialty training interview skills course
Authors: Lilantha Wedisinghe
Journal: BMJ (2009)

Several competencies are assessed at interviews for specialty training, and unique skills are required for the best demonstration of these competencies. Interview skills courses aim to help prospective interviewees develop such skills. My journey towards securing a year 3 specialty training post took 14 months, during which time I attended six specialist trainee interview skills courses, all of which I believe were worth it.

Any junior doctor who wishes to maximise his or her interview performance. It is highly recommended for doctors who have been unsuccessful in the recruitment process.

Competition for the specialty training programme is increasing. Enlistment for some specialties is through a structured, centralised system that offers only one or two interviews. Therefore, the chance of securing a post in such a competitive recruitment …
Regeneration of diaphragm with bio-3D cellular patch
Authors: Xiu-Ying Zhang, Yusuke Yanagi, Zijing Sheng, Kouji Nagata, Koichi Nakayama, Tomoaki Taguchi
Journal: Biomaterials (2018)

Neonates with congenital diaphragmatic hernia often require surgical defect closure with a patch. Alternatives to native diaphragmatic tissue are critically needed for this paediatric surgery. The clinical efficacy of mesh patches is limited by complications associated with residual foreign material and by hernia recurrence. In this study, we used a novel bio-3D printer method to generate large scaffold-free tissue patches composed of human cells. The resulting large tissue constructs had high elasticity and strength. Cellular patches were transplanted into rats with surgically created diaphragmatic defects. Rats survived for over 710 days after implantation of tissue constructs. CT confirmed complete tissue integration of the grafts during rat growth. Histology revealed regeneration of muscle structure, neovascularization, and neuronal networks within the reconstructed diaphragms. Our results demonstrate that created cellular patches are a highly safe and effective therapeutic strategy for repairing diaphragmatic defects, and thus pave the way for a clinical trial.
I have completed my MRCOG and would like to work in community gynaecology or infertility. How should I go about this?
Authors: Alan Mathers
Journal: BMJ (2007)

Have a career related problem that needs answering? Can9t find the 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>
WAIST CIRCUMFERENCE VERSUS OTHER OBESITY INDICES FOR PREDICTION OF CORONARY ARTERY DISEASE IN ESSENTIAL HYPERTENSION
Authors: Konstantinos P. Tsioufis, Kyriakos Dimitriadis, Athanasios Kordalis, Alexandros Kasiakogias, Dimitris Roussos, Ioannis Liatakis, Theodoros Kalos, Evaggelia Koutra, Dimitris Syrseloudis, Ioannis Kallikazaros, Dimitris Tousoulis
Journal: Journal of the American College of Cardiology (2015)
Aseptic Loosening of Elbow Prostheses Diagnosed on F-18 FDG PET/CT
Authors: Chidambaram Natrajan Balasubramanian Harisankar, Bhagwant Rai Mittal, Anish Bhattacharya, Madan Parmar, Baljinder Singh
Journal: Clinical Nuclear Medicine (2010)

A 35-year-old woman, having recurrent pain after total elbow arthroplasty, was subjected to positron emission tomography/computed tomography with fluorodeoxyglucose (FDG PET/CT) to rule out infected orthopedic hardware. A diagnosis of aseptic loosening was made based on the gram staining and 9 months of clinical follow-up. This case report highlights the utility of FDG PET/CT in evaluation of painful elbow prostheses and describes the FDG uptake pattern in confirmed case of aseptic loosening.
Team research must credit individuals, says Academy of Medical Sciences
Authors: Matthew Limb
Journal: BMJ (2016)

The Academy of Medical Sciences has warned of a threat to “team science” if individual participants in biomedical research projects do not get the credit they deserve.

It said that talented researchers could drop out of science, abandon research, or shun major scientific collaborations if their contributions were not recognised.

The Academy published a report on 9 March that recommended new ways of acknowledging and rewarding researchers’ contributions.1

Anne Ridley, who chaired the working group said, “We need team science to be attractive to talented researchers or it will not develop.”

The report …
Ring Uncemented Plastic on Metal Hip Replacements-Results from an Independent Unit
Authors: D W H Mok, K M Bryant
Journal: Journal of the Royal Society of Medicine (1989)

We present 251 Ring uncemented plastic on metal (UPM) hip replacements with a follow-up of 2-5 years. Judging the functional results by the Harris hip evaluation for the surviving 234 hips, 79.8% were good to excellent, 11.7% fair, and 8.5% poor at an average of 3 years. The mortality within one month of surgery was 0.79%. There were 4 cases of deep infection (1.59%), 3 of which required excision arthroplasty. At 3 years, 6 hips (2.39%) had required revision, all for aseptic femoral loosening, 2 of which also had acetabular loosening. Ring UPM hip is both safe and reliable in the hands of many surgeons outside Ring's unit.
AO Principles in Operative Fracture Management for Surgeons
Authors: Simon Newman
Journal: BMJ (2008)

The Principles in Operative Fracture Management course is run by Arbeitsgemeinschaft fur Osteosythesefragen (AO), an international organisation that originated in Switzerland 50 years ago with the aim of developing excellence in the surgical management of musculoskeletal trauma. It focuses on developing an understanding of the principles behind fracture fixation, learning how to plan operations, and acquiring the necessary practical skills. Courses are held four times a year in the United Kingdom and the Republic of Ireland (in Edinburgh, Dublin, Leeds, and Basingstoke).

The course is aimed at surgical trainees who wish to pursue a career in trauma and orthopaedics. Most participants have membership of the Royal College of Surgeons and more than six months’ experience in trauma and orthopaedics; the majority are either working or about to work at middle grade level. Participants are advised to have done the …
Diploma for graduates in management, University of London
Authors: Bhaskar Punukollu
Journal: BMJ (2010)

The University of London describes the diploma for graduates in management as: “suitable for graduates of any discipline who, for professional or personal reasons, wish to secure a stand-alone qualification in management. It is also ideal for those who wish to undertake postgraduate work and whose first degree is in an unrelated field.”

I took this course between my final specialist registrar year and my current post as a first year consultant.

As a specialist registrar I attended the King’s Fund management course and spent a week shadowing the chief executive officer. I attended Monitor and Medical Protection Society conferences, with lectures from the NHS’s chief executive, from …
BMA’s withdrawal from negotiations was “complete surprise,” says NHS Employers
Authors: Abi Rimmer
Journal: BMJ (2014)

The BMA’s decision to cease negotiating on changes to contracts for consultants and junior doctors came as a “complete surprise,” NHS Employers has said.

Last week the BMA announced that negotiations between itself and NHS Employers, which represents the government in contract negotiations, had stalled.1 The BMA said that negotiations had come to a standstill because the government had refused to agree necessary safeguards to protect doctors from working excessively long hours.

In a statement NHS Employers said that the BMA informed it of the decision to “cease negotiating” on both the consultant and junior doctors’ contracts through social media.2 It said that the BMA’s decision to withdraw from negotiations had come “as a complete surprise” and that it had agreed with the association to discuss safeguards on working hours in the consultants’ contract …
If I take more than 12 months off from practising medicine what will I need to do before returning in terms of my General Medical Council registration, pension, and finding a new job (probably GP)?
Authors: Brian Keighley
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>
Near infrared-emitting persistent luminescent nanoparticles for Hepatocellular Carcinoma imaging and luminescence-guided surgery
Authors: Ting Ai, Wenting Shang, Hao Yan, Chaoting Zeng, Kun Wang, Yuan Gao, Tianpei Guan, Chihua Fang, Jie Tian
Journal: Biomaterials (2018)
Testicular Cancer Review Panel: Multidisciplinary specialist review of a rare cancer at Kaiser Permanente, Northern California.
Authors: Andrea Lynne Harzstark, Max Kong, Robert Brinsko, Kavita Mamtora, Lisa J. Herrinton, Liyan Liu, Sonali Kumar, Tatjana Kolevska, David M. Baer, Kotak Dinesh M., Mark St. Lezin, Joseph C Presti
Journal: Journal of Clinical Oncology (2018)

561 Background: Testicular cancer is a rare disease; multidisciplinary management by experienced clinicians is recommended. Methods: Multidisciplinary specialized review of all new testicular cancer cases was established in a community setting by creating a twice monthly Testicular Cancer Review Panel, comprised of two subspecialized medical oncologists and two surgical urologic oncologists, at Kaiser Permanente in Northern California. An early ascertainment list of new testicular cancer diagnoses was obtained and review of the history, labs, pathology reports, and all relevant imaging was performed via a web-based conference. Urologic cancer fellowship trained pathologists and body fellowship trained radiologists were available for secondary review when requested. All recommendations were documented in patient charts. Results: From June 2016 to June 2017, 131 cases were reviewed. Review by the panel resulted in significant changes in care in 19 of 131 patients (14.5%). Pathology and radiology re-reviews were the most common sources of changes in treatment recommendations. Embryonal predominant T1 disease was referred for GU pathology review in 14 cases; in 8, lymphovascular invasion was identified, upstaging 6.1% of patients from 1A to 1B, changing treatment from observation to chemotherapy. Radiology re-review changed the stage and treatment in 11 patients (8.4%), identifying lymphadenopathy not previously noted in 7 patients and reassessing previously identified lymphadenopathy as a non-pathologic finding in 4 patients. The percentage of patients with stage I seminoma observed rather than undergoing adjuvant therapy increased from 11/15 (73.3%) over the first six months of the panel to 18/20 (90%) over the second six months. Convening the panel also resulted in dissemination of oncologic knowledge among treating physicians. Conclusions: Multidisciplinary specialized case review for a rare disease is feasible in the community setting and frequently alters care.
Limonoids from seeds of Azadirachta indica A. Juss. and their cytotoxic activity
Authors: Jian Chen, Xiaona Fan, Jianhua Zhu, Liyan Song, Zhiwei Li, Fei Lin, Rongmin Yu, Hanhong Xu, Jiachen Zi
Journal: Acta Pharmaceutica Sinica B (2018)

Four new limonoid-type nortriterpenoids, 1-detigloyl-1-O-methacryloylsalannin (1), 28-deoxo-2,3-dihydronimbolide (2), 12-acetoxy-3-O-acetyl-7-O-tigloylvilasinin (3) and 12-acetoxy-3-O-acetyl-7-O-methacryloylvilasinin (4), along with five known ones, were isolated from seeds of Azadirachta indica A. Juss. Their structures were elucidated by various spectroscopic methods, including UV, IR, MS, NMR, X-ray crystallography, quantum chemical calculation, as well as by comparison of their spectroscopic data with those reported. In the in vitro cytotoxic assay, 2 showed inhibitory activity against human breast cancer MDA-MB-231 cell line with IC50 value of 7.68±1.74 μmol/L, and 5 inhibited growth of human cervical cancer Hela cell line, melanoma A375 cell line and promyelocytic leukemia HL-60 cell line, with IC50 12.00±2.08, 17.44±2.11, and 13.95±5.74 μmol/L, respectively.
Abstract 13134: Impact of the American Heart Association’s 2007 Guidelines on the Practice of Dental Prophylaxis for the Prevention of Infective Endocarditis in Olmsted County, Minnesota
Authors: Daniel C DeSimone, Abdelghani El Rafei, Alan B Carr, Walter A Rocca, Jennifer St. Sauver, Brian D Lahr, James M Steckelberg, Walter R Wilson, Larry M Baddour
Journal: Circulation (2015)

Background: In 2007, the American Heart Association (AHA) infective endocarditis (IE) prevention guidelines recommended that antibiotic prophylaxis before invasive dental procedures for the “moderate risk” (MR) group, which represented the bulk of patients who were to receive prophylaxis before 2007, be eliminated. This decision was met with much concern among some healthcare providers and that concern persists today. We therefore evaluated dental office records in Olmsted County (OC), Minnesota to determine whether patients included in the MR group continue to receive antibiotic prophylaxis despite the 2007 AHA recommendations. Methods: Eligible patients include all adult (≥18 years) residents of OC, classified as having MR cardiac condition for IE (i.e. mitral valve prolapse [MVP], bicuspid aortic valve [BAV], hypertrophic obstructive cardiomyopathy [HOCM], acquired valvular dysfunction [AVD]), with at least one dental visit between January 1, 2005 and June 1, 2015. Eight dental offices located within OC were sampled to identify both dental procedures and whether antibiotic prophylaxis was administered according to AHA guidelines. Results: We identified 334 MR patients. Approximately 62% of MR patients received antibiotic prophylaxis prior to the change in AHA guidelines in 2007. There was a decrease to 7% post-2007 AHA guidelines (P&lt;.001). The magnitude of decline was greater among visits for dental cleanings (from 63% to 6%), as compared to other invasive procedures (57% to 11%; P=0.003) (Figure 1). AVD was the most common cardiac condition (85%), followed by MVP (8%), and BAV (4%). Conclusion: Following publication of the 2007 AHA IE prevention guidelines, there was a rapid, 9-fold decrease in antibiotic prophylaxis in patients with MR cardiac conditions who underwent invasive dental procedures in OC. These data are also critical as we attempt to evaluate the impact, if any, of this practice on the incidence of IE due to viridans group streptococci.
Endothelial TFEB (Transcription Factor EB) Positively Regulates Postischemic Angiogenesis
Authors: Yanbo Fan, Haocheng Lu, Wenying Liang, Minerva T. Garcia-Barrio, Yanhong Guo, Ji Zhang, Tianqing Zhu, Yibai Hao, Jifeng Zhang, Y. Eugene Chen
Journal: Circulation Research (2018)

Postischemic angiogenesis is critical to limit the ischemic tissue damage and improve the blood flow recovery. The regulation and the underlying molecular mechanisms of postischemic angiogenesis are not fully unraveled. TFEB (transcription factor EB) is emerging as a master gene for autophagy and lysosome biogenesis. However, the role of TFEB in vascular disease is less understood.We aimed to determine the role of endothelial TFEB in postischemic angiogenesis and its underlying molecular mechanism.In primary human endothelial cells (ECs), serum starvation induced TFEB nuclear translocation. VEGF (vascular endothelial growth factor) increased TFEB expression level and nuclear translocation. Utilizing genetically engineered EC-specific TFEB transgenic and KO (knockout) mice, we investigated the role of TFEB in postischemic angiogenesis in the mouse hindlimb ischemia model. We observed improved blood perfusion and increased capillary density in the EC-specific TFEB transgenic mice compared with the wild-type littermates. Furthermore, blood flow recovery was attenuated in EC-TFEB KO mice compared with control mice. In aortic ring cultures, the TFEB transgene significantly increased vessel sprouting, whereas TFEB deficiency impaired the vessel sprouting. In vitro, adenovirus-mediated TFEB overexpression promoted EC tube formation, migration, and survival, whereas siRNA-mediated TFEB knockdown had the opposite effect. Mechanistically, TFEB activated AMPK (AMP-activated protein kinase)-α signaling and upregulated autophagy. Through inactivation of AMPKα or inhibition of autophagy, we demonstrated that the AMPKα and autophagy are necessary for TFEB to regulate angiogenesis in ECs. Finally, the positive effect of TFEB on AMPKα activation and EC tube formation was mediated by TFEB-dependent transcriptional upregulation of MCOLN1 (mucolipin-1).In summary, our data demonstrate that TFEB is a positive regulator of angiogenesis through activation of AMPKα and autophagy, suggesting that TFEB constitutes a novel molecular target for ischemic vascular disease.
<i>I would like to become a medical journalist. Where do I start?</i>
Authors: Leyla Sanai
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>
The Chairman of the Royal College of General Practitioners
Authors: Zosia Kmietowicz
Journal: BMJ (2005)

Mayur Lakhani took over the chairmanship of the Royal College of General Practitioners (RCGP) in November 2004. He graduated from the University of Dundee in 1983 and has worked in Scotland, Cambridge, and Harlow. Since 1991 he has been a general practitioner (GP) principal in Sileby near Loughborough. He came to the United Kingdom in 1972 as a 12 year old boy after the dictator Idi Amin gave all Asians in Uganda 90 days to leave the country. His family left within 12 days of the announcement, leaving behind all their belongings. He is the RCGP9s youngest ever chairman.
Abstract 14589: Adiponectin Inhibits Hepatic Production of Triglyceride-Rich Apolipoprotein B Lipoproteins Through Both LDL-Receptor Dependent and Independent Mechanisms
Authors: Michelle Melone, Shirya Rashid
Journal: Circulation (2015)

Background and Rationale: Increasing plasma concentrations of the anti-inflammatory protein, adiponectin, are significantly and independently associated with a lower risk of coronary heart disease (CHD), while hypoadiponectinemia, conversely, is a strong risk factor for CHD. The mechanisms by which adiponectin mediates its cardioprotective role are not clearly understood. Here, we have elucidated a key cause of the cardioprotective effect of adiponectin, involving a direct inhibitory action on hepatic production of pro-atherogenic triglyceride-rich apolipoprotein B (apoB) lipoproteins, mediated through both LDL-receptor dependent mechanisms, involving PCSK9, and LDL-receptor independent mechanisms. Methods and Results: Cultured human hepatocytes (HepG2 cells) and primary human hepatocytes were treated with physiological concentrations of purified recombinant human adiponectin (10 μg/mL) for 24 hours. Adiponectin treatment reduced endogenous apoB cellular expression and secretion markedly by 60% and 30%, respectively, (P&lt;0.01). Adiponectin also reduced apoB production stimulated by prior treatment of cells with oleate or with pro-inflammatory obese human serum (25% reduction for both, P&lt;0.01). Adiponectin-mediated inhibition of cellular apoB production occurred through a substantial increase in levels of hepatocyte LDL-receptors (70%, P&lt;0.01), which promote proteasome-mediated apoB degradation, and which resulted from a 50% reduction in cellular PCSK9 levels (P&lt;0.01 for both). Multiple LDL-receptor independent effects of adiponectin involved mechanisms which reduce cellular apoB stability: (1) a decrease in cellular microsomal triglyceride transfer protein (MTP) (by 25%, (P&lt;0.01); (2) an increase in AMP kinase (by 40%, P&lt;0.01); and (3) marked stimulation of the Akt/Erk insulin signaling pathways. Conclusions: Adiponectin has a direct mitigating effect on hepatic apoB production through mechanisms mediated in part by the LDL-receptor and PCSK9, MTP and the insulin signaling pathway. These findings indicate that that inhibition of apoB may explain in large part adiponectin’s cardioprotective role. Furthermore, targeted adiponectin-based therapies may be a novel approach to inhibit hepatic apoB production.