tbuckley/cabot-search huggingface dataset:
PATENT FORAMEN OVALE CLOSURE VERSUS MEDICAL THERAPY TO PREVENT RECURRENT STROKE: A META-ANALYSIS AND TRIAL SEQUENTIAL ANALYSIS
Authors: Tomo Ando, Anthony Holmes, Mohit Pahuja, Arshad Ali Javed, Alexandros Briasoulis, Tesfaye Telila, Hisato Takagi, Theodore Schreiber, Luis Afonso, Cindy Grines, Sripal Bangalore
Journal: Journal of the American College of Cardiology (2018)
Open science versus commercialization: a modern research conflict?
Authors: Timothy Caulfield, Shawn HE Harmon, Yann Joly
Journal: Genome Medicine (2012)

Efforts to improve research outcomes have resulted in genomic researchers being confronted with complex and seemingly contradictory instructions about how to perform their tasks. Over the past decade, there has been increasing pressure on university researchers to commercialize their work. Concurrently, they are encouraged to collaborate, share data and disseminate new knowledge quickly (that is, to adopt an open science model) in order to foster scientific progress, meet humanitarian goals, and to maximize the impact of their research. We present selected guidelines from three countries (Canada, United States, and United Kingdom) situated at the forefront of genomics to illustrate this potential policy conflict. Examining the innovation ecosystem and the messages conveyed by the different policies surveyed, we further investigate the inconsistencies between open science and commercialization policies. Commercialization and open science are not necessarily irreconcilable and could instead be envisioned as complementary elements of a more holistic innovation framework. Given the exploratory nature of our study, we wish to point out the need to gather additional evidence on the coexistence of open science and commercialization policies and on its impact, both positive and negative, on genomics academic research.
Inflammatory response and cytokine levels induced by intralesional photodynamic therapy and 630-nm laser in a case series of basal cell carcinoma
Authors: María Jesús Suárez-Valladares, Sara María Calleja-Antolín, Jose María García Ruíz de Morales, Manuel Angel Rodríguez Prieto, Jesús Vega-Gutierrez
Journal: Journal of the American Academy of Dermatology (2018)
Royal College of Anaesthetists launches review of equality and diversity in its membership exam
Authors: Abi Rimmer
Journal: BMJ (2014)

The Royal College of Anaesthetists has commissioned a review of its membership exam to examine equality and diversity issues.

The college said that the Fellowship of the Royal College of Anaesthetists (FRCA) exam met the “minimum standards” for equality and diversity “but improvements are required.”

In its annual specialty report for 2013 the college said that candidates who achieved their primary medical qualification (PMQ) in the United Kingdom had achieved the highest pass rate in all examination components of the FRCA exam.1 The report, which was submitted to the General Medical Council (GMC), added, “Candidates with PMQs from overseas performed less well, with those from …
Clinical significance of monitoring <i>KRAS</i> in tissue and plasma of pancreatic cancer patients.
Authors: Fumiaki Watanabe, Koichi Suzuki, Toshiki Rikiyama
Journal: Journal of Clinical Oncology (2020)

745 Background: KRAS monitoringprovides valuable information for early diagnosis and prediction of treatment outcome in colorectal cancer. KRASmutation is observed in only half of colon cancer patients, whereas it is detected in 90% of pancreatic cancer patients. Therefore, investigating tumor DNA in plasma by KRAS monitoringmay be even more valuablein pancreatic cancerpatients. In this study, we elucidated the clinicalsignificance of KRASmonitoring in pancreatic cancer patients during treatment. Methods: KRASin tumor tissues was analyzed for mutations by Scorpion ARMS or RASKET in 83 patients with pancreatic tumors. KRASin plasma was analyzed for mutations(G12D, G12V, G12C, G12A, G12S, G12R, G13D, Q61L, and Q61H) using droplet digital polymerase chain reaction in 88 patients who underwent the curative surgery (N = 45) or the chemotherapy (N = 33) and who had KRAS mutation in their tissues. Results: KRASmutation in tumor tissues was detected in 74 of 83 patients (89.2%). These 74 patients showed significantly poorer prognosis (MST; 32) than the seven patients without mutation (p = 0.03), whose MST were 193. Monitoring of KRASin plasma revealed KRASmutation in 35 of 88 patients (39.8%). In patients who underwent the chemotherapy (N = 33), 2years OS of patients who detected KRASmutation in plasma (N = 23) was 16.4% and them which not detected it (N = 10) was 53.3% (p = 0.18). But in the curative resection group (N = 45), 3years OS of patients who detected KRASmutation in plasma (N = 12) was 16.7% and them which not detected it (N = 33) was 68.2% (p = 0.00). Conclusions: KRASmutation in tissue and plasma could be a valuable predictive and prognostic biomarker in pancreatic cancer patients.
A critical role for IL-18 in transformation and maturation of naive eosinophils to pathogenic eosinophils
Authors: Sathisha Upparahalli Venkateshaiah, Akanksha Mishra, Murli Manohar, Alok K. Verma, Priya Rajavelu, Rituraj Niranjan, Laurianne G. Wild, Nereida A. Parada, Uwe Blecker, Joseph A. Lasky, Anil Mishra
Journal: Journal of Allergy and Clinical Immunology (2018)
DIAGNOSTIC AND PROGNOSTIC VALUE OF CORONARY CALCIUM IN COMBINATION WITH DIAMOND-FORRESTER SCORE IN ACUTE CHEST PAIN PATIENTS
Authors: Philip Lavenburg, Gregg Cantor, Olufunmilayo Agunloye, Ivan Crnosija, Erin Taub, Pamela Noack, Michael Poon, Getu Teressa
Journal: Journal of the American College of Cardiology (2018)
EXTRA-ADRENAL PHEOCHROMOCYTOMA PRESENTING WITH INVERSE TAKOTSUBO-PATTERN CARDIOMYOPATHY SUCCESSFULLY TREATED WITH SURGICAL RESECTION
Authors: Syed Yaseen Naqvi, Jeffrey Bruckel, Thomas Welch, Jason Pacos, Ryan Nelson, Jacob Moalem, Sabu Thomas
Journal: Journal of the American College of Cardiology (2018)
Michael William Newbery Nicholls
Authors: Harold Lipman
Journal: BMJ (2018)

Michael William Newbery Nicholls was born in London. Before and during the years of the second world war, he attended several schools in London and was then evacuated to Taunton. During his time at school, he represented English schools nationally as a successful sprinter.

Having decided to study medicine he entered University College London in September 1950 as a 2nd MB student and subsequently studied clinical medicine at UCHMS. He qualified LRCP MRCS in 1955 and MB BS (London) in 1957.

He spent his preregistration house posts as casualty officer in the Prince of Wales Hospital, Tottenham (north London), and was then house physician in chest medicine, neurology, and gastrointestinal and paediatric surgery in the same hospital.

A man of strong …
NHS spends “vast sums” on improving leadership but many programmes are based on “fads and fashions,” King’s Fund says
Authors: Matthew Limb
Journal: BMJ (2015)

The NHS spends “vast sums” on improving leadership, but many programmes are based on “fads and fashions” rather than on hard evidence, says a review commissioned by the Faculty of Medical Leadership and Management, the King’s Fund, and the Center for Creative Leadership.

A report of the review’s findings argued that healthcare organisations should use evidence to nurture cultures that deliver safe, compassionate, and high quality care, noting the importance of “collective leadership.”1

As leadership was “the most influential factor” in shaping organisational culture it was vital to ensure that the necessary leadership behaviours, strategies, and …
Royal college calls for clinician led reconfiguration of surgical services
Authors: Helen Jaques
Journal: BMJ (2013)

Surgeons should seize 2013 to lead the centralisation of specialist surgical services, before the issue is “kicked into the long grass yet again,” the Royal College of Surgeons believes. 

In a post for NHS Voices, the NHS Confederation’s blog for NHS leaders, the college’s president, Norman Williams, said that service redesign was “the greatest health challenge” facing the NHS.1 However 2013 represented a big opportunity for surgeons to reshape services …
Who do I contact about a job in Australia?
Authors: Stephen Kisely
Journal: BMJ (2004)

<i>Got a career or related 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>
Prosarcopenic Effects of Statins May Limit Their Effectiveness in Patients with Heart Failure
Authors: Agata Bielecka-Dabrowa, Jarosław Fabis, Dimitri P. Mikhailidis, Stephan von Haehling, Amirhossein Sahebkar, Jacek Rysz, Maciej Banach
Journal: Trends in Pharmacological Sciences (2018)
Level of preoperative CRP as an independent predictor of survival in patients after nephrectomy for renal cell carcinoma: Long-term outcomes.
Authors: Md Saon, Dattatraya H Patil, Tiffany Ding, Frances Y Kim, Mersiha Torlak, Kenneth Ogan, Viraj A. Master
Journal: Journal of Clinical Oncology (2018)

687 Background: Preoperative C- Reactive Protein (CRP) has predictive value for metastasis development and mortality in renal cell carcinoma (RCC). However, the predictive potential of preoperative CRP at presentation on survival after nephrectomy remains unclear. This study investigates the prognostic value of preoperative CRP on overall long term survival in RCC patients post-nephrectomy. Methods: 683 post-nephrectomy patients for localized clear cell RCC were evaluated from 2005-2017 to investigate preoperative CRP’s prognostic value on overall survival. Cohort was divided into 3 groups based on preoperative CRP (≤ 10, 10-100, &gt; 100 mg/L). Kaplan-Meier curve and Cox proportional hazards models evaluated the predictive value of preoperative CRP in addition to established covariates. Results: Mean age was 59±12 years. 81 (11.6%) patients were deceased at the end of follow-up. T-stage distribution of cohort as follows: T1 = 444 (65%), T2 = 38 (6%), T3 = 197 (29%), and T4 = 4 (1%). Log Rank test of the Kaplan–Meier estimates of survival probability in RCC patients stratified by preoperative CRP revealed significant difference (p-value &lt; 0.001). Per Cox models, high preoperative CRP values were associated with higher mortality (P &lt; 0.001), higher T Stage (P &lt; 0.001), Fuhrman Grade (P &lt; 0.001), fat invasion (P &lt; 0.001), and necrosis (P &lt; 0.001). Multivariable model identified high preoperative CRP ( &gt; 100) as an independent predictor of survival compared to low-to-normal (HR: 2.1, 95%CI: 1.00-4.23, p-value-0.05). 5-year survival of patients with CRP &gt; 100 was 43%. Conclusions: Preoperative CRP could potentially be used as an independent predictor of overall survival post nephrectomy in patients with RCC. Higher CRP values are associated with higher mortality in such patients.
Making sense of strabismus
Authors: Gwyn Samuel Williams
Journal: BMJ (2011)

Making Sense of Strabismus is a three day course run by eyelearn. Most of the tutors are staff from Alder Hey Children’s Hospital, and the course itself is based in Liverpool. I attended the inaugural Making Sense of Strabismus course, which is now held monthly.

The literature states that the course is primarily aimed at ophthalmology trainees and optometrists, although there were one or two consultant ophthalmologists attending as well. It is most suited to specialty registrars at specialty training year 3-7 level.

I did the course during the second year of specialty training, while I was working in paediatric …
FLOW RATE NOT STROKE VOLUME IS A SUPERIOR PROGNOSTIC MARKER OF TRANSORTIC FLOW AND FLOW RESERVE IN PATIENTS WITH LOW-FLOW LOW-GRADIENT AORTIC STENOSIS UNDERGOING LOW-DOSE DOBUTAMINE ECHOCARDIOGRAPHY
Authors: Anastasia Vamvakidou, Wenying Jin, Oleksandr Danylenko, George Papasozomenos, Navtej Chahal, Rajdeep Khattar, Roxy Senior
Journal: Journal of the American College of Cardiology (2018)
Integrating a paradigm shift into treatment of renal cell cancer: Effect of online CME on oncologists' knowledge and competence.
Authors: Tara Herrmann, Charlotte Warren, Haleh Kadkhoda, Erin Pacheco, David F. McDermott
Journal: Journal of Clinical Oncology (2018)

651 Background: The objective of this study was to determine the effect of online, case-based, continuing medical education (CME) on the knowledge and competence of oncologists regarding the management of metastatic renal cell cancer (mRCC). Methods: Oncologists participated in a text-based online CME activity composed of 2 patient cases with interactive questions. Evidence-based educational feedback was provided following each response. Three multiple-choice knowledge/competence and 1 self-efficacy question were selected from the set of intra-activity questions to be repeated after participation. These were used to assess the impact of the education in the form of a repeated pairs, in which each participant served as his/her own control. The analysis included: For all questions combined, McNemar’s chi-square test assessed the differences from pre- to post-assessment; P values &lt;.05 are considered statistically significant; Effect size was calculated using Cramer’s V by determining the change in proportion of participants who answered questions correctly; The activity launched online 9/2016 and data collected through 10/2016. Results: Upon completion of the activity, an improvement was observed in oncologists’ ability to: Identify the most appropriate evidence-based regimen for a patient with mRCC that has progressed on a first line TKI (60% vs 18%, P =0.019); Recognize the symptoms of an irAE in a patient receiving an immune checkpoint inhibitor (55% vs 85%, P &lt;0.001); Elicit patient preferences, goals, and values to help decide the best course of action in their care and disease management (26% vs 83%, P &lt;0.001); Feel more confident in selecting the most appropriate option for a patient with mRCC whose disease has progressed on therapy (+17%). Conclusions: An online, interactive, case-based CME activity improved the knowledge/competence of oncologists, showing that unique educational methodologies and platforms, available on-demand, can be effective tools for advancing clinical decision making in the rapidly changing environment of mRCC disease management. Additional studies are needed to assess whether improved aptitude translates to improved performance during clinical practice.
Locum numbers fall in secondary care but with concurrent rise in permanent doctors
Authors: Helen Jaques
Journal: BMJ (2012)

In January 2012 a total of 2279 locum doctors were employed by NHS hospitals and community health services, down 10% from 2534 in January 2011. 

However, the number of non-locum doctors rose by a similar number, from 90 382 to 92 280 (2.1%), in the same period.

From January 2010 to January 2011 the number of locums employed in secondary and community care had risen by 1.2%.

In particular, the number of locum trainee doctors fell dramatically in 2011 after a …
Results Reporting for Trials With the Same Sponsor, Drug, and Condition in ClinicalTrials.gov and Peer-Reviewed Publications
Authors: Kevin M. Fain, Thiyagu Rajakannan, Tony Tse, Rebecca J. Williams, Deborah A. Zarin
Journal: JAMA Internal Medicine (2018)

This study examines the extent to which trials registered in ClinicalTrials.gov by individual sponsors for the same drug and condition were available publicly in ClinicalTrials.gov and/or PubMed.
DYNAMIC CHANGES IN HIGH SENSITIVITY CARDIAC TROPONIN I IN RESPONSE TO ANTHRACYCLINE-BASED CHEMOTHERAPY: A PILOT STUDY FOR THE CARDIAC CARE TRIAL
Authors: Philip D. Adamson, Peter Hall, Ninian Lang, Iain Macpherson, Olga Oikonomidou, Morag Maclean, Steff Lewis, Heather McVicars, David Newby, Nicholas Mills, Peter Henriksen
Journal: Journal of the American College of Cardiology (2018)
Cost-effectiveness of pembrolizumab in second-line advanced bladder cancer.
Authors: Michal Sarfaty, Peter Hall, Kelvin K. Chan, Kiran Virik, Moshe Leshno, Noa Gordon, Assaf Moore, Victoria Neiman, Eli Rosenbaum, Daniel A. Goldstein
Journal: Journal of Clinical Oncology (2018)

472 Background: Recently, immune-modulating drugs have been introduced to the second line setting of advanced bladder cancer. Pembrolizumab increases overall survival and is associated with less toxicity compared to chemotherapy in this setting based on the Keynote-045 study. The high cost of immunotherapy necessitates an assessment of its value by considering both efficacy and cost. The objective of this study is to estimate the cost-effectiveness of pembrolizumab for the second-line treatment of advanced bladder cancer from the perspective of payers in multiple countries. Methods: We developed a Markov model to compare the costs and effectiveness of pembrolizumab with those of chemotherapy in the second-line treatment of advanced bladder cancer. Health outcomes were measured in life-years (LYs) and quality-adjusted life-years (QALYs). Drug costs were acquired for the following countries: U.S., U.K., Canada and Australia. Model robustness was addressed in univariate and probabilistic sensitivity analyses. Results: Pembrolizumab generated a gain of 0.36 QALYs compared to chemotherapy. Our analysis established the following incremental cost-effectiveness ratios (ICERs) for pembrolizumab versus chemotherapy in second-line advanced bladder cancer treatment - U.S. $122,557/QALY, U.K. $91,995/QALY, Canada $93,648/QALY, and Australia $99,966/QALY. The willingness-to-pay (WTP) thresholds per QALY are considered to be around 100,000-150,000 US dollars for the U.S., 20,000-50,000 pounds for the U.K. [25,000-65,000 US $], 20,000-100,000 CAD for Canada [16,000-80,000 US $] and 40,000-75,000 AUD for Australia [32,000-60,000 US $]. Conclusions: Cost-effectiveness and WTP thresholds vary between countries. Compared to the other countries examined, U.S. drug prices were found to be highest, leading to the highest ICER. With standard willingness-to-pay thresholds, pembrolizumab may be considered cost-effective in the U.S., but not in the other countries examined.
I have presented two research studies at scientific meetings. The abstracts have been published in society journal supplements. Is it appropriate for me to include both presentations and publications in my curriculum vitae?
Authors: Peter Weissberg
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.
Considerations in Assessing Disability Trajectories Before and After Stroke and Myocardial Infarction—Reply
Authors: Mandip S. Dhamoon
Journal: JAMA Neurology (2018)

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18F-Choline PET/MR Can Detect and Delineate Local Recurrence After High-Intensity Focused Ultrasound Therapy of Prostate Cancer
Authors: Irene A. Burger, Andrei Gafita, Julian Müller, Benedikt Kranzbühler, Olivio F. Donati, Daniel Eberli
Journal: Clinical Nuclear Medicine (2018)

Restaging local recurrence after high-intensity focused ultra-sound (HIFU) is based on multiparametric MRI (mpMRI). However, postinterventional changes of the tissue, such as edema or hemorrhage, are limiting tumor detection on mpMRI. We present a case of a rising prostate-specific antigen values, negative mpMRI, and a Gleason score of 4+4 on template biopsy after HIFU. On F-choline PET/MR, high focal uptake was detected at the location of positive biopsy. Re-HIFU based on the fused F-choline PET/MR images was performed, followed by a recurrence-free period of 11 months. Thus, F-choline PET/MR could improve guiding retreatment in patients with recurrence after HIFU.
TRITON3: An international, randomized, open-label, phase III study of the PARP inhibitor rucaparib vs. physician’s choice of therapy for patients with metastatic castration-resistant prostate cancer (mCRPC) associated with homologous recombination deficiency (HRD).
Authors: Charles J. Ryan, Wassim Abida, Alan Haruo Bryce, Arjun Vasant Balar, Igor Dumbadze, Robert W. Given, David Morris, Daniel Peter Petrylak, Charles H. Redfern, Howard I. Scher, Simon Paul Watkins, Andrew Simmons, Luke Passler, Tony Golsorkhi, Simon Chowdhury
Journal: Journal of Clinical Oncology (2018)

TPS389 Background: Recent data have shown that up to 25% of patients with advanced prostate cancer, including mCRPC, have a deleterious germline or somatic mutation in BRCA1, BRCA2, ATM, or another homologous recombination DNA repair gene. Such mutations can be used as a molecular marker to select patients for targeted treatment with poly(ADP-ribose) polymerase inhibitors (PARPis), which are lethal to cells with HRD. Treatment with PARPis has shown preliminary evidence of antitumor activity in patients with mCRPC and a mutation in a homologous recombination DNA repair gene (Mateo et al. N Engl J Med. 2015;373:1697-708). These data provide a compelling rationale for evaluating rucaparib, a potent inhibitor of PARP1, PARP2, and PARP3, in patients with mCRPC associated with HRD. Methods: TRITON3 (NCT02975934) is a randomized, phase 3 study evaluating rucaparib 600 mg BID vs physician’s choice of abiraterone, enzalutamide, or docetaxel in patients with mCRPC and a deleterious germline or somatic BRCA1, BRCA2, or ATM mutation (identified by prior local testing or central testing during screening). Patients must have progressed on androgen receptor signaling–directed therapy in the mCRPC setting; prior PARPi treatment or chemotherapy for mCRPC are exclusion criteria. Patients will be randomly assigned in a 2:1 ratio to either rucaparib or physician’s choice, with the possibility for cross over from the comparator treatment to rucaparib upon radiographic progression confirmed by independent radiology review. The primary endpoint is radiographic progression-free survival (modified RECIST v1.1/PCWG3 criteria) assessed by independent radiology review. Secondary endpoints include objective response rate, duration of response, patient-reported outcomes, overall survival, and safety. Pretreatment blood samples collected from all patients will enable development of a noninvasive plasma-based companion diagnostic to select patients who may benefit from rucaparib treatment. Patients (≈400) will be enrolled at &gt; 100 sites worldwide. Clinical trial information: NCT02975934.