tbuckley/cabot-search huggingface dataset:
Councils give top public health jobs to people without specialty training
Authors: Helen Jaques
Journal: BMJ (2013)

Three councils in the north of England have appointed individuals with no training in public health to lead their new public health directorates, a move the Faculty of Public Health says will undermine the recruitment and retention of public health doctors.

Lancashire County Council has appointed an individual with a background in social care to head up its new combined directorate of public health and adult services. Telford and Wrekin Council and Bolton Council have also appointed people without public health training to take charge of joint public health and social services departments. 

The faculty branded the appointments a “disaster,” and warned that such moves would …
Birth Defects Potentially Related to Zika Virus Infection During Pregnancy in the United States
Authors: Brenda Fitzgerald, Coleen Boyle, Margaret A. Honein
Journal: JAMA (2018)

This Viewpoint summarizes findings from a population-based birth defect surveillance report from the Centers for Disease Control and Prevention estimating the prevalence of birth defects potentially related to Zika virus infection in US areas with documented local Zika virus transmission in 2016.
Hepatitis B Recommendations Updated
Authors: Bridget M. Kuehn
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 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) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More 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
Emergency medicine workforce has increased, but college warns over ongoing recruitment problem
Authors: Abi Rimmer
Journal: BMJ (2013)

The number of doctors specialising in emergency medicine has risen, show data from the NHS’s Health and Social Care Information Centre.1

But Chris Moulton, vice president of the Royal College of Emergency Medicine, said it was important that people didn’t underestimate the recruitment crisis still facing the specialty.

The statistics for 2012-13 from the Health and Social Care Information Centre show that the number of doctors with a specialty in emergency medicine rose by 71% between 2002 and 2012, from 3183 to 5437. By comparison, the number of doctors …
11β-HSD1 in Human Fetal Membranes as a Potential Therapeutic Target for Preterm Birth
Authors: Wangsheng Wang, Zi-Jiang Chen, Leslie Myatt, Kang Sun
Journal: Endocrine Reviews (2018)

Human parturition is a complex process involving interactions between the myometrium and signals derived from the placenta, fetal membranes, and fetus. Signals originating from fetal membranes are crucial components that trigger parturition, which is clearly illustrated by the labor-initiating consequence of membrane rupture. It has been recognized for a long time that among fetal tissues in late gestation the fetal membranes possess the highest capacity for cortisol regeneration by 11β-hydroxysteroid dehydrogenase type 1 (11β-HSD1). However, the exact role of this unique feature remains a mystery. Accumulating evidence indicates that this extra-adrenal source of cortisol may serve as an upstream signal for critical events in human parturition, including enhanced prostaglandin and estrogen synthesis as well as extracellular matrix remodeling. This may explain why such high capacity for cortisol regeneration develops in human fetal membranes at late gestation. Therefore, inhibition of 11β-HSD1 may provide a potential therapeutic target for prevention of preterm birth. This review summarizes the current understanding of the functional role of cortisol regeneration by 11β-HSD1 in human fetal membranes.
PROGNOSTIC VALUE OF ELECTROLYTE IMBALANCE AT THE TIME OF ADMISSION IN PATIENTS WITH ACUTE MYOCARDIAL INFARCTION: SUBANALYSIS FROM JAPANESE REGISTRY OF ACUTE MYOCARDIAL INFARCTION DIAGNOSED BY UNIVERSAL DEFINITION (J-MINUET)
Authors: Hitoshi Takano, Wataru Shimizu, Takeshi Yamamoto, Koichi Nakao, Yukio Ozaki, Kazuo Kimura, Junya Ako, Teruo Noguchi, Satoshi Yasuda, Satoru Suwa, Kazuteru Fujimoto, Yasuharu Nakama, Takashi Morita, Yoshihiko Saito, Atsushi Hirohata, Yasuhiro Morita, Teruo Inoue, Atsunori Okamura, Toshiaki Mano, Kazuhito Hirata, Kunihiro Nishimura, Yoshihiro Miyamoto, Hisao Ogawa, Masaharu Ishihara, J-MINUET Investigators
Journal: Journal of the American College of Cardiology (2018)
CHK1 inhibition in soft-tissue sarcomas: biological and clinical implications
Authors: A. Laroche-Clary, C. Lucchesi, C. Rey, S. Verbeke, A. Bourdon, V. Chaire, M.-P. Algéo, S. Cousin, M. Toulmonde, V. Vélasco, J. Shutzman, A. Savina, F. Le Loarer, A. Italiano
Journal: Annals of Oncology (2018)

Inhibition of ChK1 appears as a promising strategy for selectively potentiate the efficacy of chemotherapeutic agents in G1 checkpoint-defective tumor cells such as those that lack functional p53 protein. The p53 pathway is commonly dysregulated in soft-tissue sarcomas (STS) through mutations affecting TP53 or MDM2 amplification. GDC-0575 is a selective ATP-competitive inhibitor of CHK1.We have performed a systematic screening of a panel of 10 STS cell lines by combining the treatment of GDC-0575 with chemotherapy. Cell proliferation, cell death and cell cycle analysis were evaluated with high throughput assay. In vivo experiments were carried out by using TP53-mutated and TP53 wild-type patient-derived xenograft models of STS. Clinical activity of GDC-0575 combined with chemotherapy in patients with TP53-mutated and TP53 wild-type STS was also assessed.We found that GDC-0575 abrogated DNA damage-induced S and G2-M checkpoints, exacerbated DNA double-strand breaks and induced apoptosis in STS cells. Moreover, we observed a synergistic or additive effect of GDC-0575 together with gemcitabine in vitro and in vivo in TP53-proficient but not TP53-deficient sarcoma models. In a phase I study of GDC-0575 in combination with gemcitabine, two patients with metastatic TP53-mutated STS had an exceptional, long-lasting response despite administration of a very low dose of gemcitabine whereas one patient with wild-type TP53 STS had no clinical benefit. Genetic profiling of samples from a patient displaying secondary resistance after 1 year showed loss of one preexisting loss-of-function mutation in the helical domain of DNA2.We provide the first preclinical and clinical evidence that potentiation of chemotherapy activity with a CHK1 inhibitor is a promising strategy in TP53-deficient STS and deserves further investigation in the phase II setting.
MSc in cognitive therapy
Authors: Maged Swelam
Journal: BMJ (2007)

FURTHER INFORMATION 

Course Secretary, MSc/diploma in cognitive therapy, School of Psychology, University of Southampton, Southampton SO17 1BJ. Tel +44 (0)23 8059 3578, email sjf1@soton.ac.uk

This innovative two year, part time programme was set up in 2000 and is run in partnership between the University of Southampton and Hampshire Partnership NHS Trust.

The diploma/MSc programme is suitable for people working in mental health settings who have an approved professional training. They should also have a good grasp of the principles of cognitive behavioural therapy and some supervised practice in applying it. Candidates who intend to proceed to the …
Microsurgery training course, Columbia University, New York
Authors: Nigel Abreo, Niroshan Sivathasan
Journal: BMJ (2009)

Microsurgery is a technique used in a wide range of surgical specialties, including neurosurgery and cardiothoracic, plastic, orthopaedic hand, and, vascular surgery. The aim of any basic microsurgery course is to introduce the fundamental skills and techniques required for microsurgical dissection, anastomosis, and neurovascular repair. 

Currently, only two microsurgery courses are run in the United Kingdom, each costing about £1300 (€1500; $2000) for five days. These courses are offered sporadically and infrequently during the year, have relatively high student to teacher ratios, and require animal licences to practise. Furthermore, they are often oversubscribed and have waiting lists. With most surgical departments strictly limiting the number of junior doctors allowed on leave at any given time, trainees often find themselves constrained and competing with colleagues to attend these seldom obtainable courses. Additionally, given that study allowances for trainees have been drastically slashed, the cost and value for money of any course are even more important. 

On searching the internet, we found several courses around the world, including India, Romania, Singapore, and the United States. We chose to attend the Columbia University microsurgery course 2009 in New York City. 

Each year the Columbia microsurgery course teaches roughly 80 people in …
Certificate in the management of drug misuse
Authors: Nigel Williams
Journal: BMJ (2005)

The “specialised generalist” or GP with a special interest (GPwSI)—although it is relevant to a range of practitioners who have exposure to drug users, such as prison doctors and some hospital specialists. It's run by the Royal College of General Practitioners and is now divided into Parts 1 and 2.

In 2002, after I had been a GP principal for about eight years …
Focal Irradiation and Systemic TGFβ Blockade in Metastatic Breast Cancer
Authors: Silvia C. Formenti, Percy Lee, Sylvia Adams, Judith D. Goldberg, Xiaochun Li, Mike W. Xie, Josephine A. Ratikan, Carol Felix, Lin Hwang, Kym F. Faull, James W. Sayre, Sara Hurvitz, John A. Glaspy, Begoña Comin-Anduix, Sandra Demaria, Dörthe Schaue, William H. McBride
Journal: Clinical Cancer Research (2018)

Abstract Purpose: This study examined the feasibility, efficacy (abscopal effect), and immune effects of TGFβ blockade during radiotherapy in metastatic breast cancer patients. Experimental Design: Prospective randomized trial comparing two doses of TGFβ blocking antibody fresolimumab. Metastatic breast cancer patients with at least three distinct metastatic sites whose tumor had progressed after at least one line of therapy were randomized to receive 1 or 10 mg/kg of fresolimumab, every 3 weeks for five cycles, with focal radiotherapy to a metastatic site at week 1 (three doses of 7.5 Gy), that could be repeated to a second lesion at week 7. Research bloods were drawn at baseline, week 2, 5, and 15 to isolate PBMCs, plasma, and serum. Results: Twenty-three patients were randomized, median age 57 (range 35–77). Seven grade 3/4 adverse events occurred in 5 of 11 patients in the 1 mg/kg arm and in 2 of 12 patients in the 10 mg/kg arm, respectively. Response was limited to three stable disease. At a median follow up of 12 months, 20 of 23 patients are deceased. Patients receiving the 10 mg/kg had a significantly higher median overall survival than those receiving 1 mg/kg fresolimumab dose [hazard ratio: 2.73 with 95% confidence interval (CI), 1.02–7.30; P = 0.039]. The higher dose correlated with improved peripheral blood mononuclear cell counts and a striking boost in the CD8 central memory pool. Conclusions: TGFβ blockade during radiotherapy was feasible and well tolerated. Patients receiving the higher fresolimumab dose had a favorable systemic immune response and experienced longer median overall survival than the lower dose group. Clin Cancer Res; 24(11); 2493–504. ©2018 AACR.
Parking your patients
Authors: Caroline Elton
Journal: BMJ (2013)

A junior trainee came to see me recently wondering whether he had chosen the right specialty. There were aspects of his training in obstetrics and gynaecology that he enjoyed, but overall he had a sense that his heart wasn’t in it. Harking back to a rotation during his foundation years in the emergency department, he questioned whether this specialty might have been a better fit for him.

We explored his experience in greater detail, and he remembered that working in the emergency department had actually been somewhat frustrating. It had entailed too much “clerk and park” for his liking, he said. He explained that, although it was satisfying to make rapid clinical decisions in the emergency department, he was also left wondering what happened to …
A NOVEL TOOL FOR PRE-PROCEDURAL RISK STRATIFICATION FOR CONTRAST-INDUCED NEPHROPATHY AND ASSOCIATIONS BETWEEN HYDRATION VOLUME AND CLINICAL OUTCOMES FOLLOWING CORONARY ANGIOGRAPHY AT DIFFERENT RISK LEVELS
Authors: Pengyuan Chen, Yong Liu, Shiqun Chen, Ying Xian, Jiyan Chen, Ning Tan
Journal: Journal of the American College of Cardiology (2018)
In England and Wales, GP assessment centres are the order of the day, but in Scotland it would appear that recruitment remains relatively traditional. Is that correct? I struggle with assessment centres and would welcome the opportunity not to have to go through them.
Authors: Brian Keighley
Journal: BMJ (2006)

Have 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 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>
I am about to take the GP VTS exam for the London Deanery. Can you tell me what they are looking for and how they shortlist candidates?
Authors: Anne Hastie
Journal: BMJ (2006)

<b>www.bmjcareers.com/advicezone</b> Have 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 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.
Doctors in the spotlight
Authors: Graham Easton
Journal: BMJ (2005)

Apparently, as recently as the 1970s, some medical students were taught that a doctor's name should only appear in the press at birth, death, and marriage. How things have changed. Whether they are opening up to journalists for their own ends, or running away from them to avoid some embarrassing scandal, doctors have a much closer relationship with the media than they did 30 years ago (perhaps closer than …
Increase in general practices open during core hours in Wales
Authors: Helen Jaques
Journal: BMJ (2012)

Nearly three quarters of general practices in Wales were open during core hours or until within an hour of core hours during 2011, statistics from the Welsh government show.

In 2011 149 (31%) of the 477 general practices in Wales were open for the core hours of 8:00 am to 6:30 pm, up from 93 (19%) of 487 practices in 2010. A further 4% of practices were open during core hour …
LONG-TERM MORTALITY AND ESTIMATED FUNCTIONAL CAPACITY AMONG WOMEN WITH SYMPTOMS OF ISCHEMIC HEART DISEASE: FROM THE NHLBI-SPONSORED WOMEN'S ISCHEMIA SYNDROME EVALUATION
Authors: Islam Elgendy, Li Qian, Yi Guo, Eileen Handberg, C. Noel Bairey Merz, Carl Pepine
Journal: Journal of the American College of Cardiology (2018)
Identification of microRNAs that target PD-L1 in mismatch repair-deficient colorectal cancer.
Authors: Mai Ashizawa, Hirokazu Okayama, Teruhide Ishigame, Kousaku Mimura, Koji Kono
Journal: Journal of Clinical Oncology (2018)

85 Background: Programmed cell death 1 (PD-1) / PD-ligand 1 (PD-L1) immune checkpoint blockade has emerged as a promising therapeutic strategy in various types of cancer. Here we report that certain microRNAs (miRNAs) are involved in immunosuppressive microenvironment by directly targeting PD-L1 in mismatch repair deficient (dMMR) colorectal cancer (CRC). Methods: We identified candidate miRNAs by using RNA-sequence analyses for mRNA and miRNA expression obtained from The Cancer Genome Atlas (TCGA) Colon Adenocarcinoma combined with miRNA target prediction programs. HCT116 and SW837 CRC cell lines were transfected with miRNA mimics and inhibitors, and PD-L1 expression was examined by qRT-PCR, western blotting and flow cytometry. The CRC cell lines were co-cultured with activated T cells and then cytotoxicity for T cells were evaluated. Results: Using miRNA expression profiles of 260 tumors obtained through TCGA Colon Adenocarcinoma, 47 miRNA probes were found to be inversely correlated with PD-L1 expression. Among them, 19 mature miRNAs were down-regulated in dMMR tumors. Furthermore, eight in silico miRNA-target prediction programs were utilized to identify candidate miRNAs that target the 3’UTR of PD-L1 mRNA. We found that forced miRNA expression decreased PD-L1 expression in protein (total and surface) and mRNA levels, and they also dramatically decreased IFN-induced cell surface PD-L1 expression by 32% in CRC cell lines. Furthermore, we found that forced miRNA expression decreased PD-L1 associated apoptotic cell death in co-cultured activated T cells. Conclusions: Our findings suggest that PD-L1 expression is at least in part regulated by miRNAs and may also suggest potential miRNAs to serve as biomarkers and therapeutic targets for cancer immunotherapy.
Limb- and Person-Level Risk Factors for Lower-Limb Amputation in the Prospective Seattle Diabetic Foot Study
Authors: Edward J. Boyko, Amber D. Seelig, Jessie H. Ahroni
Journal: Diabetes Care (2018)

Diabetes is the leading cause of nontraumatic lower-limb amputations in the U.S., but no research has prospectively examined associations between limb-specific measurements and amputation risk among patients without foot ulcer. We investigated amputation risk by limb in relation to the same limb- and person-level factors.We conducted a 22-year prospective study among 1,461 male patients with diabetes without foot ulcer (mean age 62.4 years), with 2,893 lower limbs among subjects recruited between 1990 and 2002 from one Department of Veterans Affairs general internal medicine clinic. The following information was collected: demographic, lifestyle, and diabetes characteristics; visual acuity; kidney function (estimated glomerular filtration rate [eGFR]); and lower-limb measurements including presence of Charcot deformity, sensory neuropathy by 10-g monofilament, dorsal foot transcutaneous oximetry (TcPO2) at 44°C, and ankle-brachial index (ABI).Over 25,735 limb-years, 136 amputations occurred. A multivariable Cox model identified multiple independent risk factors: sensory neuropathy (hazard ratio 3.09 [95% CI 2.02-4.74]), ABI ≤0.5 vs. >0.9 to <1.3 (3.98 [2.31-6.85]), ABI ≥1.3 vs. >0.9 to <1.3 (2.20 [1.18-4.09]), 1-SD decrease in eGFR (1.18 [1.00-1.38]), poor vision (1.70 [1.05-2.73]), body weight in 21.4-kg increments (0.78 [0.61-0.98]), and age >70 years vs. <57 years (0.13 [0.04-0.38]). Although TcPO2 was not significantly associated with amputation overall, TcPO2 <26 mmHg significantly predicted a higher risk in the ABI ≥1.3 category.Arterial disease and neuropathy emerged as the only limb-specific risk factors for amputation, but these and several person-level factors may be amenable to prevention or treatment interventions to potentially reduce diabetic amputation risk.
What is the SHO banding system?
Authors: Dan Saunders
Journal: BMJ (2004)

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.
Epigenome-based cancer risk prediction: rationale, opportunities and challenges
Authors: Martin Widschwendter, Allison Jones, Iona Evans, Daniel Reisel, Joakim Dillner, Karin Sundström, Ewout W Steyerberg, Yvonne Vergouwe, Odette Wegwarth, Felix G Rebitschek, Uwe Siebert, Gaby Sroczynski, Inez D de Beaufort, Ineke Bolt, David Cibula, Michal Zikan, Line Bjørge, Nicoletta Colombo, Nadia Harbeck, Frank Dudbridge, Anne-Marie Tasse, Bartha M Knoppers, Yann Joly, Andrew E Teschendorff, Nora Pashayan
Journal: Nature Reviews Clinical Oncology (2018)
Cardiovascular and Metabolic Heterogeneity of Obesity
Authors: Ian J. Neeland, Paul Poirier, Jean-Pierre Després
Journal: Circulation (2018)

The prevalence of obesity has increased globally over the last 2 decades. Although the body mass index has been a convenient and simple index of obesity at the population level, studies have shown that obesity defined by body mass index alone is a remarkably heterogeneous condition with varying cardiovascular and metabolic manifestations across individuals. Adipose tissue is an exquisitely active metabolic organ engaged in cross-talk between various systems; perturbation of adipose tissue results in a pathological response to positive caloric balance in susceptible individuals that directly and indirectly contributes to cardiovascular and metabolic disease. Inadequate subcutaneous adipose tissue expansion in the face of dietary triglycerides leads to visceral and ectopic fat deposition, inflammatory/adipokine dysregulation, and insulin resistance. Conversely, preferential fat storage in the lower body depot may act as a metabolic buffer and protect other tissues from lipotoxicity caused by lipid overflow and ectopic fat. Translational, epidemiological, and clinical studies over the past 30 years have clearly demonstrated a strong link between visceral and ectopic fat and the development of a clinical syndrome characterized by atherogenic dyslipidemia, hyperinsulinemia/glucose intolerance, hypertension, atherosclerosis, and adverse cardiac remodeling/heart failure. This relationship is even more nuanced when clinical entities such as metabolically healthy obesity phenotype and the obesity paradox are considered. Although it is clear that the accumulation of visceral/ectopic fat is a major contributor to cardiovascular and metabolic risk above and beyond the body mass index, implementation of fat distribution assessment into clinical practice remains a challenge. Anthropometric indexes of obesity are easily implemented, but newer imaging-based methods offer improved sensitivity and specificity for measuring specific depots. Lifestyle, pharmacological, and surgical interventions allow a multidisciplinary approach to overweight/obesity that may improve outcomes and align with a public health message to combat the growing epidemic of obesity worldwide and to build healthier lives free of cardiovascular diseases.