tbuckley/cabot-search huggingface dataset:
Teasing Diabetes Apart, One Locus at a Time
Authors: R. David Leslie, Struan F.A. Grant
Journal: Diabetes Care (2018)

Although most organ-specific autoimmune diseases show middle-age onset and a range of severity, type 1 diabetes appears to be relatively atypical given its striking severity and childhood onset. But the discovery of islet cell antibodies (ICA) as a disease hallmark by the recently deceased Franco Bottazzo in 1974 posed interesting conundrums (1). Not everyone with type 1 diabetes had ICA, and not everyone with ICA had diabetes; indeed, they were also found in a fraction of patients with type 2 diabetes. Further, the higher the ICA titer, the more likely one was to get the disease and to get it early. It followed that individuals with low-titer ICA could develop diabetes in adulthood, while others escaped diabetes altogether (2,3). The passing years have illuminated these points, with tracking of multiple autoantibodies with disease progression (4).

Type 1 diabetes is a classic example of a complex trait with a strong genetic basis. However, a differential impact of genetic and nongenetic factors is encapsulated in the “threshold hypothesis”—more of one, less of the other, and vice versa (2). In children, diabetes has a high heritability, but data suggests it declines with increasing age of onset (5), reflecting declining HLA impact. The appearance of multiple high-titer diabetes autoantibodies, likely secondary to environmental events around birth, presage early-onset type 1 diabetes (2,6) (Fig. 1). But a second wave of serum autoantibodies, which appear in subjects for up to 10 more years, presents with different immunogenetic characteristics (Fig. 1). In those cases, autoantibodies are often single, low-titer, and raised to glutamic acid decarboxylase, with enrichment of HLA DR3/DQ2 without depletion of protective HLA genotypes (6). We do not know how these “second-wave” autoantibodies in …
Re: Reddy et al.: Vitrectomy and vitrector port needle biopsy of choroidal melanoma for gene expression profile testing immediately before brachytherapy. ( Ophthalmology . 2017;124:1377-1382)
Authors: Armin R. Afshar, Bertil E. Damato, Jay M. Stewart, Heinrich Heimann, Sarah E. Coupland
Journal: Ophthalmology (2018)
Bladder filling during radiation therapy for prostate cancer treatment: Assessment via bladder ultrasound scanner.
Authors: Mark Raymond Waddle, Robin Landy, Karen Ryan, Katherine S. Tzou, William C Stross, Tasneem Kaleem, Daniel Miller, Daniel Michael Trifiletti, Steven Herchko, Christopher Serago, Steven J. Buskirk
Journal: Journal of Clinical Oncology (2018)

147 Background: Prostate cancer patients treated with external beam radiation therapy are instructed to present daily with a full bladder to decrease small bowel and bladder toxicity and to increase reproducibility of treatment. However, older patients may have difficulty presenting with full bladders and variation of bladder volume with treatment is unknown. The objective of this study was to assess bladder filling at the time of radiation treatment (RT) using a bladder ultrasound in patients undergoing treatment for prostate cancer. Methods: Patients with prostate cancer were prospectively enrolled prior to CT simulation from January to August 2017. Bladder volume was recorded during CT simulation and daily immediately prior to RT. Patients were instructed to drink 8-12 ounces of water 30-60 minutes prior to RT. Three bladder volume measurements were recorded daily and averaged at the time of each treatment. Average bladder volume during treatment and the number of treatments with low bladder volumes ( &lt; 50cc, &lt; 60cc, and &lt; 100cc) were reported using descriptive statistics. Results: A total of 13 patients completed a median of 42 days of RT during the study period, resulting in 550 daily bladder volumes. Ten patients were treated definitively and 3 with salvage radiation after prostatectomy. The median age of patients in the study was 72 years. Older patients were statistically more likely to present with low bladder volumes, with percentage of treatments with a bladder volume less than 50cc, 60cc, and 100cc being 29%, 42%, and 66% compared to only 4%, 7%, and 18% in patients aged &lt; 70 (P &lt; 0.01). The average bladder volume at the time of CT simulation was 176cc ± 57cc and the average volume during treatment was 140cc± 93cc, which was not statistically different (P = 0.28). The bladder volume did not significantly change over the course of treatment. Conclusions: Older patients (age 70+) with prostate cancer were more likely to present for RT with low bladder volumes in this prospective study. Our findings suggest that older patients should receive extra counseling about bladder filling and/or may require less bladder filling at the time of CT simulation to provide more accurate bowel dosimetry measurements.
INDEXING OF GLOBAL AND REGIONAL LONGITUDINAL STRAIN: A STEP TOWARDS IMPROVING THE CORRELATION WITH VENTRICULAR VOLUMES AND EJECTION FRACTION
Authors: Mosaad El-Banna, Guirgis Gabra, Khalid Bakr, Medhat Soliman, Santhi Adigopula, Julia Grapsa
Journal: Journal of the American College of Cardiology (2018)
Is membership of the Royal College of Physicians (MRCP) of any use in obstetrics and gynaecology?
Authors: Anna Kenyon
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>
Wales has fewer doctors per head than all EU countries except Poland and Romania
Authors: Helen Jaques
Journal: BMJ (2013)

Wales is ranked third from bottom in the European Union for the number of doctors per head of population, with only Poland and Romania performing worse, analysis by Plaid Cymru has found.

Wales has 24.6 doctors for every 10 000 people, show medical workforce and population census data. Of the 24 EU countries with available data on the doctor workforce, only Romania and Poland have fewer doctors per 10 000 population, at 23.9 and 20.7, respectively.

England and Northern Ireland rank 21st and …
IMPACT OF TRICUSPID REGURGITATION ON POSTOPERATIVE OUTCOMES AFTER NON-CARDIAC SURGERIES
Authors: Parth Parikh, Kinjal Banerjee, Anil Kumar, Reddy Anumandla, Venu Menon, Brian Griffin, E. Murat Tuzcu, Samir Kapadia
Journal: Journal of the American College of Cardiology (2018)
Emergency medicine procedures course
Authors: Geraldine Leonard
Journal: BMJ (2009)

The emergency medicine procedures course is a one day practical skills course developed for doctors who work in emergency medicine. Candidates rotate around seven stations during the day and receive hands on training in more than 15 procedures commonly used in the accident and emergency department. The course provides participants with the valuable opportunity to learn and practise practical skills de novo, or to refresh and update their skills in a friendly and relaxed environment.

This course is aimed at two groups of doctors—all trainees about to do their first attachment in accident and emergency, either as a foundation year doctor or as part of specialty training, and doctors training in emergency medicine who wish to maintain their skills and ensure that their practice conforms to current guidelines and best practice.

I completed the course in November 2008 while working in accident and emergency as …
A hypothesis study on a four-period prevention model for high altitude disease
Authors: Xian-Sheng Liu, Xiang-Rong Yang, Lu Liu, Xian-Kui Qin, Yu-Qi Gao
Journal: Military Medical Research (2018)

High altitude disease (HAD) can reduce combat effectiveness and damage the health of soldiers at high altitudes. The objective of this hypothesis study is to build a four-period prevention model for high altitude disease that can be applied at high altitudes of over 3000 m. We divided the time at high altitude into nine periods, with three stages from the ascent preparation to the descent to the plain, and applied a continuous dynamic and systematic four-period prevention model across the nine periods. Each period of three stages has its own different measures and targets high altitude health care services for the prevention of high altitude disease. A standard four-period prevention model for high altitude disease was constructed for the high altitude health services at the population level. Our hypothesized HAD prevention model represents a continuous dynamic and systematic four-period prevention model across the nine periods. This hypothesis can be tested from three aspects. The first one isassessment of soldiers' operating efficacies. The second is comparison of the long-term high altitude population health basic data and development and utilization of big data. The third is descent population health status comparative study and historical retrospective study on prevention. As we know, it is necessary to protect soldiers’ health through the ascent and descent. Through the standard four-period model, we can protect soldiers’ health by preventing high altitude diseases, screening the susceptible population, securely tracking their location and maintaining soldiers’ health statuses; we also maintain their operational capabilities, eliminate their psychological fears and ease their family troubles.
Outbreak of Fluoroquinolone-Resistant <i>Campylobacter jejuni</i> Infections Associated with Raw Milk Consumption from a Herdshare Dairy — Colorado, 2016
Authors: Alexis Burakoff, Kerri Brown, Joyce Knutsen, Christina Hopewell, Shannon Rowe, Christy Bennett, Alicia Cronquist
Journal: MMWR Morbidity and Mortality Weekly Report (2018)

In August 2016, a local public health agency (LPHA) notified the Colorado Department of Public Health and Environment (CDPHE) of two culture-confirmed cases of Campylobacter infection among persons who consumed raw (unpasteurized) milk from the same herdshare dairy. In Colorado, the sale of raw milk is illegal; however, herdshare programs, in which a member can purchase a share of a herd of cows or goats, are legal and are not regulated by state or local authorities. In coordination with LPHAs, CDPHE conducted an outbreak investigation that identified 12 confirmed and five probable cases of Campylobacter jejuni infection. Pulsed-field gel electrophoresis (PFGE) patterns for the 10 cases with available isolates were identical using the enzyme Sma. In addition, two milk samples (one from the dairy and one obtained from an ill shareholder) also tested positive for the outbreak strain. Five C. jejuni isolates sent to CDC for antimicrobial susceptibility testing were resistant to ciprofloxacin, tetracycline, and nalidixic acid (1). Although shareholders were notified of the outbreak and cautioned against drinking the milk on multiple occasions, milk distribution was not discontinued. Although its distribution is legal through herdshare programs, drinking raw milk is inherently risky (2). The role of public health in implementing control measures associated with a product that is known to be unsafe remains undefined.
A novel piperidine identified by stem cell-based screening attenuates pulmonary arterial hypertension by regulating BMP2 and PTGS2 levels
Authors: Yanjiang Xing, Shuang Zhao, Qingxia Wei, Shiqiang Gong, Xin Zhao, Fang Zhou, Rafia AI-Lamki, Daniel Ortmann, Mingxia Du, Roger Pedersen, Guangdong Shang, Shuyi Si, Nicholas W. Morrell, Jun Yang
Journal: European Respiratory Journal (2018)

Genetic defects in bone morphogenetic protein type II receptor (BMPRII) signalling and inflammation contribute to the pathogenesis of pulmonary arterial hypertension (PAH). The receptor is activated by bone morphogenetic protein (BMP) ligands, which also enhance BMPR2 transcription. A small-molecule BMP upregulator with selectivity on vascular endothelium would be a desirable therapeutic intervention for PAH. We assayed compounds identified in the screening of BMP2 upregulators for their ability to increase the expression of inhibitor of DNA binding 1 (Id1), using a dual reporter driven specifically in human embryonic stem cell-derived endothelial cells. These assays identified a novel piperidine, BMP upregulator 1 (BUR1), that increased endothelial Id1 expression with a half-maximal effective concentration of 0.098 μmol·L −1 . Microarray analyses and immunoblotting showed that BUR1 induced BMP2 and prostaglandin-endoperoxide synthase 2 (PTGS2) expression. BUR1 effectively rescued deficient angiogenesis in autologous BMPR2 +/R899X endothelial cells generated by CRISPR/Cas9 and patient cells. BUR1 prevented and reversed PAH in monocrotaline rats, and restored BMPRII downstream signalling and modulated the arachidonic acid pathway in the pulmonary arterial endothelium in the Sugen 5416/hypoxia PAH mouse model. In conclusion, using stem cell technology we have provided a novel small-molecule compound which regulates BMP2 and PTGS2 levels that might be useful for the treatment of PAH.
IMPACT OF LEFT ATRIAL SIZE AND FUNCTION ON EXERCISE HEMODYNAMICS IN PATIENTS WITH HEART FAILURE WITH MID-RANGE AND PRESERVED EJECTION FRACTION
Authors: Emma Gard, Shane Nanayakkara, Sanjiv Jayendra Shah, Barry Borlaug, Frank Silvestry, Thomas Hanff, Scott L. Hummel, Sheldon Litwin, Mark Petrie, Jan Komtebedde, David Kaye
Journal: Journal of the American College of Cardiology (2018)
The Impact of Ultrasound on the Use and Efficacy of Intraarticular Glucocorticoid Injections in Early Rheumatoid Arthritis
Authors: Lena B. Nordberg, Siri Lillegraven, Anna‐Birgitte Aga, Joe Sexton, Elisabeth Lie, Hilde B. Hammer, Inge C. Olsen, Till Uhlig, Désirée van der Heijde, Tore K. Kvien, Espen A. Haavardsholm
Journal: Arthritis & Rheumatology (2018)

Intraarticular glucocorticoid injections are common in rheumatoid arthritis (RA) treatment. This study was undertaken to investigate whether ultrasound in combination with clinical examination is better than clinical examination alone at identifying joints that will benefit from intraarticular injections, and to compare the efficacy of ultrasound-guided versus palpation-guided procedures.In the treat-to-target Aiming for Remission in Rheumatoid Arthritis: a Randomised Trial Examining the Benefit of Ultrasonography in a Clinical Tight Control Regimen (ARCTIC), patients with early RA were randomized 1:1 to follow-up with or without ultrasound. In addition to disease-modifying antirheumatic drugs, intraarticular glucocorticoids were used to treat inflamed joints. The distribution of injections was assessed in both study groups. The relationship of clinical and ultrasound findings at the time of injection with treatment efficacy was examined, with non-swollen joint at the next visit as the outcome measure. Treatment success was compared across study groups to evaluate ultrasound-guided versus palpation-guided procedures.More injections were administered in the ultrasound group than in the conventional strategy group (n = 770 versus 548), especially in intercarpal joints (n = 58 versus 5) and metatarsophalangeal joints (n = 200 versus 104). Injecting clinically swollen joints without power Doppler (PD) activity on ultrasound was not efficacious compared to not injecting (odds ratio [OR] 1.3; P = 0.59). Efficacy was best in swollen joints (OR 9.0; P = 0.001) and non-swollen joints (OR 8.4; P = 0.016) with moderate PD activity. Treatment success was similar for the ultrasound-guided and palpation-guided procedures.Our findings indicate that the efficacy of intraarticular glucocorticoid injections varies according to ultrasound findings at the time of injection, supporting the use of ultrasound as a tool to select joints that will benefit from intraarticular injections. However, ultrasound needle guidance was not superior to palpation guidance.
Refusing to Become a “Potted Plant”
Authors: Elisabeth E. G. de Vries
Journal: JAMA Oncology (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 Oncology HomeNew OnlineCurrent IssueFor Authors Podcast Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA Oncology journal
IMPACT OF HIGH SENSITIVITY C REACTIVE PROTEIN LEVELON CLINICAL OUTCOMES OF ACUTE CORONARY SYNDROME PATIENTS WITH DYSLIPIDEMIA UNDERGOING CONTEMPORARY LIPID LOWERING THERAPY
Authors: Erisa Watanabe, Risa Ogawa, Junichi Yamaguchi, Haruki Sekiguchi, Masataka Ogiso, Hiroyuki Arashi, Hiroshi Ogawa, Nobuhisa Hagiwara
Journal: Journal of the American College of Cardiology (2018)
Is PI-RADS 3/total lesion ratio associated with clinically-significant prostate cancer in patients with equivocal-risk lesions on multi-parametric MRI?
Authors: Kamyar Ghabili, Matthew Swallow, Alfredo Suarez-Sarmiento, Jamil Syed, Michael Leapman, Jeffrey Weinreb, Preston Sprenkle
Journal: Journal of Clinical Oncology (2018)

149 Background: Prostate imaging reporting and data system (PI-RADS) category 3 (P3) provides an equivocal assessment of prostate cancer (PCa). We aimed to investigate imaging parameters including the ratio of P3-to-total regions of interest (ROI) that may assist in identifying P3 lesions harboring clinically-significant PCa (csPCa). Methods: We retrospectively queried our institutional MRI-ultrasound fusion biopsy database to identify patients without a prior diagnosis of PCa and with at least one P3 lesion on multi-parametric MRI (mpMRI) who underwent fusion biopsy during Feb 2015-Oct 2017. mpMRI findings were assessed, including prostate and P3 volumes, number of ROIs, and P3-to-total ROIs ratio (P3 lesion volume/total ROIs volumes). Logistic regression and area under the curve (AUC) were used to assess the ability of clinical and mpMRI characteristics to predict csPCa, defined as any grade group (GG)≥2 cancer or GG 1 cancer in &gt; 2 cores or &gt; 50% of any positive core from targeted biopsy of the P3 lesion. Results: Of 127 men with at least one P3 lesion, 29 (22.8%) had csPCa on the biopsy of P3 lesions. Patients with csPCa in P3 lesions had smaller prostate volumes (42.1mL vs 56mL, p = 0.003), lower P3/total ROIs ratios (0.46 vs 1.00, p &lt; 0.001), and higher numbers of total ROIs (2 vs 1, p = 0.004). Compared with patients who had a P3/total ROIs ratio &gt; 0.58, men with ratios &lt; 0.58 were more likely to be diagnosed with csPCa in a P3 lesion (57.1% vs 9%, p &lt; 0.001). Using a threshold of 0.58, P3/total ROIs ratio was 76.1% sensitive and 80.6% specific for csPCa in a P3 lesion. On multivariate analysis, smaller prostate volume (OR1.04, 95%CI 1.01-1.07, p = 0.01) and lower P3/total ROIs ratio (OR1.04, 95%CI 1.02-1.07, p = 0.003) were associated with an increased risk of csPCa in P3 lesions. P3/total ROIs ratio (AUC 0.73) and prostate volume (AUC 0.70) were superior to PSA density (AUC 0.65) for the prediction of csPCa in P3 lesions. Conclusions: Our data indicated that prostate volume and P3/total ROIs ratio outperformed PSA density in and were associated with detecting csPCa in P3 lesions. P3/total ROIs ratio could be used to avoid 80.6% of unnecessary biopsies of a P3 lesion in men with multiple ROIs.
Dying for the group: Towards a general theory of extreme self-sacrifice
Authors: Harvey Whitehouse
Journal: Behavioral and Brain Sciences (2018)

Abstract Whether upheld as heroic or reviled as terrorism, people have been willing to lay down their lives for the sake of their groups throughout history. Why? Previous theories of extreme self-sacrifice have highlighted a range of seemingly disparate factors, such as collective identity, outgroup hostility, and kin psychology. In this paper, I attempt to integrate many of these factors into a single overarching theory based on several decades of collaborative research with a range of special populations, from tribes in Papua New Guinea to Libyan insurgents and from Muslim fundamentalists in Indonesia to Brazilian football hooligans. These studies suggest that extreme self-sacrifice is motivated by identity fusion, a visceral sense of oneness with the group, resulting from intense collective experiences (e.g., painful rituals or the horrors of frontline combat) or from perceptions of shared biology. In ancient foraging societies, fusion would have enabled warlike bands to stand united despite strong temptations to scatter and flee. The fusion mechanism has often been exploited in cultural rituals, not only by tribal societies but also in specialized cells embedded in armies, cults, and terrorist organizations. With the rise of social complexity and the spread of states and empires, fusion has also been extended to much larger groups, including doctrinal religions, ethnicities, and ideological movements. Explaining extreme self-sacrifice is not only a scientific priority but also a practical challenge as we seek a collective response to suicide, terrorism, and other extreme expressions of outgroup hostility that continue to bedevil humanity today.
Teaching and Learning in Clinical Settings
Authors: Rachel Hooke
Journal: BMJ (2006)

Richard Hays

Radcliffe, 2006, £24.95, 168 pages

ISBN: 1 85775 751 3

Rating: ★★★/5



This book is timely. The establishment of more medical schools in the United Kingdom is leading to expansion in medical student numbers, which will place a greater burden on existing clinical firms. Tuition fees mean today's learners expect higher education institutions and trusts to be more accountable for the syllabus they provide. Learning and assessment theories are fashionable, and this is one of the latest contributions by Radcliffe on the subject.

When I …
Relevance of Social Networks for Adolescent Obesity
Authors: Leonard H. Epstein, Xiaozhong Wen
Journal: JAMA Pediatrics (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 Pediatrics HomeNew OnlineCurrent IssueFor Authors Podcast Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA Pediatrics journal