tbuckley/cabot-search huggingface dataset:
Hyperandrogenism controversy in elite women’s sport: an examination and critique of recent evidence
Authors: Peter H Sőnksen, L Dawn Bavington, Tan Boehning, David Cowan, Nishan Guha, Richard Holt, Katrina Karkazis, Malcolm Andrew Ferguson-Smith, Jovan Mircetic, Dankmar Bőhning
Journal: British Journal of Sports Medicine (2018)

In July 2017, the International Association of Athletics Federations (IAAF) was expected to return to the Court of Arbitration for Sport (CAS) with evidence to justify reinstatement of their controversial hyperandrogenism rule. CAS has granted IAAF a 2-month extension for their response, which was due by the end of September. CAS suspended the IAAF Hyperandrogenism Regulations1 2 years earlier following the successful appeal by the Indian runner Dutee Chand.2 IAAF advisors have published two recent articles in this journal3 4 to support their claims that women with high endogenous testosterone levels have such a significant performance advantage over women with lower levels that it is necessary to exclude them from competing in the female category.

Both papers have examined the relationship between blood testosterone concentration and athletic performance using a cross-sectional design. While such studies can show the presence of association, they do not prove causality and no mention is made of the possible importance of associated androgen insensitivity, while in some there may be a contribution from …
Reported Biologic Differences in Breast Cancer by Race Due to Disparities in Screening
Authors: Ryan A. Denu
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
Certificate in urodynamics
Authors: Jemma Hale
Journal: BMJ (2007)

FURTHER INFORMATION 

Bristol Urological Institute, Southmead Hospital, Bristol BS10 5NB; tel: 0117 959 5690; fax: 0117 950 2229; edu@bui.ac.uk; www.bui.ac.uk

Urologists, gynaecologists, urology nurse specialists, and gynaecology nurse specialists, but really anybody who helps perform or is interested in learning more about urodynamics. The course is aimed at clinicians who have some experience, but do not consider themselves experts.

As part of my current job I am expected to perform urodynamics, and in …
Gestational Diabetes Mellitus: Does One Size Fit All? A Challenge to Uniform Worldwide Diagnostic Thresholds
Authors: H. David McIntyre, Dorte M. Jensen, Richard C. Jensen, Henriette B. Kyhl, Tina K. Jensen, Dorte Glintborg, Marianne Andersen
Journal: Diabetes Care (2018)

OBJECTIVE To define the prevalence and pregnancy outcomes related to elevated fasting venous plasma glucose (FVPG) in a Danish pregnancy cohort. RESEARCH DESIGN AND METHODS This was an observational cohort study including 1,516 women without gestational diabetes mellitus (GDM) by Danish criteria. FVPG measured at 28 weeks’ gestation was related to pregnancy outcomes. RESULTS With use of the World Health Organization (WHO) 2013 threshold of FVPG ≥5.1 mmol/L, 40.1% of the cohort qualified as having GDM. There was no evidence of excess fetal growth, hypertension in pregnancy, or cesarean delivery in women with FVPG &amp;lt;5.6 mmol/L. CONCLUSIONS The WHO 2013 FVPG threshold for GDM is unsuitable for Denmark. It inappropriately labels as having GDM an unmanageably large number of women who are at low absolute risk of pregnancy complications.
I recently declined a job offer after an interview because the job I was offered differed from what I was hoping for. Can a hospital force a doctor to take up a job accepted verbally? What are the GMC guidelines on this?
Authors: James A McCaul
Journal: BMJ (2005)

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>
Effect of epidural block on restoration of protease inhibitors in patients with local kidney cancer.
Authors: Oleg Ivanovich Kit, Dmitry A. Rozenko, Elena Frantsiyants, Larisa S. Kozlova, Valeria A. Bandovkina, Sergey N Dimitriadi, Natalya D. Ushakova, Ludmila Ya. Rozenko, Maksim N. Duritskiy
Journal: Journal of Clinical Oncology (2018)

593 Background: The purpose of the study was to reveal the effect of the epidural block (EB) on the dynamics of the main universal inhibitors in the blood plasma and urine of patients with local kidney cancer. Methods: 58 patients aged 56.5±8.7 years underwent partial nephrectomy with warm ischemia for 15-20 minutes (EB – 35 patients, standard anesthesia (SA) - 23 patients). EB involved catheterization of the epidural space at Th10-L1 with the following infusion of a mixture of ropivacaine 2 mg/ml and epinephrine 2 μg/ml at 6-10 ml/hr using a syringe doser, intraoperatively and within the first three postoperative days. α2-Macroglobulin (α2M) and α1-proteinase inhibitor (α1PI) were studied by ELISA and spectrophotometry in the blood plasma and urine of patients before the surgery (b/s), 40 min after the start of the surgery (40' s/s) and on days 1 and 3 after the surgery (a/s). Results were compared to the levels in the blood plasma and urine of 29 healthy donors (N). Results: α2M and α1PI in the blood plasma and urine of all patients b/s were lower than N (p &lt; 0.05). α2M in the blood plasma of all patients 40' s/s was similar to N. Normal α2M levels were maintained in the blood plasma in EB on days 1-3 a/s, while in SA they increased by 2.8 times on day 1 and decreased by 3.4 times on day 3, compared to the previous measurement results. α1PI in EB began to increase since 40' s/s with its normalization by the day 3 a/s; α1PI in SA was decreased in the blood plasma and urine during the whole study period. The urine/blood plasma ratio for α2M (α2Mu/α2Mb) was increased b/s in all patients, with its normalization on days 1-3 in EB and its decrease by 9.5-3.1 times on days 1 and 3 in SA. The α1PIu/α1PIb ratio was increased b/s on average by 2.1 times in all patients, with its normalization 40' s/s in EB, and remained similar to N by the day 3. Normalization was not observed in SA; α1PIu/α1PIb was decreased since 40' s/s to the day 3 by 1.8-1.4 times (p &lt; 0.05), compared to N. The results showed that in SA, the proteolysis was not controlled in the kidney due to the inhibitor deficiency. Conclusions: The epidural block contributes to the restoration of the activity of α2M and α1PI universal endogenous inhibitors during and after surgery, in contrast to the standard anesthesia.
Targeting Brain-Adaptive Cancer Stem Cells Prohibits Brain Metastatic Colonization of Triple-Negative Breast Cancer
Authors: Ding Ren, Xiaoping Zhu, Ren Kong, Zhen Zhao, Jianting Sheng, Jiang Wang, Xiaoyun Xu, Jiyong Liu, Kemi Cui, Xiang H.-F. Zhang, Hong Zhao, Stephen T.C. Wong
Journal: Cancer Research (2018)

Triple-negative breast cancer (TNBC) exhibits more traits possessed by cancer stem cells (CSC) than other breast cancer subtypes and is more likely to develop brain metastases. TNBC patients usually have shorter survival time after diagnosis of brain metastasis, suggesting an innate ability of TNBC tumor cells in adapting to the brain. In this study, we establish novel animal models to investigate early tumor adaptation in brain metastases by introducing both patient-derived and cell line-derived CSC-enriched brain metastasis tumorsphere cells into mice. We discovered astrocyte-involved tumor activation of protocadherin 7 (PCDH7)-PLCβ-Ca2+-CaMKII/S100A4 signaling as a mediator of brain metastatic tumor outgrowth. We further identified and evaluated the efficacy of a known drug, the selective PLC inhibitor edelfosine, in suppressing the PCDH7 signaling pathway to prohibit brain metastases in the animal models. The results of this study reveal a novel signaling pathway for brain metastases in TNBC and indicate a promising strategy of metastatic breast cancer prevention and treatment by targeting organ-adaptive cancer stem cells.Significance: These findings identify a compound to block adaptive signaling between cancer stem cells and brain astrocytes. Cancer Res; 78(8); 2052-64. ©2018 AACR.
Case 9-2018: A 55-Year-Old Man with HIV Infection and a Mass on the Right Side of the Face
Authors: Kevin L. Ard, Hillary R. Kelly, Rajesh T. Gandhi, Abner Louissaint
Journal: New England Journal of Medicine (2018)

A 55-year-old man with HIV infection and a CD4+ T-cell count of 65 per cubic millimeter presented to the hospital 1 week after he started antiretroviral therapy because of a rapidly enlarging mass at the angle of the right mandible. A diagnostic procedure was performed.
HEE calls for registration at point of graduation and exam entry into foundation training to happen “as swiftly as possible”
Authors: Abi Rimmer
Journal: BMJ (2013)

Health Education England (HEE) wants the proposal to bring full General Medical Council registration forward to the point of graduation to become reality “as swiftly as possible.”

A paper presented to the organisation’s board last week, written by HEE’s medical director, Wendy Reid, also suggested that there should be an exam for entry to the foundation programme.1 The paper said, “Full GMC registration should be brought forward to the point of graduation, but entry to the foundation programme should then be through an enhanced selection process open to all applicants.”

It said that the plans required “major change” to existing legislation in the Medical Act but that there was “an ideal opportunity to enact this change through the Law Commission legislative changes proposed to be submitted to parliament in 2014.”

HEE said that the proposals would meet its …
Minority Equity and Recruitment Into Trials program: Self-assessment of disease-specific cancer clinical trial recruitment patterns at a comprehensive cancer center.
Authors: Hala Borno, Joseph P. McGuire, Ann C. Griffin, Charles J. Ryan, Celia Kaplan, Eric Jay Small
Journal: Journal of Clinical Oncology (2018)

267 Background: Prostate cancer disparities research has largely focused on access to care, treatment, and outcomes. Disparities based on race/ethnicity in clinical trial (CT) participation are less well understood. African American men are known to have an increased risk of developing and dying from prostate cancer compared to their white counterparts yet remain underrepresented in prostate cancer CTs. The goal of this study was to examine the demographic accrual patterns in prostate cancer CTs at an academic cancer center. Methods: A retrospective analysis of demographic data of cancer cases per year was performed from: 1) the central cancer registry of California, Surveillance, Epidemiology, and End Results; 2) new patients (“analytic cases”) identified in the University of California, San Francisco (UCSF) cancer registry; and (3) the UCSF Clinical Trials Management System database. The Catchment Area for the center was prospectively defined, and patients from this region comprised 98% of all cancer cases seen at UCSF. Descriptive statistics were applied to characterize CT accruals for men with prostate cancer relative to cases in our Catchment Area. Results: Overall there were 67,046 new cancer cases of all types in the Catchment Area, of which 6,558 were prostate cancer cases. The distribution of patients with prostate cancer by ethnicity/minority status are summarized (Table). Conclusions: The distribution of minority accruals to prostate cancer CTs conducted at academic cancer centers may not reflect overall accruals to all CTs. At UCSF, the accrual of Latino men with prostate cancer to CTs was representative of the Catchment Area, whereas Asian and Black men were under-represented. These results suggest that tailored, disease-specific interventions are required to achieve equitable CT recruitment.[Table: see text]
The Devil Is in the Details When Removing Cervical Collars After Blunt Trauma
Authors: Mayur B. Patel, John J. Como, Elliott R. Haut
Journal: JAMA Surgery (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 Surgery 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 Surgery journal
Predicted rise in trusts’ income from private patients fails to materialise
Authors: Nigel Hawkes
Journal: BMJ (2018)

Private patients remain a very small proportion of all patients treated by NHS hospitals, in spite of legislation in 2012 that opened the door to increased private income.

Critics of Andrew Lansley’s Health and Social Care Act 2012 said that raising the amount a hospital could earn from 2% to 49% of total earnings would lead to a flood of private patients to the detriment of the NHS. But the study, published by the Centre for Health and the Public Interest, found that this income increased by 16% in cash terms (12% in real terms) between 2012-13 and 2015-16.1

As a proportion of completed treatments, private patients rose from 0.49% to 0.5% over the same period. The proportion was actually higher as long ago as 2009-10, at 0.61%. There were also slightly fewer beds in private patient units in 2016 (1142) than …
ADMISSION MACROPHAGE MIGRATION INHIBITORY FACTOR PREDICTS LONG-TERM PROGNOSIS IN PATIENTS WITH ST-SEGMENT ELEVATION MYOCARDIAL INFARCTION
Authors: Xiangning Deng, Xinyu Wang, Haiyi Yu, Shaomin Chen, Xinye Xu, Youyi Zhang, Anthony Dart, Xiaojun Du, Wei Gao
Journal: Journal of the American College of Cardiology (2018)
Hospitals are reluctant to release senior doctors for national advisory roles
Authors: Ingrid Torjesen
Journal: BMJ (2012)

Hospitals across the United Kingdom are increasingly likely to prevent leading clinicians from taking time out of their day jobs to work part time or as consultants on projects for government organisations and medical colleges.

The General Medical Council has sent a letter to all UK NHS organisations, co-signed by senior government medical officers, asking their boards “to look …
Forming a consultant limited liability partnership
Authors: Tim Trebble, R A Jones
Journal: BMJ (2011)

The continuing liberalisation of secondary healthcare in the NHS is likely to challenge the roles of both hospital based specialist services and their consultants for the foreseeable future. However, this developing market for specialist services also offers considerable opportunities for consultants willing to engage with different healthcare providers.

Forming a limited liability partnership (LLP) provides a legal, financial, and professional framework for consultants prepared to work in partnerships partly or wholly outside their traditional NHS hospital roles. This article discusses the reasons for forming a consultant LLP and gives a nuts and bolts overview of how to set one up.

Over the past decade, the NHS has seen fundamental changes in the ways that specialist services are provided, from hospital based and consultant delivered to a plurality of providers with competition between NHS and foundation trusts, independent sector, and primary care organisations. The next decade is likely to see an acceleration of this trend driven by reduced funding, pressure to decommission secondary care services, and increased competition from general practitioner consortiums and healthcare companies for potentially lucrative NHS contracts.

These trends may threaten the security of tenure that consultants have expected over the duration of their working lives in the NHS. However, this new healthcare environment also offers the possibility of contractual relations with other organisations for those prepared to work in self employed partnerships (in common with GPs). This may include subcontractual work for an independent sector or primary care provider or directly commissioned contractual work, and may involve clinical sessions, education, and advisory services for healthcare delivery.

The benefits of working within a partnership undertaking contractual work include increased flexibility to negotiate salaries and hours, particularly where demand for consultant time outmatches its availability. Furthermore, it may allow consultants greater direct control over how their services are organised …
GMC seeks doctors’ views on introducing credentials
Authors: Abi Rimmer
Journal: BMJ (2015)

The General Medical Council is asking doctors’ for their views on its plan to launch a system of “regulated credentials.”

The regulator has published a consultation document setting out its plan to introduce credentialing for doctors.1 It said that credentialing was a system “which provides formal accreditation of competences (which include knowledge, skills and performance) in a defined area of practice, at a level that provides confidence that the individual is fit to practise in that area.”

David Greenaway’s Shape of Training review suggested that credentialing be introduced into specialty training for doctors. “In our proposed approach to training, some specialty …
Phase II trial of neoadjuvant nivolumab with cisplatin and gemcitabine in muscle-invasive bladder cancer patients undergoing radical cystectomy.
Authors: Shilpa Gupta, Neeraj Agarwal, Badrinath R. Konety, Christopher J. Weight, Bharat Thyagarajan, Paari J Murugan, Joseph S Koopmeiners, Guru Sonpavde
Journal: Journal of Clinical Oncology (2018)

TPS528 Background: Cisplatin-based neoadjuvant chemotherapy in muscle-invasive bladder cancer (MIBC) improves survival outcomes. The survival benefit correlates with pathologic response (PaR) and strategies to improve pathologic response at cystectomy are urgently needed to improve outcomes in these pts. while limiting toxicity. We are exploring the efficacy and safety of N with gemcitabine-cisplatin (GC) as neoadjuvant therapy for MIBC. Methods: This is a single-arm, multi-center phase II study for pts with MIBC eligible for neoadjuvant GC and planned for radical cystectomy. Pts will be treated with N+ GC every 21 days for 4 treatment cycles over 12 weeks followed by radical cystectomy. The primary endpoint of PaR will be evaluated in a single stage design; 41 adult pts will be enrolled and the treatment will be worthy of further study (and the null hypothesis rejected) if paR is seen at the time of cystectomy in more than 19 pts. Key inclusion criteria are presence of MIBC (predominantly urothelial carcinoma) with clinical stage T2-T4a and N≤1 disease (solitary lymph node measuring &lt; 2 cm) and M0 and deemed eligible for radical cystectomy, ECOG PS of 0 or 1, Cr Cl ≥ 50 ml/min, adequate organ function, eligible to receive GC and no contraindications to receiving N. Patients will receive C (70mg/m 2 ) IV on D1, G (1000mg/m2) on D1,D8 and N (360 mg) IV on D8 every 21 days for 4 cycles followed by radical cystectomy within 6-8 weeks. Secondary Objectives are to determine safety of N+GC in pts with MIBC prior to radical cystectomy and PFS. The correlative objectives include: 1)Whole Exome Sequencing (WES) of the pre-treatment bladder cancer biopsy tissues will be correlated with response.2) Molecular subtypes of bladder cancer will be performed using Genomedx to evaluate whether addition of N alters the response to neoadjuvant GC. 3)PD-L1 expression in tumor tissue at baseline will be correlated with response to N+GC therapy and 4) Nanostring pancan immune panel gene expression will be studied at baseline and at cystectomy.The extensive exploratory analyses are aimed at understanding correlation between genomic and immunologic changes in tumor tissues with clinical outcomes. (NCT03294304) Clinical trial information: NCT03294304.
Epitope mapping of PD-L1 primary antibodies (28-8, SP142, SP263, E1L3N).
Authors: Kelly Schats, Emily A. Van Vre, Dorien Schrijvers, Ingrid De Meester, Mark Kockx
Journal: Journal of Clinical Oncology (2017)

3028 Background: Currently, programmed death-ligand 1 (PD-L1) immunohistochemistry (IHC) assays received approval in combination with an anti-PD-1 or anti-PD-L1 compounds. However, the FDA blueprint and other publications revealed differences in staining pattern between PD-L1 IHC assays. More precisely the SP142 assay detects less tumor cells (TC), but more immune cells (IC), while the 28-8 assay is more sensitive for TC and less appropriate for IC detection. SP263 stains TC and IC equally well. E1L3N IHC reveals IC and slightly more TC staining than SP142. This study investigates whether these staining discrepancies can be partly explained by specific epitope recognition. Methods: Linear epitope mapping was performed for PD-L1 antibody clones 28-8, E1L3N, SP142 and SP263. In brief, the PD-L1 sequence (Q9NZQ7, Uniprot) was split into 15 amino acid (AA) peptides with a peptide overlap of 14 AA . Each peptide was printed in duplicate on the PD-L1 microarray. The microarray was exposed to different concentration of the four PD-L1 antibodies. For the detection, sheep anti-rabbit IgG DyLight800 was used. Results: Epitope mapping for the E1L3N antibody revealed a linear epitope in the intracellular domain. The other clones showed weaker binding to multiple peptides. The 28.8 clone demonstrated binding to predominantly intracellular epitopes, while SP142 and SP263 clones showed binding to both intracellularly and extracellularly located epitopes. Blasting the epitope sequences of the PD-L1 antibodies did not disclose identity with another (non-PD-L1) human protein. Conclusions: Different binding characteristics were found for all four PD-L1 antibody clones in a linear epitope mapping experiment. This could lead to particular staining patterns depending on PD-L1 conformation (folding) or isoform expression. Two PD-L1 isoforms are known, with isoform 2 lacking AA 19-132 of the extracellular domain. Especially SP142 binding can be impacted in the case of dominant isoform 2 presence, since epitopes were observed in this spliced domain. Further investigation is needed into the potentially conformational epitopes of SP142, SP263 and 28.8 antibody clones as well as in the PD-L1 conformation and isoform expression in TC and IC.