tbuckley/cabot-search huggingface dataset:
What characteristics would you look for in a preregistration house officer that would suggest the candidate would make a successful consultant anaesthetist?
Authors: Peter Maguire
Journal: BMJ (2004)

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 (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.
Lipid Lowering in Acute Coronary Syndrome
Authors: Stephen J. Nicholls, Peter J. Psaltis
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
Quarter of female medical academics struggle to return to work after a career break
Authors: Helen Jaques
Journal: BMJ (2013)

A quarter of female medical academics have problems restarting work after a career break, analysis by the Medical Women’s Federation has found.

The federation found that such difficulties affect 23% of female medical academics and that 13% believe that having taken a break has harmed their career progression. 

By comparison, only one in 10 (13%) male …
Some more positives about geriatric medicine
Authors: Alasdair M MacLullich
Journal: BMJ (2005)

EDITOR—The article by Suman provided a good overview of the characteristics of geriatric medicine.1 However, I think it undersold the richness and intellectual complexity of the specialty.

In my view, geriatric medicine is perhaps the most challenging of all hospital specialties to do well. This is because of the sheer complexity entailed. Optimal assessment and management of the average patient in geriatrics requires more knowledge, in more elaborate combinations, than in most other areas of medicine.

There is the general medicine. Then there is the specialist …
Small airways dysfunction: the link between allergic rhinitis and allergic asthma
Authors: Amaryllis Haccuria, Alain Van Muylem, Andrei Malinovschi, Vi Doan, Alain Michils
Journal: European Respiratory Journal (2018)

Abnormal airway reactivity and overproduction of nitric oxide (NO) occurring in small airways have been found in asthma. If the “one airway, one disease” concept is consistent, such dysfunctions should also be detected in the peripheral airways of patients suffering from allergic rhinitis. We investigated whether peripheral airway reactivity and NO overproduction could be documented in distal airways in patients with allergic rhinitis. Exhaled NO fraction ( F eNO ) and the slope (S) of phase III of the single-breath washout test (SBWT) of helium (He) and sulfur hexafluoride (SF 6 ) were measured in 31 patients with allergic asthma, 23 allergic rhinitis patients and 24 controls, before and after sputum induction. SBWT is sensitive to airway calibre change occurring in the lung periphery. The F eNO decrease was more significant in asthma and rhinitis than in controls (−55.1% and −50.0%, respectively, versus −40.8%) (p=0.007 and p=0.029, respectively). S SF 6 and S He increased in all groups. Change in S He (ΔS He ) &gt; ΔS SF 6 was observed in rhinitis (p=0.004) and asthma (p&lt;0.001), whereas ΔS SF 6 = ΔS He in controls (p=0.431). This study provides evidence of peripheral airway dysfunction in patients with allergic rhinitis quite similar to that described in asthma. Furthermore, a large proportion of the increased NO production reported in allergic rhinitis appears to originate in the peripheral airways.
What are the requirements for an SHO job in urology?
Authors: John Bolton
Journal: BMJ (2004)

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 (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.
Delay in review of clinical excellence awards is hitting local award rounds
Authors: Helen Jaques
Journal: BMJ (2012)

The uncertainty over the future of the clinical excellence awards is negatively affecting the local awards system, resulting in variation around the country as to whether trusts will be allocating awards to NHS consultants in 2012. 

The Review Body on Doctors’ and Dentists’ Remuneration (DDRB) submitted its report on the various local …
Abstract OT3-05-11: Palbociclib after CDK inhibitor and endocrine therapy (PACE): A randomized phase II study of fulvestrant versus palbociclib plus fulvestrant, with and without avelumab, for CDK inhibitor pre-treated HR+/HER2- metastatic breast cancer
Authors: EL Mayer, SA Wander, MM Regan, AM DeMichele, A Forero, MF Rimawi, CX Ma, M Cristofanilli, CK Anders, C Huang Bartlett, M Koehler, EP Winer, HJ Burstein
Journal: Cancer Research (2018)

Abstract Background: CDK4/6 inhibition (CDK4/6i) has a significant role in contemporary management of hormone receptor positive/HER2 negative (HR+/HER2-) metastatic breast cancer (MBC). The addition of a CDK4/6i to endocrine therapy (ET) in HR+/HER2- MBC leads to prolongation of progression-free survival in previously untreated and pre-treated HR+/HER2- MBC. Mechanisms of resistance to CDK4/6i are not well described, and it is not known if continuation of CDK4/6i with subsequent lines of ET improves outcomes over ET alone. Further, preclinical data suggest combination therapy with ET, CDK4/6i, and anti-PDL1 may provide synergistic efficacy. The PACE trial was designed to determine the optimal subsequent line of therapy in patients (pts) with HR+ /HER2- MBC that has progressed despite prior CDK4/6 inhibition and endocrine therapy. Methods: PACE (NCT03147287) is a multicenter phase II trial randomizing pts 1:2:1 to Arm A: fulvestrant alone (with option for Palbociclib (P) monotherapy crossover at time of progression); Arm B: fulvestrant + P; or Arm C: fulvestrant + P + avelumab. The primary objective is to evaluate progression-free survival (PFS) with the combination of fulvestrant + P vs. fulvestrant alone; secondary objectives include overall response (OR), safety and tolerability, and PFS comparisons of avelumab containing arm vs other arms. Exploratory objectives include assessment of outcomes in predefined molecular subgroups (i.e. ESR mutation, PI3K mutation, and loss of Rb); and comparing OR by RECIST vs irRECIST in the avelumab cohort. Extensive molecular profiling of tissue, ctDNA, and CTCs for markers of response and resistance to therapy is also planned. Eligible pts have HR+/HER2- MBC, with prior response to and subsequent progression on any CDK4/6i and ET, defined as at least 6 months of prior treatment, with confirmed subsequent progression, and no more than one prior P dose reduction for toxicity. Pts may have had 1-2 prior ET (aromatase inhibitor or tamoxifen), and 0-1 prior lines of chemotherapy. A sample size of 220 patients is planned. Citation Format: Mayer EL, Wander SA, Regan MM, DeMichele AM, Forero A, Rimawi MF, Ma CX, Cristofanilli M, Anders CK, Huang Bartlett C, Koehler M, Winer EP, Burstein HJ. Palbociclib after CDK inhibitor and endocrine therapy (PACE): A randomized phase II study of fulvestrant versus palbociclib plus fulvestrant, with and without avelumab, for CDK inhibitor pre-treated HR+/HER2- metastatic breast cancer [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr OT3-05-11.
Government announces scheme to “fast track” clinicians into senior manager roles in response to Francis report
Authors: Abi Rimmer
Journal: BMJ (2013)

Plans to develop a leadership programme to recruit clinicians into senior management roles have been announced by the government as part of its response to the Francis inquiry.1

Overall the government accepted 281 of the 290 recommendations made by Robert Francis QC in his inquiry into failings at Mid Staffordshire NHS Foundation Trust,2 including nearly all the recommendations on medical training.

The government’s response, which called for greater openness, accountability, and a stronger focus on patient safety, also included plans …
Higher mortality of adults with asthma: A 15‐year follow‐up of a population‐based cohort
Authors: R. E. Lemmetyinen, J. V. Karjalainen, A. But, R. L. O. Renkonen, J. R. Pekkanen, S. K. Toppila‐Salmi, J. K. Haukka
Journal: Allergy (2018)

Abstract Background Higher all‐cause mortality in asthmatics has been shown previously. Polysensitization is associated with higher morbidity among asthmatic children, and allergic rhinitis and/or allergic conjunctivitis ( AR / AC ) are associated with higher morbidity in adult asthmatics. Little is known about the effect of AR / AC and other factors on mortality among adult asthmatics. The aim was to study mortality and its risk factors in adults with and without asthma. Methods We randomly selected 1648 asthmatics with age over 30 years from national registers and matched the asthma sample with one or two controls. Baseline information was obtained by a questionnaire in 1997, and the study population was linked with the death certificate information of Statistics Finland from 1997 to 2013. Overall and cause‐specific survival between the groups was compared in several adjusted models. Results During a mean follow‐up period of 15.6 years, 221 deaths among 1052 asthma patients and 335 deaths among 1889 nonasthmatics were observed. Cardiovascular diseases were the main cause of death in both groups. Asthma was associated with increased all‐cause mortality (adjusted HR 1.25; 95% CI 1.05‐1.49, P = .011) as well as mortality from chronic obstructive pulmonary disease ( HR 12.0, 4.18‐34.2, P &lt; .001) and malignant neoplasms of respiratory organs ( HR 2.33, 1.25‐4.42, P = .008). Among asthmatics, smoking was associated with increased all‐cause mortality, and self‐reported AR / AC was associated with decreased mortality. Among nonasthmatics, smoking, and obesity were associated with increased all‐cause mortality, whereas female gender showed an association with a decreased risk. Conclusions Increased mortality among adult asthmatics was largely explained by the development of COPD , malignant respiratory tract neoplasms, and cardiovascular diseases. Smoking cessation is important for reduction in total mortality in both asthmatic and nonasthmatic adults. AR / AC was associated with decreased mortality only in asthmatics. Thus, studies in other populations of larger size are needed to explore further the nature of this association.
Healthy food for staff will be a focus for NHS in 2015, Royal Society for Public Health says
Authors: Abi Rimmer
Journal: BMJ (2015)

Healthy food for hospital staff will be a key issue for the NHS in 2015, the Royal Society for Public Health believes.

Speaking to BMJ Careers, Shirley Cramer, the chief executive of the Royal Society for Public Health, said that there would a push for NHS employees to be exemplars of healthy living. Providing healthy food for NHS staff …
Climate event consequences on food insecurity and child stunting among smallholder farmers in Uganda: a cross-sectional study
Authors: Stephanie Ly, Patrick Olobo Okello, Robert Mpiira, Zulfigar Ali
Journal: The Lancet Global Health (2018)

BackgroundClimate fluctuations and crop loss are predicted for Uganda. The rural poor rely on subsistence farming, and the consequences of climate events including droughts, floods, and pests have a considerable impact on food security and health. Nationally, 29% of Ugandan children are stunted or below expected height. In this study, we investigated farmers’ experiences of climate events with household food insecurity and child stunting.MethodsBRAC Uganda did a cross-sectional study with random sampling across 210 villages in four districts in southwestern Uganda between October and December 2015. Questionnaires on socioeconomics, nutrition, and farming were administered to 7787 smallholder farmers. Anthropometry measurements were taken from the youngest child under 2 years in each household. Stunting, defined as a height-for-age Z-score below −2, was analysed using logistic regression. Food insecurity, self-reported as the number of months without enough food to meet needs, was analysed using multivariate linear regression.FindingsMost adults had received only primary-level education and mean monthly income was 332 274 Ugandan Shillings (US$92). In the past 12 months, 6815 (87·8%) farmers experienced a major loss of crops due to drought, 1595 (20·6%) due to flooding, and 7754 (39·1%) due to pests and disease. Food insecurity was reported in 7269 (93·3%) households, for a mean of 4·53 (SD 2·84) out of 12 months. Anthropometric data were collected from 2177 children with a mean age of 11·6 months. 899 were stunted (41·3%). Households with drought-related crop loss had higher odds of child stunting (OR 1·38, 95% CI 1·01–1·89) than households with no crop loss, after controlling for food insecurity, income, education, the child's sex, and age. Food insecurity was significantly associated with crop loss due to drought (p<0·001) and pests (p<0·001), after controlling for covariates. Interestingly, household coping behaviours after pest-related crop loss changed the pest loss effects, which suggests farmers could influence food insecurity.InterpretationAs climate patterns shift in Uganda, smallholder farmers will continue to experience events like drought, flooding, and pests. In our study, most farmers’ food security was affected by drought and pests, and droughts were linked to child stunting. These findings have implications in building resiliency in crops and farmer techniques to mitigate climate shocks.FundingBRAC, Japan Social Development Fund, World Bank Group Africa Gender Innovation Lab, UCLA World Policy Analysis Center, Conrad N Hilton Foundation, UCLA FSPH Dean's Global Health Fellowship.
Doncaster third gastrointestinal anastomosis course
Authors: Judith Ritchie
Journal: BMJ (2012)

This excellent one day course is aimed at trainees in general surgery at core training year 1 to specialty training year 3 level. Trainees must have completed a basic surgical skills course and ideally should be doing a general surgical rotation so that the techniques covered in the course can be applied in clinical practice. The course is open to trainees from anywhere within the United Kingdom and is now becoming affiliated with the Association of Surgeons in Training.

The course is run by the general surgery department of Doncaster Royal Infirmary and is led by consultant colorectal surgeon AB Harikrishnan, two consultant colleagues, and two registrars in general surgery. In future, the course will be held twice a year, with a maximum of 12 delegates on each course. Delegate numbers are limited to maintain a high trainer to trainee ratio. My course was …
USEFULNESS OF COMBINED RIGHT VENTRICULAR EJECTION FRACTION AND THE MODE OF END-STAGE LIVER DISEASE SCORE FOR WORSENING HEART FAILURE IN CHRONIC HEART FAILURE
Authors: Eiji Fukuhara, Takahisa Yamada, Takahisa Morita, Yoshio Furukawa, Shunsuke Tamaki, Yusuke Iwasaki, Masato Kawasaki, Astushi Kikuchi, Tsutomu Kawai, Masahiro Seo, Iyo Ikeda, Jyun Nakamura, Makoto Abe, Kiyomi Kayama, Masatsugu Kawahira, Kazuya Tanabe, Masatake Fukunami
Journal: Journal of the American College of Cardiology (2018)
Characterization and allergic role of IL-33-induced neutrophil polarization
Authors: Bo Sun, Linnan Zhu, Yaling Tao, Hai-Xi Sun, Yang Li, Peng Wang, Yuzhu Hou, Yang Zhao, Xiaodong Zhang, Lianfeng Zhang, Ning Na, Yong Zhao
Journal: Cellular and Molecular Immunology (2018)
Effect of a Health Care Professional Communication Training Intervention on Adolescent Human Papillomavirus Vaccination
Authors: Amanda F. Dempsey, Jennifer Pyrznawoski, Steven Lockhart, Juliana Barnard, Elizabeth J. Campagna, Kathleen Garrett, Allison Fisher, L. Miriam Dickinson, Sean T. O’Leary
Journal: JAMA Pediatrics (2018)

The incidence of human papillomavirus (HPV)-related cancers is more than 35 000 cases in the United States each year. Effective HPV vaccines have been available in the United States for several years but are underused among adolescents, the target population for vaccination. Interventions to increase uptake are needed.To evaluate the effect of a 5-component health care professional HPV vaccine communication intervention on adolescent HPV vaccination.A cluster randomized clinical trial using covariate-constrained randomization to assign study arms and an intent-to-treat protocol was conducted in 16 primary care practices in the Denver, Colorado, metropolitan area. Participants included 188 medical professionals and 43 132 adolescents.The 5 components of the intervention were an HPV fact sheet library to create customized information sheets relevant to each practice's patient population, a tailored parent education website, a set of HPV-related disease images, an HPV vaccine decision aid, and 2½ hours of communication training on using a presumptive vaccine recommendation, followed by motivational interviewing if parents were resistant to vaccination. Each practice participated in a series of 2 intervention development meetings over a 6-month period (August 1, 2014, to January 31, 2015) before the intervention.Differences between control and intervention changes over time (ie, difference in differences between the baseline and intervention period cohorts of patients) in HPV vaccine series initiation (≥1 dose) and completion (≥3 doses) among patients aged 11 to 17 years seen at the practices between February 1, 2015, and January 31, 2016. Vaccination data were obtained from the practices' records and augmented with state immunization information system data.Sixteen practices and 43 132 patients (50.3% female; median age, 12.6 years [interquartile range, 10.8-14.7 years] at the beginning of the study period) participated in this trial. Adolescents in the intervention practices had significantly higher odds of HPV vaccine series initiation (adjusted odds ratio [aOR], 1.46; 95% CI, 1.31-1.62) and completion (aOR, 1.56; 95% CI, 1.27-1.92) than those in the control practices (a 9.5-absolute percentage point increase in HPV vaccine series initiation and a 4.4-absolute percentage point increase in HPV vaccine series completion in intervention practices). The intervention had a greater effect in pediatric practices compared with family medicine practices and in private practices compared with public ones. Health care professionals reported that communication training and the fact sheets were the most used and useful intervention components.A health care professional communication intervention significantly improved HPV vaccine series initiation and completion among adolescent patients.clinicaltrials.gov Identifier: NCT02456077.
The Origins and Vulnerabilities of Two Transmissible Cancers in Tasmanian Devils
Authors: Maximilian R. Stammnitz, Tim H.H. Coorens, Kevin C. Gori, Dane Hayes, Beiyuan Fu, Jinhong Wang, Daniel E. Martin-Herranz, Ludmil B. Alexandrov, Adrian Baez-Ortega, Syd Barthorpe, Alexandra Beck, Francesca Giordano, Graeme W. Knowles, Young Mi Kwon, George Hall, Stacey Price, Ruth J. Pye, Jose M.C. Tubio, Hannah V.T. Siddle, Sukhwinder Singh Sohal, Gregory M. Woods, Ultan McDermott, Fengtang Yang, Mathew J. Garnett, Zemin Ning, Elizabeth P. Murchison
Journal: Cancer Cell (2018)

Transmissible cancers are clonal lineages that spread through populations via contagious cancer cells. Although rare in nature, two facial tumor clones affect Tasmanian devils. Here we perform comparative genetic and functional characterization of these lineages. The two cancers have similar patterns of mutation and show no evidence of exposure to exogenous mutagens or viruses. Genes encoding PDGF receptors have copy number gains and are present on extrachromosomal double minutes. Drug screening indicates causative roles for receptor tyrosine kinases and sensitivity to inhibitors of DNA repair. Y chromosome loss from a male clone infecting a female host suggests immunoediting. These results imply that Tasmanian devils may have inherent susceptibility to transmissible cancers and present a suite of therapeutic compounds for use in conservation.
Endoplasmic reticulum stress induced Lox-1<sup>+</sup> CD15<sup>+</sup> polymorphonuclear myeloid-derived suppressor cells in hepatocellular carcinoma and associated with poor prognsis.
Authors: Xing Li, Xiang-yuan Wu, Nan Jiang, Yan-Fang Xing, Jie Chen, Qu Lin
Journal: Journal of Clinical Oncology (2018)

38 Background: A recent study indicated that Lectin-type oxidized LDL receptor-1 (LOX-1) was a distinct surface marker for human polymorphonuclears myeloid-derived suppressor cells (PMN-MDSC). The present study was aimed to investigate the existence LOX-1 PMN-MDSC in hepatocellular carcinoma (HCC) patients, the latent mechanism and their association with clinical parameters. Methods: 30 HCC patients and 30 health control were included. LOX-1 + CD15 + PMN-MDSCs were investigated. Results: LOX-1 + CD15 + PMN-MDSC were significantly elevated in both WB and PBMC of HCC patients compared with healthy control. LOX-1 + CD15 + PMN-MDSC were more abundant in PBMC than WB. Addition of PMN-MDSCs resulted in significantly reduced proliferation and IFN-γ production of T cells with a dosage dependent manner. LOX-1 - CD15 + PMNs present no suppressive function. The suppression on T cell proliferation and IFN-γ production was reversed by ROS inhibitor and Arginase inhibitor. ROS level of LOX-1 + CD15 + PMN by DCFDA were higher in LOX-1 + CD15 + PMN-MDSCs than LOX-1 - CD15 + PMNs, as well as the mRNA levels of the NADPH oxidase NOX2. Meanwhile, the expression of arginase I and activity of arginase were also significantly raised in LOX-1 + CD15 + PMN-MDSCs. LOX-1 + CD15 + PMN-MDSCs displayed significantly higher expression of spliced X-box–binding protein 1 (sXBP1), ATF3 and CCAAT/enhancer binding protein (CHOP) were higher. For HCC patients, LOX-1 + CD15 + PMN-MDSCs in WB were positively related to Cancer of the Liver Italian Program (CLIP) score. Conclusions: LOX-1 + CD15 + PMN-MDSC were elevated in HCC patients and suppressed T cell proliferation through ROS/Arg I pathway with ER stress as a potential feature. LOX-1 + CD15 + PMN-MDSC presented positive association with the prognosis of HCC patients.
MSCT-GUIDED OVERSIZING OF SELF-EXPANDABLE TRANSCATHETER AORTIC VALVE REPLACEMENT: IMPACT ON 3-YEAR CLINICAL OUTCOMES
Authors: Maria Drakopoulou, Konstantinos Toutouzas, Konstantinos Stathogiannis, George Latsios, Andreas Synetos, George Oikonomou, Maria Xanthopoulou, Vasiliki Penesopoulou, George Trantalis, Odysseas Kaitozis, Eleftherios Tsiamis, Dimitris Tousoulis
Journal: Journal of the American College of Cardiology (2018)