tbuckley/cabot-search huggingface dataset:
Comparing high-income and low- and middle-income country host perspectives on students’ short-term experiences in global health: a qualitative analysis
Authors: Catherine Myser, Barbara Astle, W Cherniak, Emily Latham, Geoffrey Anguyo, Tessa Beaunoir, Joel H Buenaventura, Matthew DeCamp, Karla Diaz, Quentin Eichbaum, Marius Hedimbi, Charles Nwobu, Kate Standish, Jessica Evert
Journal: The Lancet Global Health (2018)

BackgroundThousands of students travel yearly from high-income countries (HICs) to low-income and middle-income countries (LMICs) for short-term experiences in global health, with much less travel by LMIC students to HICs. Little structured research has been done to seek host perspectives, particularly from LMICs, on what they would like to teach learners. By seeking LMIC host perspectives, we aimed to improve global health pedagogy, curriculum design, assessment, and experiential learning, better meeting host goals and expectations. Our additional aim was to improve mutual respect and trust, share power honestly and ethically, and facilitate more genuinely collaborative agenda setting between LMIC and HIC partners.MethodsWe previously did a hybrid quantitative and qualitative web-based survey from Sept 1, 2015, to Dec 31, 2015, exploring global health competencies with particular attention to LMIC hosts supervising and housing trainees in short-term experiences in global health. 274 host perspectives were gleaned from 38 countries speaking 22 languages. In this qualitative study, we analysed open-ended questions and responses not previously covered from the same survey data. 97 of 274 responses were selected for qualitative analysis, conducted via content analysis and coding, ensuring inter-rater reliability, and comparing HIC and LMIC responses.FindingsFour core themes emerged in our content analysis regarding desired global health core competencies: most important global health core competencies; biggest mistakes students make; biggest challenges students face; and what students should remember most in experiential global health education.InterpretationOur qualitative study revealed intriguing comparative results addressing core controversies in global health, such as who "does global health" and where one must be to "do global health". Moving forward we hope this initial survey research will facilitate more genuinely collaborative agenda setting between North–South and East–West partners.FundingChild Family Health International.
I am interested in a full time career teaching undergraduate or postgraduate students. I would like teaching to be the main focus of my job, but with the opportunity to do some clinical work too. Do such jobs exist (other than research fellow posts and professorial jobs), and if so, how do I go about getting one?
Authors: Michael Dobson
Journal: BMJ (2005)

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Funding hole could leave NHS short of 16 000 GPs, warns royal college
Authors: Helen Jaques
Journal: BMJ (2013)

The NHS in England could be short of up to 16 000 general practitioners (GPs) by 2021 if steps aren’t taken to plug the potential £30bn (€35bn; $46bn) funding shortfall expected by 2020, the Royal College of General Practitioners has said.

Last week, NHS England warned that the health service could face a funding deficit of £30bn between 2013-14 and 2020-21 if the health service continues with the current model of care and expected …
Effect of NT-proBNP–Guided Therapy on All-Cause Mortality in Chronic Heart Failure With Reduced Ejection Fraction
Authors: Navkaranbir S. Bajaj, Nirav Patel, Sumanth D. Prabhu, Garima Arora, Thomas J. Wang, Pankaj Arora
Journal: Journal of the American College of Cardiology (2018)
What are the chances of an ECG-loving surgical SHO making the switch to medicine and eventually cardiology?
Authors: Shrilla Banerjee
Journal: BMJ (2005)

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Elevated Expression of miR302-367 in Endothelial Cells Inhibits Developmental Angiogenesis via CDC42/CCND1 Mediated Signaling Pathways
Authors: Jingjiang Pi, Jie Liu, Tao Zhuang, Lin Zhang, Huimin Sun, Xiaoli Chen, Qian Zhao, Yashu Kuang, Sheng Peng, Xiaohui Zhou, Zuoren Yu, Ting Tao, Brian Tomlinson, Paul Chan, Ying Tian, Huimin Fan, Zhongmin Liu, Xiangjian Zheng, Edward Morrisey, Yuzhen Zhang
Journal: Theranostics (2018)

Rationale: Angiogenesis is critical for embryonic development and microRNAs fine-tune this process, but the underlying mechanisms remain incompletely understood. Methods: Endothelial cell (EC) specific miR302-367 line was used as gain-of-function and anti-miRs as loss-of-function models to investigate the effects of miR302-367 on developmental angiogenesis with embryonic hindbrain vasculature as an in vivo model and fibrin gel beads and tube formation assay as in vitro models. Cell migration was evaluated by Boyden chamber and scratch wound healing assay and cell proliferation by cell count, MTT assay, Ki67 immunostaining and PI cell cycle analysis. RNA high-throughput sequencing identified miR-target genes confirmed by chromatin immunoprecipitation and 3'-UTR luciferase reporter assay, and finally target site blocker determined the pathway contributing significantly to the phenotype observed upon microRNA expression. Results: Elevated EC miR302-367 expression reduced developmental angiogenesis, whereas it was enhanced by inhibition of miR302-367, possibly due to the intrinsic inhibitory effects on EC migration and proliferation. We identified Cdc42 as a direct target gene and elevated EC miR302-367 decreased total and active Cdc42, and further inhibited F-actin formation via the WASP and Klf2/Grb2/Pak1/LIM-kinase/Cofilin pathways. MiR302-367-mediated-Klf2 regulation of Grb2 for fine-tuning Pak1 activation contributing to the inhibited F-actin formation, and then the attenuation of EC migration. Moreover, miR302-367 directly down-regulated EC Ccnd1 and impaired cell proliferation via the Rb/E2F pathway. Conclusion: miR302-367 regulation of endothelial Cdc42 and Ccnd1 signal pathways for EC migration and proliferation advances our understanding of developmental angiogenesis, and meanwhile provides a rationale for future interventions of pathological angiogenesis that shares many common features of physiological angiogenesis.
I am on a GP vocational training scheme and want to become a GP and work in the NHS, but I would love to do part of my training in New Zealand as my partner is there on a surgical rotation. Is this possible?
Authors: Miriam Martin
Journal: BMJ (2005)

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Overexpression of BLM promotes DNA damage and increased sensitivity to platinum salts in triple-negative breast and serous ovarian cancers
Authors: N.J. Birkbak, Y. Li, S. Pathania, A. Greene-Colozzi, M. Dreze, C. Bowman-Colin, Z. Sztupinszki, M. Krzystanek, M. Diossy, N. Tung, P.D. Ryan, J.E. Garber, D.P. Silver, J.D. Iglehart, Z.C. Wang, D. Szuts, Z. Szallasi, A.L. Richardson
Journal: Annals of Oncology (2018)

BackgroundPlatinum-based therapy is an effective treatment for a subset of triple-negative breast cancer and ovarian cancer patients. In order to increase response rate and decrease unnecessary use, robust biomarkers that predict response to therapy are needed.Patients and methodsWe performed an integrated genomic approach combining differential analysis of gene expression and DNA copy number in sensitive compared with resistant triple-negative breast cancers in two independent neoadjuvant cisplatin-treated cohorts. Functional relevance of significant hits was investigated in vitro by overexpression, knockdown and targeted inhibitor treatment.ResultsWe identified two genes, the Bloom helicase (BLM) and Fanconi anemia complementation group I (FANCI), that have both increased DNA copy number and gene expression in the platinum-sensitive cases. Increased level of expression of these two genes was also associated with platinum but not with taxane response in ovarian cancer. As a functional validation, we found that overexpression of BLM promotes DNA damage and induces sensitivity to cisplatin but has no effect on paclitaxel sensitivity.ConclusionsA biomarker based on the expression levels of the BLM and FANCI genes is a potential predictor of platinum sensitivity in triple-negative breast cancer and ovarian cancer.
HOSPITAL VARIATION IN THE UTILIZATION OF SHORT-TERM NON-DURABLE MECHANICAL CIRCULATORY SUPPORT IN MYOCARDIAL INFARCTION COMPLICATED BY CARDIOGENIC SHOCK
Authors: Jordan B. Strom, Yuansong Zhao, Changyu Shen, Mabel Chung, Jeffrey Popma, Robert Yeh
Journal: Journal of the American College of Cardiology (2018)
A targeted genomic analysis uncovered a large spectrum of acquired resistance mechanisms to BRAF inhibitor therapy in metastatic melanoma patients
Authors: B. Louveau, C. Reger de Moura, M. Battistella, A. Sadoux, I. Chami, J. Caramel, S. Dalle, N. Dumaz, C. Lebbe, S. Mourah
Journal: Annals of Oncology (2018)
Night Shift Work, Genetic Risk, and Type 2 Diabetes in the UK Biobank
Authors: Céline Vetter, Hassan S. Dashti, Jacqueline M. Lane, Simon G. Anderson, Eva S. Schernhammer, Martin K. Rutter, Richa Saxena, Frank A.J.L. Scheer
Journal: Diabetes Care (2018)

To examine the effects of past and current night shift work and genetic type 2 diabetes vulnerability on type 2 diabetes odds.In the UK Biobank, we examined associations of current (N = 272,214) and lifetime (N = 70,480) night shift work exposure with type 2 diabetes risk (6,770 and 1,191 prevalent cases, respectively). For 180,704 and 44,141 unrelated participants of European ancestry (4,002 and 726 cases, respectively) with genetic data, we assessed whether shift work exposure modified the relationship between a genetic risk score (comprising 110 single-nucleotide polymorphisms) for type 2 diabetes and prevalent diabetes.Compared with day workers, all current night shift workers were at higher multivariable-adjusted odds for type 2 diabetes (none or rare night shifts: odds ratio [OR] 1.15 [95% CI 1.05-1.26]; some nights: OR 1.18 [95% CI 1.05-1.32]; and usual nights: OR 1.44 [95% CI 1.19-1.73]), except current permanent night shift workers (OR 1.09 [95% CI 0.93-1.27]). Considering a person's lifetime work schedule and compared with never shift workers, working more night shifts per month was associated with higher type 2 diabetes odds (<3/month: OR 1.24 [95% CI 0.90-1.68]; 3-8/month: OR 1.11 [95% CI 0.90-1.37]; and >8/month: OR 1.36 [95% CI 1.14-1.62]; Ptrend = 0.001). The association between genetic type 2 diabetes predisposition and type 2 diabetes odds was not modified by shift work exposure.Our findings show that night shift work, especially rotating shift work including night shifts, is associated with higher type 2 diabetes odds and that the number of night shifts worked per month appears most relevant for type 2 diabetes odds. Also, shift work exposure does not modify genetic risk for type 2 diabetes, a novel finding that warrants replication.
I am looking for information on post-graduate courses in traditional Chinese medicine that are suitable for UK medical practitioners as part of a VTS scheme, or alongside it. A variety of courses can be identified via the internet; does anyone have experience or knowledge of accredited training in this area?
Authors: Colin Lewis
Journal: BMJ (2006)

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A randomized phase III double-blind clinical trial (S1600) evaluating the effect of immune-enhancing nutrition on radical cystectomy outcomes.
Authors: Jill Hamilton-Reeves, Jeffrey M. Holzbeierlein, Joseph M. Unger, Danika L Lew, Michael Jordan Fisch, Norah Lynn Henry
Journal: Journal of Clinical Oncology (2018)

TPS529 Background: This phase III trial will compare the impact of consuming Specialized IMmunonutrition (SIM) to oral nutritional support on postoperative complications after radical cystectomy. Specialized IMmunonutrition is fortified with nutrients (L-arginine, omega-3 fatty acids, dietary nucleotides, and vitamin A) that have immediate effects on immune and inflammatory responses, muscle sparing, and wound healing after surgery. Methods: Two hundred patients will be randomized in a 1:1 fashion to one of two arms. Subjects will be stratified by diversion type (neobladder vs. ileal conduit) and whether the patient had neoadjuvant chemotherapy (any vs. none) to balance the intervention assignment according to important prognostic factors. Nutrition drinks are given three times a day for 5 days before and 5 days after surgery. The primary endpoint is 30 day overall complication rate. Two hundred patients gives 80% power to detect an absolute reduction of 23% in the 30 day overall complication rate (from 65% down to 42%). Secondary endpoints will assess infections, muscle mass, readmissions, quality of life, recurrence, DFS, OS, immune response, cytokines, amino acids, and fatty acids. The trial is testing a high yield, low-risk, low-cost strategy to improve the outcome of patients with bladder cancer who undergo cystectomy. Funding: NIH/NCI/DCP grant award UG1CA189974. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
Epidemiology and survival disparities of prostate cancer in Appalachian Kentucky.
Authors: Zin Myint, Bin Huang, Quan Chen, Peng Wang
Journal: Journal of Clinical Oncology (2018)

292 Background: Prostate cancer is the most common cancer in men in the United States. When comparing the incidence and mortality rates of prostate cancer in Appalachian Kentucky and general population in the United States, Appalachian Kentucky had lower incidence (113 per 100,000 rate vs. 137 per 100,000) but higher mortality rate (23.08% vs. 21.79%) from Surveillance Epidemiology and End Results (SEER) data in 2005-2014. The aim of our study is to further characterize the epidemiology and survival disparities of prostate cancer between Appalachian and non-Appalachian Kentucky. Methods: All stages of prostate cancer patients diagnosed between 2007-2011 were identified through Kentucky Cancer Registry (KCR). Baseline characteristics and survival outcome were compared between Appalachian Kentucky and non-Appalachian Kentucky. Kaplan-Meier plots and cox regression analyses were performed in this population-based study. Results: Out of 12871 patients studied, 3482 patients (26.8%) were Appalachian Kentucky whereas 8489 patients (73.2%) were non-Appalachian Kentucky. Caucasians were the most predominant in both groups. Most Appalachian Kentucky patients fell in the age group between 65-74. Appalachian Kentucky had high Gleason score, high prostate specific antigen (PSA), aggressive histologic grade, more distant disease, high comorbidity score, low high school education and high poverty rate compared to non-Appalachian Kentucky. There was a 5-year survival difference between Appalachian Kentucky and non-Appalachian Kentucky in unadjusted analysis (p &lt; 0.0001). After adjusting with cox regression analysis, no survival difference was seen (p = 0.3866). However, statistical significance in survival was seen in high GLS, high PSA, distant stage, high charlson comorbidity score, and low high school education (p &lt; 0.0001). Conclusions: Our study shows a significant difference in prostate cancer survival between Appalachian and non-Appalachian Kentucky. The difference was not related to geographic location, rather it was more related to high comorbidity score, high poverty rate, low education and less knowledge of health care. Additional research is needed to understand the health care in Appalachia.
EARLY IMPACT OF GUIDELINE PUBLICATION ON ANGIOTENSIN-RECEPTOR NEPRILYSIN INHIBITOR USE AMONG PATIENTS HOSPITALIZED FOR HEART FAILURE
Authors: Nancy Luo, Nicholas G. Ballew, Emily O’Brien, Melissa Greiner, Pamela Peterson, Bradley Hammill, N. Chantelle Hardy, Warren Laskey, Paul Heidenreich, Chun-Lan Chang, Adrian Hernandez, Lesley Curtis, Robert Mentz, Gregg C. Fonarow
Journal: Journal of the American College of Cardiology (2018)
Meta-analysis of randomized clinical trials (RCT) for the adjuvant treatment of high-risk clear cell renal carcinoma (RCC) with vascular endothelial growth factor receptor tyrosine-kinase inhibitors (VEGFR TKIs).
Authors: Daniel Vargas Almeida, Cleyton Z. Oliveira, Andrey Soares, Denis L Jardim, Diogo Assed Bastos, Fernando C. Maluf, Gustavo Werutsky, Fernando Sabino M Monteiro, Vinicius Carrera Souza, Andre Poisl Fay, Fabio A. B. Schutz
Journal: Journal of Clinical Oncology (2018)

660 Background: A significant proportion of RCC patients with localized disease will eventually recur after a curative intent nephrectomy. VEGFR TKIs have significantly improved the outcomes of patients with advanced disease. RCT are ongoing to evaluate the impact of adjuvant VEGFR TKI on clinical outcome of patients with RCC after definitive treatment . Results from 3 RCT have been already published, but data is controversial. Methods: PubMed databases were searched for articles published from January 1996 to October 2017. Eligible studies were limited to phase 3 RCT of US Food and Drug Administration-approved VEGFR TKIs that reported on patients with RCC treated in the adjuvant setting. Statistical analyses were conducted to calculate the summary hazard-ratio (HR) of disease-free survival (DFS), using 95% CIs by random-effects or fixed-effects models on the basis of the heterogeneity of included studies. Results: A total of 4,096 patients from 3 RCT (ASSURE, S-TRAC and PROTECT trials) were included. 2374 patients were randomized to receive sorafenib, sunitinib or pazopanib, and 1722 to receive placebo. The summary HR of DFS for the overall population was 0.88 (95%CI 0.77-1.01; p = 0.0605). When evaluating the report of the ASSURE trial that included only clear cell RCC (n = 3222), the summary HR was 0.85 (95%CI 0.77-0.94; p = 0.0018) favoring adjuvant treatment. No evidence of publication bias was found. Conclusions: This meta-analysis failed to demonstrate a statistically significant improvement in DFS of RCC patients treated with adjuvant VEGFR TKI. However, a statistically significant improvement in DFS was observed when only patients with clear cell histology were evaluated. Longer follow-up of the ongoing trials is necessary in order to better evaluate the impact on overall survival.
Ovarian Cancer Treatment — Are We Getting Warmer?
Authors: David R. Spriggs, Oliver Zivanovic
Journal: New England Journal of Medicine (2018)

Regional chemotherapy theoretically results in a decreased rate of systemic toxic effects and a high pharmacologic advantage in tumors that are confined to a single organ or body cavity.1 However, only in the case of ovarian cancer has such chemotherapy (intraperitoneal chemotherapy) been accepted as part of the standard of care.2 Hyperthermia, at temperatures of up to 42.0°C (107.6°F), has also been considered to be a potential strategy for enhancing the chemotherapeutic effect but has not been widely accepted as part of routine cancer care. Previous uncontrolled trials in which hyperthermia was used in combination with intraperitoneal chemotherapy showed improved . . .
Quality improvement must be part of training, say experts
Authors: Matthew Limb
Journal: BMJ (2016)

All doctors should have access to training in quality improvement, which should be made “part of the mindset” of all health and social care staff, experts have said. Quality improvement has at least as much potential to improve outcomes for patients as cardio-pulmonary resuscitation, they said. A report by the Academy of Medical Royal Colleges, published on 14 March, said that quality improvement should be put at the heart of medical training.1 It sets out how the General Medical Council, medical schools, and medical royal colleges should make the necessary changes in undergraduate and postgraduate education. Among the key recommendations are:
Royal College of Physicians backs campaign for EU to tackle health worker shortages
Authors: Matthew Limb
Journal: BMJ (2015)

The Royal College of Physicians is backing an international campaign calling on the European Union to act on shortages in the healthcare workforce worldwide.

The college has signed a “call to action on human resources for health” (http://bit.ly/1EU7KVv) to be presented to European parliamentarians and the European Commission later this year. The call was launched by a civil society initiative called “Health workers for all and all for health workers” (HW4All), which is funded by the EU. It …
Implementation of working time directive has had adverse impact on training in UK, taskforce says
Authors: Abi Rimmer
Journal: BMJ (2014)

The implementation of the European Working Time Directive in the NHS has had an adverse impact on training in certain medical specialties, including surgery and acute medicine, an independent taskforce has reported.1

Last October the government commissioned an independent taskforce to review concerns about the impact the directive was having on doctors’ learning and patient care in the UK.

The directive was fully incorporated into the NHS in 2009 and means that trainee doctors can work for a maximum of 48 hours a week across a six month period.

The taskforce found that although doctors in some specialties were able to …