tbuckley/cabot-search huggingface dataset:
Trends and Patterns of Geographic Variation in Mortality From Substance Use Disorders and Intentional Injuries Among US Counties, 1980-2014
Authors: Laura Dwyer-Lindgren, Amelia Bertozzi-Villa, Rebecca W. Stubbs, Chloe Morozoff, Shreya Shirude, Jürgen Unützer, Mohsen Naghavi, Ali H. Mokdad, Christopher J. L. Murray
Journal: JAMA (2018)

<h3>Importance</h3> Substance use disorders, including alcohol use disorders and drug use disorders, and intentional injuries, including self-harm and interpersonal violence, are important causes of early death and disability in the United States. <h3>Objective</h3> To estimate age-standardized mortality rates by county from alcohol use disorders, drug use disorders, self-harm, and interpersonal violence in the United States. <h3>Design and Setting</h3> Validated small-area estimation models were applied to deidentified death records from the National Center for Health Statistics (NCHS) and population counts from the US Census Bureau, NCHS, and the Human Mortality Database to estimate county-level mortality rates from 1980 to 2014 for alcohol use disorders, drug use disorders, self-harm, and interpersonal violence. <h3>Exposures</h3> County of residence. <h3>Main Outcomes and Measures</h3> Age-standardized mortality rates by US county (N = 3110), year, sex, and cause. <h3>Results</h3> Between 1980 and 2014, there were 2 848 768 deaths due to substance use disorders and intentional injuries recorded in the United States. Mortality rates from alcohol use disorders (n = 256 432), drug use disorders (n = 542 501), self-harm (n = 1 289 086), and interpersonal violence (n = 760 749) varied widely among counties. Mortality rates decreased for alcohol use disorders, self-harm, and interpersonal violence at the national level between 1980 and 2014; however, over the same period, the percentage of counties in which mortality rates increased for these causes was 65.4% for alcohol use disorders, 74.6% for self-harm, and 6.6% for interpersonal violence. Mortality rates from drug use disorders increased nationally and in every county between 1980 and 2014, but the relative increase varied from 8.2% to 8369.7%. Relative and absolute geographic inequalities in mortality, as measured by comparing the 90th and 10th percentile among counties, decreased for alcohol use disorders and interpersonal violence but increased substantially for drug use disorders and self-harm between 1980 and 2014. <h3>Conclusions and Relevance</h3> Mortality due to alcohol use disorders, drug use disorders, self-harm, and interpersonal violence varied widely among US counties, both in terms of levels of mortality and trends. These estimates may be useful to inform efforts to target prevention, diagnosis, and treatment to improve health and reduce inequalities.
Abstract 20258: Low Yield of Routine Coronary Angiography in the Setting of Monomorphic VT
Authors: Amar Trivedi, Nishant Verma, Rishi Arora, Bradley P Knight, Susan S Kim, Albert C Lin, Rod S Passman, Alexandru P Chicos
Journal: Circulation (2016)

Introduction:  Monomorphic Ventricular Tachycardia (MVT) in patients with CAD is often a reentrant rhythm related to a healed myocardial infarction. Coronary ischemia is not a well-described cause of MVT. However, the routine use of coronary angiography to evaluate and treat obstructive CAD in patients with MVT is recommended by prior and current guidelines and used routinely in practice.   Hypothesis:  The routine use of coronary angiography in the evaluation of patients with MVT is unlikely to discover new obstructive CAD.   Methods:  A retrospective analysis of patients at a single center undergoing cardiac catheterization for MVT during a 5-year period from 2010 to 2015 was performed. Baseline characteristics, coronary angiography findings, PCI and any documentation of recurrent MVT were collected.   Results:  We identified 123 patients that underwent cardiac catheterization for evaluation of MVT. The average age of patients in the study was 64 years (+/-12.5 years). 45% of patients had a known history of CAD, 26% had previously underwent coronary artery bypass grafting, and 32% had a previously implanted ICD. The average ejection fraction was 46% (+/-15%). 40% of patients in the study had no structural heart disease, 37% were previously diagnosed with ischemic cardiomyopathy, 8% with non-ischemic cardiomyopathy and 12% with other forms of cardiomyopathy. 55 patients (45%) had non-sustained MVT (NSVT), 53 patients (54%) had sustained MVT or ICD therapy, 2 patients (1.6%) had MVT with cardiac arrest. Only 11 patients (9%) underwent PCI. Eight of these patients had recurrent MVT. Of 3 patients without known recurrence (2.4%), 1 is on amiodarone and the other two patients initially presented with asymptomatic NSVT. No patient that underwent PCI had angiographic findings consistent with plaque rupture.   Conclusion:  Few patients had CAD that prompted PCI, and there appears to be little or no benefit from PCI in the treatment of MVT. Coronary angiography may not be warranted in the routine evaluation of patients with MVT.
ABSOLUTE CORONARY ARTERY CALCIUM SCORES PREDICT MORTALITY BETTER THAN AGE-SEX-RACE/ETHNICITY PERCENTILE: CAC CONSORTIUM
Authors: Gowtham Grandhi, Tanuja Rajan, Zeina Dardari, Michael Miedema, Leslee Shaw, John Rumberger, Alan Rozanski, Mouaz H. Al-Mallah, Daniel Berman, Matthew Budoff, Khurram Nasir, Michael Blaha
Journal: Journal of the American College of Cardiology (2018)
P051 Loss of bone mass in patients with head and neck tumours in the first year after the diagnosis of the disease
Authors: R Hernández, J Fuentes Pradera, J Uceda, JL Marenco de la Fuente
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Introduction</h3> Head and neck tumours (TTCC) constitute a heterogeneous group of diseases that affect the otorhinolaryngological sphere. The risk factors such as tobacco and alcohol are also for osteoporosis too. The cancer itself, with the malnutrition suffered after surgical treatment and chemoradiotherapy, represents a potential situation of bone loss with the subsequent appearance of osteoporosis and its complication 'the fracture'. We do not have data on the frequency of osteoporosis in patients with head and neck tumours. <h3>Objectives</h3> To evaluate the loss of bone mineral density (BMD) in the lumbar spine during the first year of follow-up after diagnosis in a cohort of patients with head and neck tumours. <h3>Methods</h3> Observational, longitudinal and prospective study in a cohort of patients with TTCC at the Virgen de Valme hospital, one year follow-up. Bone mineral density was measured by DXA in the lumbar spine before the start of treatment and once a year. To identify qualitative factors that determine bone loss (&lt;2%/≥2%), contingency tables are performed and the Chi-Square test or the non-asymptotic methods of the Monte Carlo test and the Exacta test are applied. <h3>Results</h3> A total of 50 patients were included. 100% of the patients were male. The average age at diagnosis of 60.9±7.8 years. 98% were smokers, and 76% habitual heavy drinkers. 12% had a family history of hip fracture. 18% have a disease that causes malabsorption syndrome. The median BMD at baseline is 1.05 g/cm<sup>2</sup>, and after one year of follow-up this median decrease is 1.02. The loss of bone mass in a year expressed in median is estimated at 0.03 g/cm<sup>2</sup>, which corresponds to a loss of bone mass per year of 2.8%, which reflects a greater loss than that of a population of same age and sex estimated at 0.5–1% per year. Although the loss suffered by our patients is not from a significant statistical point of view, given the sample size, it does reflect a tendency to increase the risk of osteoporosis in these patients. <h3>Conclusions</h3> Patients with TTCC suffer a bone loss greater than expected in a population of equal age and sex, in the first year of follow-up. Initial screening of these patients would be indicated, which would include OP and/or fracture risk factors. <h3>Reference</h3> . Valero C, Olmos JM, Rivera F, Hernandez JL, Vega ME, Gonzalez Macias J. Osteoprotegerin and bone mass in squamous cell head and neck cancer patients. <i>Calcif Tissue Int</i> 2006;78:343–347. <h3>Disclosure of interest</h3> None declared
VASOACTIVE INOTROPIC SCORE AS A PREDICTOR OF MORTALITY IN ADULT PATIENTS WITH CARDIOGENIC SHOCK
Authors: Soo Jin Na, Chi Ryang Chung, Yang Hyun Cho, Kyeongman Jeon, Gee Young Suh, Joong Hyun Ahn, Keumhee C. Carriere, Taek Kyu Park, Ga Yeon Lee, Joo Myung Lee, Young Bin Song, Joo-Yong Hahn, Jin-Ho Choi, Seung-Hyuk Choi, Hyeon-Cheol Gwon, Jeong Hoon Yang
Journal: Journal of the American College of Cardiology (2018)
Clinical radiology trainee numbers must rise, says Centre for Workforce Intelligence
Authors: Helen Jaques
Journal: BMJ (2013)

The number of specialty training places in clinical radiology in England should be increased by 17% so that the specialty can cope with rising demand, the Centre for Workforce Intelligence has said.

The number of radiology examinations conducted in England rose by 26% from 2004-5 to 2010-11. The biggest rises were in those that involved the most …
Editor’s Choice: Warnings of a new dark age
Authors: Tom Moberly
Journal: BMJ (2015)

> “Burns pointed out that a doctor has to work for nine years to earn more than the manager of a Pret a Manger sandwich shop”

Anyone entering the medical profession expects to work out of hours to meet patients’ needs. From the start of doctors’ working lives, the antisocial hours that they are required to work disrupt family and social life, and those pressures continue as careers progress into senior posts.

The hours …
Abstract 12289: The Nuclear Receptor NR4A1 Regulates Transcriptional Programs Involved in Cardiac Fuel Metabolism and Hypertrophic Growth
Authors: Yasuhiro Hayashi, Ling Lai, Michelle H Kim, Teresa C Leone, Rick B Vega, Daniel P Kelly
Journal: Circulation (2015)

The transcriptional coregulators, peroxisome proliferator-activated receptor gamma coactivator-1 (PGC-1) alpha and beta, are inducible master regulators of mitochondrial biogenesis and metabolism. Studies in rodents and in humans have shown that expression and activity of PGC-1 coactivators is downregulated in the failing heart. Surprisingly, we found that adult mice with cardiac-specific deletion of the PGC-1alpha/beta genes exhibit relatively normal cardiac function despite a significant reduction in mitochondrial state 3 respiration, suggesting the existence of a compensatory energy metabolic pathway. Unbiased transcriptional profiling demonstrated upregulation of the orphan nuclear receptor NR4A1 (Nur77) and the related nuclear receptor NR4A3 (Nor1) in PGC-1 null hearts, consistent with an adaptive response to energetic stress. We found that expression of NR4A1 family members is induced in heart by a variety of physiological stress stimuli. In addition, activation of beta-adrenergic signaling with isoproterenol led to rapid and dramatic induction in the expression of all NR4A members in the mouse heart. To identify cardiac NR4A1 targets, total RNA-seq was performed in neonatal rat ventricular myocytes (NRVMs) overexpressing NR4A1. NR4A1 expression of genes involved in glucose uptake/utilization pathways and high energy phosphate transfer including Slc2a4 (Glut4), Eno3 (enolase 3), and Ckmt2 (mitochondrial creatinine kinase). Consistent with the transcriptomic changes, NR4A1 increased myocyte 2-deoxylglucose uptake and oxygen consumption rates (OCR) in these cells. Interestingly, the RNA-seq data also revealed that NR4A1 overexpression downregulated many cardiac pathologic hypertrophic markers such as ANF and BNP. NR4A1 overexpression also significantly inhibited phenylephrine-induced NRVM hypertrophy. Finally, NR4A1 knockout mice exhibit exuberant cardiac hypertrophy following chronic isoproterenol administration. Taken together, these data suggest NR4A1 serves as a stress-induced transcription factor that regulates fuel metabolism and cardiac remodeling. The long-term goal of this project is to determine if activation of this pathway holds therapeutic benefit in acute heart failure.
Signatures of Selection on Standing Genetic Variation Underlie Athletic and Navigational Performance in Racing Pigeons
Authors: Małgorzata A Gazda, Pedro Andrade, Sandra Afonso, Jolita Dilytė, John P Archer, Ricardo J Lopes, Rui Faria, Miguel Carneiro
Journal: Molecular Biology and Evolution (2018)

Racing pigeons have been selectively bred to find their way home quickly over what are often extremely long distances. This breed is of substantial commercial value and is also an excellent avian model to gain empirical insights into the evolution of traits associated with flying performance and spatial orientation. Here, we investigate the molecular basis of the superior athletic and navigational capabilities of racing pigeons using whole-genome and RNA sequencing data. We inferred multiple signatures of positive selection distributed across the genome of racing pigeons. The strongest signature overlapped the CASK gene, a gene implicated in the formation of neuromuscular junctions. However, no diagnostic alleles were found between racing pigeons and other breeds, and only a small proportion of highly differentiated variants were exclusively detected in racing pigeons. We can thus conclude that very few individual genetic changes, if any, are either strictly necessary or sufficient for superior athletics and navigation. Gene expression analysis between racing and nonracing breeds revealed modest differences in muscle (213) and brain (29). These transcripts, however, showed only slightly elevated levels of genetic differentiation between the two groups, suggesting that most differential expression is not causative but likely a consequence of alterations in regulatory networks. Our results show that the unique suite of traits that enable fast flight, long endurance, and accurate navigation in racing pigeons, do not result from few loci acting as master switches but likely from a polygenic architecture that leveraged standing genetic variation available at the onset of the breed formation.
FusorSV: an algorithm for optimally combining data from multiple structural variation detection methods
Authors: Timothy Becker, Wan-Ping Lee, Joseph Leone, Qihui Zhu, Chengsheng Zhang, Silvia Liu, Jack Sargent, Kritika Shanker, Adam Mil-homens, Eliza Cerveira, Mallory Ryan, Jane Cha, Fabio C. P. Navarro, Timur Galeev, Mark Gerstein, Ryan E. Mills, Dong-Guk Shin, Charles Lee, Ankit Malhotra
Journal: Genome biology (2018)

Comprehensive and accurate identification of structural variations (SVs) from next generation sequencing data remains a major challenge. We develop FusorSV, which uses a data mining approach to assess performance and merge callsets from an ensemble of SV-calling algorithms. It includes a fusion model built using analysis of 27 deep-coverage human genomes from the 1000 Genomes Project. We identify 843 novel SV calls that were not reported by the 1000 Genomes Project for these 27 samples. Experimental validation of a subset of these calls yields a validation rate of 86.7%. FusorSV is available at https://github.com/TheJacksonLaboratory/SVE .
DRUG-ELUTING VERSUS BARE-METAL STENTS IN SAPHENOUS VEIN GRAFT LESIONS: A META-ANALYSIS OF RANDOMIZED CONTROLLED TRIALS
Authors: Abel Casso Dominguez, Yasmin Herrera, Yash Patel, Arpit Shah, Addi Suleiman, Jacqueline E. Tamis-Holland
Journal: Journal of the American College of Cardiology (2018)
Global Cancer Clinical Trials—Cooperation Between Investigators in High-Income Countries and Low- and Middle-Income Countries
Authors: Pankaj Kumar Panda, Rakesh Jalali
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
Editor’s Choice: Growth and nourishment
Authors: Tom Moberly
Journal: BMJ (2015)

The UK’s need for more GPs is now so inescapable that even politicians have recognised that “something must be done.” But deciding what that “something” should be remains a challenge for those with the power to drive through the necessary changes. 

Pledges to increase the number of GP training posts without tackling wider issues concerning medical education and the GP …
Restrict leave during trainee handover, say Academy of Royal Colleges and NHS Employers
Authors: Caroline White
Journal: BMJ (2013)

Trusts should consider restricting leave and rescheduling non-essential activities to ensure that consultants and other key staff are on hand to help new trainees find their feet in August, suggests a set of recommendations aimed at bolstering the safety of patients and the consistency of care during handover periods.

The new recommendations, jointly produced by the Academy of Medical Royal Colleges and NHS Employers, set out four principles to ensure that new trainees are properly supported and can maximise their learning opportunities when they are starting out.

These principles are …
IMPACT OF KNOWLEDGE-BASED ITERATIVE MODEL RECONSTRUCTION ON THE FEASIBILITY OF CORONARY COMPUTED TOMOGRAPHY ANGIOGRAPHY IN OBESE PATIENTS
Authors: Reza Reyaldeen, Sarushen Gounden, Colin Jeffries, Bruno Jesuthasan, Shashi Ranjan, Prasad Challa, Arun Dahiya
Journal: Journal of the American College of Cardiology (2018)
Detection of actionable <i>BRAF</i> missense mutations by ctDNA-based genomic analysis in prostate cancer.
Authors: Malshundria Prophet, Kun Xiao, Theodore Stewart Gourdin, Rebecca J Nagy, Lesli Ann Kiedrowski, Elisa Ledet, Guru Sonpavde, A. Oliver Sartor, Michael B. Lilly
Journal: Journal of Clinical Oncology (2018)

306 Background: Activating BRAF fusion proteins are rare in prostate cancer (PCa) patients. Driver missense BRAF mutations have not been reported in detail in this population. Methods: We examined ctDNA-derived genomic profiles (Guardant 360) from 2,721 unique PCa patients, to identify BRAF genomic anomalies (SNVs, amplification). The ctDNA results were compared with PCa tissue-based genomics from the TCGA database (1,851 unique patients). Results: BRAF missense mutations were found in 76 ctDNA patients (2.8%) and were from all known mutation classes (I, II, III) as well as variants of unknown significance (VUSs). Only 4 patients had the V600E mutation. Multiple examples of known, autonomously active, non-canonical mutations were found (27), including K601E (12), G469A (5), D594G (2), and G466E (2). There were 45 VUSs. Mutations were primarily clonal but subclonal mutations were also found. In addition BRAF was commonly amplified, usually in the presence of multiple other amplified genes. BRAF missense mutations were more common with ctDNA than TCGA (2.8% vs 1.4%). Neither dataset identified frequent V600E mutations (ctDNA: 4/2,721; TCGA 1/1,851). However patients with the same non-canonical BRAF mutations were found in each dataset (K601E, G469A, G466E, D594G). Each dataset contained unique mutations found in only one patient. BRAF mutations potentially treatable with BRAF or MEK inhibitors (class I, II) were about half of all mutations (ctDNA 40.8%; TCGA 50%). We treated a PCa patient with a clonal BRAF(G469A) mutation with targeted therapy. The patient was resistant to multiple lines of hormonal and cytotoxic therapy. Trametinib produced a clinical and RECIST response. Conclusions: ctDNA-based genomic analysis identified multiple BRAF amplifications and missense SNVs in PCa patients. SNVs are largely non-canonical, but include known activating mutations that could act as drivers. The analysis also identified more BRAF missense mutations than did tissue genomic profiling, but the mutational landscape, overall frequency of mutations was similar with either method. ctDNA-based genomic profiling can identify actionable BRAF driver mutations that may respond to MEK and BRAF inhibitors.
TWO-FOLD HIGHER ODDS OF CORONARY ARTERY PERFORATION IN FEMALES UNDERGOING CORONARY ATHERECTOMY: A NATIONAL INPATIENT OUTLOOK
Authors: Rushik R. Bhuva, Rupak Desai, Bhrugesh Shah, Sandeep Singh, Manan Shah, Rajesh Sachdeva, Gautam Kumar
Journal: Journal of the American College of Cardiology (2018)
Correction: Paraneoplastic autoimmune multiorgan syndrome and paraneoplastic pemphigus describe the same spectrum of disease pathology
Authors: Aimee S. Payne, Michael Kasperkiewicz, Christoph T. Ellebrecht, Hayato Takahashi, Jun Yamagami, Detlef Zillikens, Masayuki Amagai
Journal: Nature Reviews Disease Primers (2018)
I have recently obtained membership of the Royal College of Physicians. I'm interested in intensive care medicine and would like to work in South Africa for a period. Any advice?
Authors: Michael Dobson
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>
The myeloid mineralocorticoid receptor controls inflammatory and fibrotic responses after renal injury via macrophage interleukin-4 receptor signaling
Authors: Jonatan Barrera-Chimal, Gabriel R. Estrela, Sebastian M. Lechner, Sébastien Giraud, Soumaya El Moghrabi, Shiem Kaaki, Peter Kolkhof, Thierry Hauet, Frédéric Jaisser
Journal: Kidney International (2018)
Transcription factor Hoxb5 reprograms B cells into functional T lymphocytes
Authors: Mengyun Zhang, Yong Dong, Fangxiao Hu, Dan Yang, Qianhao Zhao, Cui Lv, Ying Wang, Chengxiang Xia, Qitong Weng, Xiaofei Liu, Chen Li, Peiqing Zhou, Tongjie Wang, Yuxian Guan, Rongqun Guo, Lijuan Liu, Yang Geng, Hongling Wu, Juan Du, Zheng Hu, Sheng Xu, Jiekai Chen, Aibin He, Bing Liu, Demin Wang, Yong-Guang Yang, Jinyong Wang
Journal: Nature Immunology (2018)