tbuckley/cabot-search huggingface dataset:
PANCREAS DIVISUM AND RECURRENT PANCREATITIS: LONG-TERM RESULTS OF MINOR PAPILLA SPHINCTEROTOMY
Authors: T Schepis, A Tringali, T Voiosu, R Landi, V Perri, I Boškoski, V Bove, G Costamagna
Journal: Endoscopy (2019)

Pancreas divisum (PD) is the most common congenital anatomical variant of the pancreatic ductal system and a potential cause of acute recurrent pancreatitis (ARP) in a minority of patients. Endoscopic therapy has been studied as a therapeutic option for symptomatic PD, but there is limited long-term data on efficacy and safety of this method. We aimed to assess the technical success and clinical benefit of minor papilla endoscopic sphincterotomy (MiES) in the setting of ARP in patients with PD.
Web-based multimedia athlete preparticipation questionnaire: introducing the video-PPE (v-PPE)
Authors: Gary Parizher, John D Putzke, Rachel Lampert, Michael Scott Emery, Aaron Baggish, Matthew Martinez, Ariel Levine, Benjamin D Levine
Journal: British Journal of Sports Medicine (2019)

Preparticipation evaluation (PPE) to screen athletes for signs and symptoms of heart disease is recommended by the American Heart Association (AHA), American Academy of Pediatrics (AAP), American Association of Family Physicians and multiple sports organisations.1 The 14-point questionnaire and the fourth edition of the Pre-participation Evaluation Monograph are two recommended screening tools. PPE is standard-of-care for high school and college athletes. As specific symptoms precede sudden cardiac death in adolescents in up to 20%–45% of cases, accurate screening can be life-saving.2 3 In contrast to asymptomatic individuals, symptomatic patients have the most compelling indications for additional testing and possible intervention, with the greatest benefit:risk ratio. However, many screening instruments do not adhere to current guidelines.4 Furthermore, nuanced symptoms are addressed with blunt questions that are easy to misinterpret, and no research has been done to improve participants’ understanding of survey items. The current PPE is hampered by a high false-positive response rate that is challenging for clinicians caring for adolescent athletes.5 

We developed a video-assisted online preparticipation survey. Computerised questionnaires may be more accurate than paper surveys, especially given adolescents’ comfort with online technology and the highly saturated mobile device markets.6 We included …
UK health service reforms
Authors: Adrian O’Dowd
Journal: BMJ (2011)

Tomorrow’s doctors face a radically different NHS The government is planning far reaching reforms for the health service in England designed to shift control from the centre to local level and give doctors control of most of the NHS budget. The planned reforms were first unveiled in July of last year and are encapsulated in the Health and Social Care Bill currently progressing through parliament. The Bill passed its first reading in the House of Commons on 31 January and is currently being scrutinised (until 31 March) by 26 MPs on a Bill Committee before going back to the Commons for debate and amendments. It could become law by July at the earliest. If passed, the Bill will mean:
Exosomal microRNA-17 and-21 in murine experimental and human paediatric asthma
Authors: S. Bartel, N. Schulz, A. Schamberger, F. Alessandrini, E. Noessner, S. Stick, Anthony Kicic, O. Eickelberg, R. Freishtat, S. Krauss-Etschmann
Journal: Allergy (2015)
Passing the situational judgement test
Authors: Michael Shaw, Nishanthan Mahesan
Journal: BMJ (2014)

How to answer questions and plan your time The situational judgement test (SJT) has been used since 2012 by the UK Foundation Programme Office (UKFPO) as one of the components to allocate students to places on the foundation programme. The test comprises 70 questions and must be answered with pencil and paper within the time limit of 140 minutes. For most students, this will be their first experience of medical job applications and will determine where they work and train for the next two years. It is therefore no surprise that the application process causes some anxiety, particularly the SJT. Most exams at medical school are knowledge based and have answers that are clear cut. In contrast, the SJT presents scenarios that require careful consideration, with the application of clinical guidelines from professional bodies and the appropriate assessment of priorities. The SJT is unlike any other exam that students might have encountered at medical school. Although it may not be the ideal way to evaluate candidates, it is the means by which trainees will be assessed and allocated to jobs and must therefore be prepared for. Support for final year students varies widely between medical schools, but in this article we cover the essential information regarding the SJT, including tips on preparing for the exam and maximising your score to help make the task less daunting. The Foundation Programme Application System score is split evenly between your SJT score and educational performance measure (EPM), with a maximum of 100 points available.1 ### EPM component The EPM score comprises the following:
Knee osteoarthritis risk is increased 4-6 fold after knee injury – a systematic review and meta-analysis
Authors: Erik Poulsen, Glaucia H Goncalves, Alessio Bricca, Ewa M Roos, Jonas B Thorlund, Carsten B Juhl
Journal: British Journal of Sports Medicine (2019)

Objective To estimate knee osteoarthritis (OA) risk following anterior cruciate ligament (ACL), meniscus or combined ACL and meniscus injury. Design Systematic review and meta-analysis. Data sources MEDLINE, Embase, SPORTDiscus, CINAHL and Web of Science until November 2018. Eligibility criteria for selecting studies Prospective or retrospective studies with at least 2-year follow-up including adults with ACL injury, meniscal injury or combined injuries. Knee OA was defined by radiographs or clinical diagnosis and compared with the contralateral knee or non-injured controls. Study appraisal and synthesis Risk of bias was assessed using the SIGN50 checklist. ORs for developing knee OA were estimated using random effects meta-analysis. Results 53 studies totalling ∼1 million participants were included: 185 219 participants with ACL injury, mean age 28 years, 35% females, 98% surgically reconstructed; 83 267 participants with meniscal injury, mean age 38 years, 36% females, 22% confirmed meniscectomy and 73% unknown; 725 362 participants with combined injury, mean age 31 years, 26% females, 80% treated surgically. The OR of developing knee OA were 4.2 (95% CI 2.2 to 8.0; I 2 =92%), 6.3 (95% CI 3.8 to 10.5; I 2 =95%) and 6.4 (95% CI 4.9 to 8.3; I 2 =62%) for patients with ACL injury, meniscal injury and combined injuries, respectively. Conclusion The odds of developing knee OA following ACL injury are approximately four times higher compared with a non-injured knee. A meniscal injury and a combined injury affecting both the ACL and meniscus are associated with six times higher odds compared with a non-injured knee. Large inconsistency (eg, study design, follow-up period and comparator) and few high-quality studies suggest that future studies may change these estimates. Clinical relevance Patients sustaining a major knee injury have a substantially increased risk of developing knee OA, highlighting the importance of knee injury prevention programmes and secondary prevention strategies to prevent or delay knee OA development. PROSPERO registration number CRD42015016900
Abstract 14004: Overactivation of N-type Calcium Channels in Stellate Ganglia and Ventricular Arrhythmogenesis in Chronic Heart Faiulre
Authors: Dongze Zhang, Huiyin Tu, Chaojun Wang, Robert L Muelleman, Michael C Wadman, Yu-Long Li
Journal: Circulation (2017)

Ventricular arrhythmia is a leading cause of sudden cardiac death in patients with chronic heart failure (CHF). Cardiac sympathetic overactivation is an important trigger for onset of ventricular a...
Association of Gestational Weight Gain With Adverse Maternal and Infant Outcomes
Authors: Ellis Voerman, Susana Santos, Hazel Inskip, Pilar Amiano, Henrique Barros, Marie-Aline Charles, Leda Chatzi, George P. Chrousos, Eva Corpeleijn, Sarah Crozier, Myriam Doyon, Merete Eggesbø, Maria Pia Fantini, Sara Farchi, Francesco Forastiere, Vagelis Georgiu, Davide Gori, Wojciech Hanke, Irva Hertz-Picciotto, Barbara Heude, Marie-France Hivert, Daniel Hryhorczuk, Carmen Iñiguez, Anne M. Karvonen, Leanne K. Küpers, Hanna Lagström, Debbie A. Lawlor, Irina Lehmann, Per Magnus, Renata Majewska, Johanna Mäkelä, Yannis Manios, Monique Mommers, Camilla S. Morgen, George Moschonis, Ellen A. Nohr, Anne-Marie Nybo Andersen, Emily Oken, Agnieszka Pac, Eleni Papadopoulou, Juha Pekkanen, Costanza Pizzi, Kinga Polanska, Daniela Porta, Lorenzo Richiardi, Sheryl L. Rifas-Shiman, Nel Roeleveld, Luca Ronfani, Ana C. Santos, Marie Standl, Hein Stigum, Camilla Stoltenberg, Elisabeth Thiering, Carel Thijs, Maties Torrent, Tomas Trnovec, Marleen M. H. J. van Gelder, Lenie van Rossem, Andrea von Berg, Martine Vrijheid, Alet Wijga, Oleksandr Zvinchuk, Thorkild I. A. Sørensen, Keith Godfrey, Vincent W. V. Jaddoe, Romy Gaillard
Journal: JAMA (2019)

Both low and high gestational weight gain have been associated with adverse maternal and infant outcomes, but optimal gestational weight gain remains uncertain and not well defined for all prepregnancy weight ranges.
Abstract 15177: Left Atrial Stasis in Patients Pre- and Post-Pulmonary Vein Ablation for the Management of Atrial Fibrillation: Preliminary Evidence of Altered Hemodynamics Using 4D Flow MRI
Authors: Julio Garcia, Cody Wu, Michael S Bristow, Carmen Lydell, Andrew G Howarth, Bobak Heydari, Frank S Prato, Maria Drangova, Rebecca Thornhill, Pablo Nery, Stephen Wilton, Allan Skanes, James A White
Journal: Circulation (2017)

Introduction: Atrial fibrillation (AF) is associated with systemic thrombo-embolism and cerebrovascular events. Prior studies have suggested thrombus formation to be related to left atrial (LA) flo...
Dealing with disability
Authors: Naomi Sakai
Journal: BMJ (2012)

“Go and have a look at the patient over there and come and tell me what you think,” said the registrar. I went to look and was confused—the patient was looking into a mirror and combing her hair, but I couldn’t understand what I was looking for. I glanced at the patient again, and realised that she had Down’s syndrome.

I walked back over to the registrar and thought about what had just happened. I have been involved with a charity that supports young people with disabilities and their families for many years so meeting someone with Down’s syndrome wasn’t …
Abstract 17680: Association of Lipid Accumulation Product with All-Cause, Cardiovascular or Ischemic Heart Disease Mortality: The National Health and Nutrition Examination Survey
Authors: Kaustubh C Dabhadkar, Abhishek J Deshmukh, Apurva Badheka, Jawahar L Mehta
Journal: Circulation (2012)

Introduction: The lipid accumulation product (LAP) has been proposed as an alternative continuous index of lipid accumulation, but the predictive role of LAP on mortality has not been adequately studied. LAP is based on a combination of waist circumference (WC) in cm and serum triglyceride (TG) in SI units: [LAP = (WC − 65) × TG for men and (WC − 58) × TG for women]. Objective: We examined association between LAP and risk of all-cause, cardiovascular (CVD) and ischemic heart disease (IHD) mortality in a nationally representative cohort. Methods: Participants between ages 30 and 74 enrolled in the National Health and Nutrition Examination Survey (NHANES) III study from 1988 to 1994 had known CVD risk factors (age, sex, race, BMI, diabetes, hypertension, smoking history, triglycerides, history of CVD, family history of CVD and medication use) measured. All-cause, CVD and IHD mortality through 2006 were obtained via linkage with the National Death Index. Cox proportional hazards model was used to estimate ha...
Abstract P2-05-24: Prognostic value of circulating <i>PIK3CA</i> mutations revealed with digital PCR in patients with HER2-positive advanced breast cancer: Results of West Japan Oncology Group study 6110BTR
Authors: J Tsurutani, K Sakai, T Takao, H Kimura, H Kawabata, K Tanaka, M Takahashi, Y Ito, S Takao, K Aogi, K Sato, Y Tsuji, T Yamanaka, Y Nakanishi, T Saeki, K Nishio
Journal: Cancer Research (2017)

Abstract This abstract was withdrawn by the authors.
Abstract P3-11-11: Prediction of treatment response to neoadjuvant chemotherapy in breast cancer by subtype using tumor-infiltrating lymphocytes: Study of a large Mexican cohort
Authors: S Campos Gomez, N Cabañas Chávez, J Hernández Alvarez, K Campos Gómez
Journal: Cancer Research (2019)

Abstract Background/aim: Tumor-infiltrating lymphocytes (TILs) are emerging as biomarkers mediating tumor response to treatments. Studies have provided evidence that the level of TILs has prognostic value in breast cancer. The level of TILs has been associated with treatment outcome and pathologic response in patients undergoing neoadjuvant chemotherapy. In this study, we analyzed TILs before neoadjuvant therapy and if they correlate with pathological response to treatment Patients and methods We retrospectively analyzed the specimen slides of patients with Breast Cancer from the Centro Oncologico Estatal ISSEMyM treated with Neoadjuvant Chemotherapy (NAC) during 2007–2014. We identified 410 patients fulfilling the inclusion criteria of this study. The histological sections had already been evaluated by hematoxylin and eosin slides. They were reassessed by our pathologist for the percentage of intratumoral and stromal TILs. The correlation with pathological response of the tumor after neoadjuvant therapy was also studied in these patients. The proportions of TILs were categorized into high and low groups using a cut-off value of 10% Resultados The mean age was 51.4 years. The most frequent type of breast cancer histology was invasive ductal breast carcinoma in 369 (90%) patients, 34 (8.3%) lobular and 1.7% other. The BC subtypes among the 410 patients who received NAC were TNBC in 82 (20%), HER2BC in 70 (17.1%), and HRBC in 258 (62.9%) patients. Treatment response was pCR in 164 (40%) and non-pCR in 245 (60%) patients. Based on subtype, pCR was achieved in 43 (52 %) patients with TNBC, 35 (50.0%) with HER2BC, and 87 (33%) with HRBC. There were 191 (46.5%) patients in the high-TIL group and 219 (53.5%) patients in the low-TIL group. Patients were divided into high-TIL and low-TIL groups, and the clinicopathological characteristics of each group were examined. High TILs that had a pathologically complete response were found in 56 % of patients, and low TILs were found in 44 %. There was a significant correlation between TILs and pathological response in patients with neoadjuvant chemotherapy (p = 0.04). Conclusion TILs may be a biomarker for predicting treatment response to NAC in patients with Breast Cancer. Studies assessing outcomes and therapeutic efficacies should consider. Citation Format: Campos Gomez S, Cabañas Chávez N, Hernández Alvarez J, Campos Gómez K. Prediction of treatment response to neoadjuvant chemotherapy in breast cancer by subtype using tumor-infiltrating lymphocytes: Study of a large Mexican cohort [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P3-11-11.
Abstract 11781: Predicting Mortality and Hospitalization in 11,327 Patients With Heart Failure Using Machine Learning
Authors: Linyuan Jing, Sanjay Doddamani, Dustin N Hartzel, Alvaro E Ulloa Cerna, Nathan M Sauers, Christopher W Good, Aalpen A Patel, Christopher M Haggerty, Brandon K Fornwalt
Journal: Circulation (2018)

Introduction: Heart failure (HF) is the leading cause of hospitalizations and death in adults > 55 years. There is an urgent need for accurate risk stratification of HF patients to appropriately ap...
Meet future leaders of evidence based medicine
Authors: Peter J Gill, Helen Macdonald
Journal: BMJ (2016)

In the run-up to Evidence Live 2016, we asked health science students, junior doctors, and early career researchers to write about projects or innovative ideas that they have been part of and that deal with some of the conference’s main themes (see box). Below are the top five submissions we received. Their authors will gain free places to attend the conference in Oxford between 22 and 24 June 2016.

At the Evidence Live conference, researchers, doctors, and professionals, working with evidence at different stages in the healthcare chain, learn about important issues in healthcare. The programme is designed to showcase the most innovative ideas, processes, and best practices that form the foundations of an evidence based approach. Several sessions focus exclusively on students and junior doctors, including a networking event and leadership showcase. Discounted tickets are still available (http://evidencelive.org/).

####   Evidence Live 2016 conference themes

#### Holding medical journals to account for publishing trials with switched outcomes

##### Improving the quality of research evidence

Aaron Dale, third year graduate entry medical student, University of Oxford, and member of the Centre for Evidence-Based Medicine Outcome Monitoring Project (COMPare) 

Outcome switching is a major problem in clinical trial reporting that can distort the evidence from which clinical decisions are made. This is when researchers fail to report the outcomes they originally set out to measure and swap them for new outcomes that they didn't initially consider. The best demonstration of why this is a problem is in the webcomic xkcd.1

By leaving out the fact that outcome switching has taken place, journals can represent interventions appearing better than they actually are, which misinforms doctors and risks considerable harm to patients.

Outcome switching is highly prevalent …
Transhepatic intraductal radiofrequency ablation of a biliary papillary mucinous neoplasm
Authors: Marcus Hollenbach, Jürgen Feisthammel, Joachim Mössner, Tobias Schlosser, Thomas Kahn, Osama Sabri, Albrecht Hoffmeister
Journal: Endoscopy (2019)

Recently, biliary tract intraductal papillary mucinous neoplasm (IPMN) was described as a rare but important preinvasive lesion coinciding with pancreatic IPMN [1]. Several studies have revealed dysregulated molecular pathways involving mutations of the GNAS and KRAS genes and have tried to distinguish between biliary IPMN and pancreatic IPMN by means of their mucin-subtype pattern [2]. Nevertheless, the majority of data on biliary tract IPMNs come from retrospective studies, mostly where surgical interventions were performed [3]. Only one case report has so far described a combined chemoradiotherapy approach in a patient with synchronous biliary tract and pancreatic IPMNs [4].
Atypical complement receptor C5aR2 transports C5a to initiate neutrophil adhesion and inflammation
Authors: Yoshishige Miyabe, Chie Miyabe, Vinidhra Mani, Thorsten R. Mempel, Andrew D. Luster
Journal: Science Immunology (2019)

C5aR2 transports C5a into the blood vessel lumen to initiate neutrophil arrest in a murine model of arthritis.
PERORAL ENDOSCOPIC MYOTOMY FOR ESOPHAGEAL ACHALASIA: OUTCOMES OF THE FIRST 500 PATIENTS WITH A MID- AND LONG-TERM FOLLOW-UP
Authors: F Mangiola, P Familiari, R Landi, V Bove, I Boskoski, A Tringali, A Costantini, V Perri, G Costamagna
Journal: Endoscopy (2019)

Peroral endoscopic myotomy (POEM), which combines the efficacy of surgical myotomy with the benefits of an endoscopic, minimally invasive, procedure, is considered now an effective treatment for achalasia. We report on the mid- and long-term outcomes of a large series of patients treated in a single European center.
Abstract 16049: Periodic Acceleration (pGz) After Cardiac Arrest Restores Antioxidant Capacity in Swine Hearts
Authors: Jose A Adams, Arkady Uryash, Jose R Lopez
Journal: Circulation (2017)

Cardiac arrest (CA) is a model of whole body ischemia reperfusion injury (I/R). Oxidative stress along with decreased antioxidant capacity is a hallmark of all models of I/R and specifically CA. An...
Organising work experience to support your medical school application
Authors: Christopher Graham, Rajiv Sethi
Journal: BMJ (2015)

Admissions panels at medical schools judge your suitability and motivation by looking for evidence that you understand what a long term career in medicine entails. Emma Rowson, admissions officer at the University of Edinburgh, says it is important to gain experience with “diseased, disadvantaged, and disabled people (the three Ds).” She highlights that looking after patients can be extremely challenging and it is important to find out whether this is something you would find rewarding and are likely to enjoy long term. Getting some work experience—be it in a medical or non-medical setting —is a great way to develop this understanding and to find answers to common questions admissions staff might ask you. Common questions include:

We would encourage you to try to get a work experience placement in a clinical setting because this will give you the opportunity to see the diversity of healthcare, from emergency admissions to long term care, and from the discharge of healthy patients to palliative care and the death of a patient. However, do not be disheartened if you cannot shadow a hospital doctor or a general practitioner (GP), because you can gain an insight into medicine in many other ways.

In this article we look at the types of work experience available, how to organise work experience, …