tbuckley/cabot-search huggingface dataset:
Interpreting cardiotocograph tracings
Authors: Sam Dobson, Jessica Keeley, Andrew Simm
Journal: BMJ (2012)

Classifying and defining each feature on the tracing leads to easier interpretation and diagnosis At some stage in your medical training you will observe normal labour and witness or assist in a birth. In these situations you will come across the intrapartum fetal monitor and the cardiotocograph (CTG). You might be asked to classify and interpret a CTG tracing at the bedside, on a ward round, in a CTG meeting, or even in an examination. Although not used routinely in an antenatal setting, a CTG can be used to ensure fetal wellbeing—for example, where reduced fetal movements are suspected.1 Correct classification and interpretation of the CTG tracing is an important part of assessing fetal wellbeing, with poor interpretation being the most common avoidable contributor to intrapartum death.2 This is because misinterpretation can lead to poor management plans, which may result in adverse outcomes such as cerebral palsy, hypoxic ischaemic encephalopathy, or perinatal death. This article presents the basics of intrapartum fetal monitoring, classification, and interpretation of the CTG tracing, aiming to give you a safe and logical approach which you can use when on the labour ward as a medical student or junior doctor. An intrapartum fetal monitor has several features (fig 1).⇓
What should go in my medical CV?
Authors: Sophia Bourne
Journal: BMJ (2017)

Dear Sophia

I know that I will probably need a CV before I leave medical school, but I haven’t got it off the ground. Where should I start?

Anon, third year medical student, University College London

CV stands for “curriculum vitae,” meaning “course of life.” It traces your working life and captures everything that you do, learn, and achieve. Your CV will have many uses: for selling yourself when applying for jobs or training, as a summary of contents for your portfolio, and as a way of introducing yourself when networking. Your CV can be used as a place to capture all …
Abstract P6-17-16: Efficacy and safety of shorter duration of adjuvant trastuzumab for patients with HER2 positive early breast cancer: A meta-analysis of randomized controlled trials
Authors: J Li, G Wang, Q Wu, C Chen, Y Tu, F Yao, W Wei, S Sun, CA Santa-Maria, P Geng
Journal: Cancer Research (2019)

Abstract Background: Trastuzumab has been shown to be able to improve disease free survival(DFS) and overall survival(OS) in HER2-positive breast cancer patients. Adjuvant trastuzumab is empirically recommended for 1 year as a standard regimen. However, several studies claimed that shorter duration of adjuvant trastuzumab is non-inferior to 12 months treatment with reduced cardiac toxicities and costs. Methods: PubMed, EMBASE, Cochrane Library, Google scholar Web, ISI Web of Science, BIOSIS and CNKI, and major conference abstracts were searched systematically in June 2018 to identify eligible non-inferiority studies comparing the intervention outcomes of adjuvant trastuzumab in chemotherapy for women with HER-2 positive breast cancer between short-term and 1-year treatments. Hazard-Ratios(HR) and corresponding 95% Confidence Intervals(CI) were calculated to compare OS and DFS of trastuzumab between short-term and long-term treatments. Pooled data of Odds-Ratio was analyzed for cardiac toxicities. Results: 5 articles were finally eligible in the study. Totally, there were 11,376 women with HER-2 positive early breast cancer, with 5,684 in short-term group and 5,692 in the 1-year group. We found a distinct difference of DFS (HR=1.19, 95% CI=1.08-1.30) and OS (HR=1.22, 95% CI=1.07-1.39) between short-term and 12 months trastuzumab in the total analysis, which demonstrated short-term treatment exhibited a worsening trend on DFS and OS. Subgroup analysis was performed based on estrogen receptor (ER) and lymph node status, and no statistical interaction could be found(p=0.12, 0.52, respectively). The two groups with different duration of trastuzumab treatment displayed statistically significant difference for cardiotoxicities, which favored shorter duration(OR=0.54, 95% CI=0.38-0.77). Conclusions: 1-year adjuvant trastuzumab remains the standard strategy for HER2 positive early breast cancer, however, a concomitant higher risk of associated cardiac adverse effects should not be ignored. Citation Format: Li J, Wang G, Wu Q, Chen C, Tu Y, Yao F, Wei W, Sun S, Santa-Maria CA, Geng P. Efficacy and safety of shorter duration of adjuvant trastuzumab for patients with HER2 positive early breast cancer: A meta-analysis of randomized controlled trials [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 P6-17-16.
Decision Fatigue, Running Late, and Population Health Management—Screening Out of Time
Authors: David T. Liss, Jeffrey A. Linder
Journal: JAMA Network Open (2019)

Esther Y. Hsiang, BA; Shivan J. Mehta, MD, MBA; Dylan S. Small, PhD; Charles A. L. Rareshide, MS; Christopher K. Snider, MPH; Susan C. Day, MD, MPH; Mitesh S. Patel, MD, MBA, MS
Abstract 677: Relationship Between Fatty Acids Level in Blood and Carotid Atherosclerosis in Patients with Coronary Artery Disease in Relation to Lipid Profile
Authors: Albert Galyavich, Lilia Salakhova
Journal: Circulation (2006)

Objective. The aim of the study was to assess changes of circulating fatty acids (FA) in relation to components of lipid profile and carotid atherosclerosis in patients with coronary artery disease...
Abstract P3-07-05: Not presented
Authors: A Hardeman, T Grushko, W Clayton, I Hurley, G Khramtsova, J Parker, C Perou, O Olopade
Journal: Cancer Research (2019)

Abstract This abstract was not presented at the conference. Citation Format: Hardeman A, Grushko T, Clayton W, Hurley I, Khramtsova G, Parker J, Perou C, Olopade O. Not presented [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 P3-07-05.
No association between Parkinson disease and autoantibodies against NMDA-type glutamate receptors
Authors: Franziska Hopfner, Stefanie H. Müller, Dagmar Steppat, Joanna Miller, Nele Schmidt, Klaus-Peter Wandinger, Frank Leypoldt, Daniela Berg, Andre Franke, Wolfgang Lieb, Lukas Tittmann, Monika Balzer-Geldsetzer, Simon Baudrexel, Richard Dodel, Ruediger Hilker-Roggendorf, Elke Kalbe, Jan Kassubek, Thomas Klockgether, Inga Liepelt-Scarfone, Brit Mollenhauer, Petra Neuser, Kathrin Reetz, Oliver Riedel, Claudia Schulte, Jörg B. Schulz, Annika Spottke, Alexander Storch, Claudia Trenkwalder, Hans-Ulrich Wittchen, Karsten Witt, Ullrich Wüllner, Günther Deuschl, Gregor Kuhlenbäumer
Journal: Translational Neurodegeneration (2019)

IgG-class autoantibodies to N-Methyl-D-Aspartate (NMDA)-type glutamate receptors define a novel entity of autoimmune encephalitis. Studies examining the prevalence of NMDA IgA/IgM antibodies in patients with Parkinson disease with/without dementia produced conflicting results. We measured NMDA antibodies in a large, well phenotyped sample of Parkinson patients without and with cognitive impairment (n = 296) and controls (n = 295) free of neuropsychiatric disease. Detailed phenotyping and large numbers allowed statistically meaningful correlation of antibody status with diagnostic subgroups as well as quantitative indicators of disease severity and cognitive impairment.NMDA antibodies were analysed in the serum of patients and controls using well established validated assays. We used anti-NMDA antibody positivity as the main independent variable and correlated it with disease status and phenotypic characteristics.The frequency of NMDA IgA/IgM antibodies was lower in Parkinson patients (13%) than in controls (22%) and higher than in previous studies in both groups. NMDA IgA/IgM antibodies were neither significantly associated with diagnostic subclasses of Parkinson disease according to cognitive impairment, nor with quantitative indicators of disease severity and cognitive impairment. A positive NMDA antibody status was positively correlated with age in controls but not in Parkinson patients.It is unlikely albeit not impossible that NMDA antibodies play a significant role in the pathogenesis or progression of Parkinson disease e.g. to Parkinson disease with dementia, while NMDA IgG antibodies define a separate disease of its own.
Abstract SY02-01: Imaging the metastatic process
Authors: Erik Sahai
Journal: Cancer Research (2010)

Abstract The acquisition of invasive behaviour enables the tumour cells to move into either the surrounding tissue or the vasculature and thereby spread to other parts of the body. The focus of our research is investigating why cancer cells become invasive and how they move. Until recently research into cancer cell movement has used highly artificial environments that do not accurately mimic the tumour environment leading to many contradictory results that could not be confirmed in vivo. The tumour environment is highly complex with numerous non-tumour cell types, variable blood flow and a diverse range of extracellular matrix components. To study cell motility in this environment we perform intravital multi-photon confocal imaging of tumours in anaesthetised mice. To complement intravital imaging, we have established a range of three-dimensional ‘organotypic’ cultures that allow us to model many aspects of the tumour environment in vitro. By using these systems it has become clear that there are a variety of different ways in which tumour cells can move. In particular, we are interested in the rapid movement of ‘amorphous’ single cells, termed amoeboid, and the slower collective movement of cohesive groups of cancer cells. The presentation will be split into two parts: the first part will focus on imaging the activity of signalling pathways that promote amoeboid motility while the second part will focus on the mechanism of collective cancer cell invasion. Citation Format: Erik Sahai. Imaging the metastatic process [abstract]. In: Proceedings of the AACR 101st Annual Meeting 2010; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr SY02-01
Abstract 4740: Selective ablation of metastatic disease with integrin ανβ3 targeted nanoparticle drug delivery
Authors: Bharat K Majeti, Eric A Murphy, Leo Barnes, Milan Makale, Kimberly Lutu-Fuga, Sara Weis, Michael Bouvet, Wolfgang Wrasidlo, David A Cheresh
Journal: Cancer Research (2008)

Abstract Angiogenic blood vessels found within growing tumors express high levels of integrin ανβ3 while mature vessels fail to express this integrin. Based on this we developed a ανβ3-targeted nanoparticle (NP) in an attempt to selectively deliver therapeutics to the tumor neovasculature. A cyclic peptide ligand (cRGDfK) coupled to a phospholipid and incorporated into a nanoparticle demonstrated specific binding to ανβ3 on cultured endothelial cells. To characterize the in vivo targeting capacity of these NPs, we monitored NP accumulation using intravital microscopy of tumor neovasculature. A dorsal skin-fold window chamber implanted with GFP-labeled melanoma cells lacking integrin ανβ3 were imaged at various times after NP injection into the bloodstream. By 5h post injection, the cRGDfK NPs targeted the neovasculature at the angiogenic tips adjacent to the tumor margin, whereas untargeted (cRADfK) NPs failed to bind. After establishing in vivo targeting, these ανβ3-targeted NPs were loaded with doxorubicin via an ammonium phosphate gradient for therapeutic studies. The cRGD-Dox particles disrupted angiogenesis in the mouse matrigel model leaving only small fragments of disrupted vessels within the FGF loaded plugs. Next, we utilized an orthotopic pancreatic cancer model to study the ability of the NPs to target the vasculature of both primary pancreatic tumors as well as metastatic sites including the hepatic hilar lymph node and mesenteric lymph nodes. cRGD-Dox particles injected systemically at 1 mg/kg produced a profound anti-metastatic effect while only marginally influencing the pre-established primary tumor within the pancreas. This is much improved compared to the free doxorubicin treatments in which 1 mg/kg of free doxorubicin had no effect and 15 mg/kg of free doxorubicin was required for a similar therapeutic effect in this orthotopic model. Animals treated with 15 mg/kg of free doxorubicin lost over 20% of their body weight within 7 days, whereas no decrease in body weight was observed in the cRGD-Dox treated animals, confirming the reduction in overall toxicity. Histology confirmed that the cRGD-Dox particles induced apoptosis in regions co-localized with β3 expressing tumor vasculature. Additionally, we tested the cRGD-Dox particles in an orthotopic renal cell carcinoma model. Similar to the pancreatic carcinoma, the cRGD-Dox particles had a slight effect on primary tumor growth but greatly reduced metastasis to several sites including the pancreas, liver, spleen, and diaphragm. These findings reveal that ανβ3 targeted NP drug delivery may preferentially disrupt newly forming metastatic lesions by delivery of chemotherapeutic agents to sites of active angiogenesis in which the endothelium expresses high levels of ανβ3.
Abstract 17684: Preliminary Effects of Renal Sympathetic Denervation With Saline Irrigated Catheter on Systolic Function in Patients With Heart Failure--A Feasibility Report From the Swan-hf Pilot Study
Authors: Yuehui Yin, Weijie Chen, Zhiyu Ling, Yanping Xu, Zengzhang Liu, Li Su, Huaan Du, Peilin Xiao, Jinqi Fan
Journal: Circulation (2013)

Objectives: To assess the efficacy and safety of renal sympathetic denervation (RSD) using saline irrigated catheter in patients with heart failure. Background: RSD has been demonstrated to be a sa...
Functional microRNA screen uncovers O-linked N-acetylglucosamine transferase as a host factor modulating hepatitis C virus morphogenesis and infectivity
Authors: Katharina Herzog, Simonetta Bandiera, Sophie Pernot, Catherine Fauvelle, Frank Jühling, Amélie Weiss, Anne Bull, Sarah C Durand, Béatrice Chane-Woon-Ming, Sébastien Pfeffer, Marion Mercey, Hervé Lerat, Jean-Christophe Meunier, Wolfgang Raffelsberger, Laurent Brino, Thomas F Baumert, Mirjam B Zeisel
Journal: Gut (2019)

Objective Infection of human hepatocytes by the hepatitis C virus (HCV) is a multistep process involving both viral and host factors. microRNAs (miRNAs) are small non-coding RNAs that post-transcriptionally regulate gene expression. Given that miRNAs were indicated to regulate between 30% and 75% of all human genes, we aimed to investigate the functional and regulatory role of miRNAs for the HCV life cycle. Design To systematically reveal human miRNAs affecting the HCV life cycle, we performed a two-step functional high-throughput miRNA mimic screen in Huh7.5.1 cells infected with recombinant cell culture-derived HCV. miRNA targeting was then assessed using a combination of computational and functional approaches. Results We uncovered miR-501-3p and miR-619-3p as novel modulators of HCV assembly/release. We discovered that these miRNAs regulate O-linked N-acetylglucosamine (O-GlcNAc) transferase (OGT) protein expression and identified OGT and O-GlcNAcylation as regulators of HCV morphogenesis and infectivity. Furthermore, increased OGT expression in patient-derived liver tissue was associated with HCV-induced liver disease and cancer. Conclusion miR-501-3p and miR-619-3p and their target OGT are previously undiscovered regulatory host factors for HCV assembly and infectivity. In addition to its effect on HCV morphogenesis, OGT may play a role in HCV-induced liver disease and hepatocarcinogenesis.
Stop before the op
Authors: Sotiris Mastoridis, Somen Banerjee, Michael Roberts
Journal: BMJ (2013)

How to give smoking cessation advice Adverse surgical outcomes have an important association with smoking, and even a short period of abstinence before surgery can be beneficial. This preoperative period is an ideal opportunity for a smoker to attempt to quit, and rates of success are far greater around this time than at others. For the junior doctor booking the surgery or doing the preoperative assessment, this opportunity to make an impact on the patient’s surgical outcome and on their longer term health simply cannot be missed. Here we look at how this can be done using a structured, evidence based intervention that need not take longer than 30 seconds. Although we discuss this intervention in the context of patients awaiting surgery, it can and should be used whenever brief smoking cessation intervention is required. This includes general practice and all ward and clinic settings. Smoking remains the greatest cause of preventable illness and early death in England, accounting for around 80 000 deaths annually.1 The overall financial burden to society, including NHS costs and loss of productivity, is around £13.7bn (€16.3bn; $21.3bn) a year—equivalent to one sixth of the annual NHS budget.2 Around a third of those undergoing surgery are smokers, and many are unaware of the surgical risk their addiction can pose.3 This risk comes about in two ways. Firstly, smoking causes at least 25 chronic illnesses, many of which are in turn associated with greater perioperative risk—coronary artery disease and chronic obstructive lung disease are two common examples.4 Secondly, more than 4000 constituents of cigarette smoke, including carbon monoxide, arsenic, and nicotine, produce acute physiological effects contributing to poor surgical and anaesthetic outcomes.5 Box 1 outlines some of the known operative risks associated with smoking. #### Box 1: Operative risks associated with smoking*
Assessing mental capacity in practice
Authors: Isobel Sleeman, Kate Saunders
Journal: BMJ (2014)

How to navigate the laws around capacity Patients require capacity, sufficient information, and freedom from coercion to give consent to medical investigation or treatment. Capacity is defined as the mental ability to make and communicate a decision, and it is estimated that 26-40% of medical inpatients lack capacity because of mental illness, learning disability, or a medical condition that affects brain function, such as delirium or head injury.123 Most countries have a legal framework for assessing capacity and guiding decisions relating to incapacitated people. In the UK, there is separate legislation in England and Wales, Scotland, and Northern Ireland. We will cover the Mental Capacity Act (MCA) 2005,4 which was enacted in England and Wales in 2007 (box 1). The law in Scotland5 and Northern Ireland6 is outlined in box 2. All doctors have a legal responsibility to understand and work within the legislation in their country or state. #### Box 1: Principles of the Mental Capacity Act (MCA)
The lying doctor
Authors: Matthew Quinn
Journal: BMJ (2013)

As a doctor, is it ever morally justifiable to lie to—or indeed, for—your patient? This is one of the questions put before us in Peter Carson’s book, The Dying President and the Lying Doctor: The Fate of FDR , which examines the maelstrom of mystery and lies surrounding the health of the United States’s longest serving president—Franklin D Roosevelt (FDR).

Described by Carson as America’s “greatest wartime leader,” FDR served as president of the US from 1933 to 1945. He played a fundamental role in ensuring the entry of the isolationist US into the second world war and in determining the fate of post-war Europe. He died from a bleed to the brain early into his fourth term as president in 1945, in mysterious circumstances. To further the intrigue, his medical records had disappeared from a hospital safe within 48 hours of his death.1

The …
Opioids for breathlessness: psychological and neural factors influencing response variability
Authors: Sara J. Abdallah, Olivia K. Faull, Vishvarani Wanigasekera, Sarah L. Finnegan, Dennis Jensen, Kyle T.S. Pattinson
Journal: European Respiratory Journal (2019)

<b>Diminished opioid efficacy in the treatment of breathlessness is related to negative affect and anticipatory brain activity in the anterior cingulate and medial prefrontal cortex.</b>http://bit.ly/2LXyyDo
A new approach to developing diagnostics and therapeutics: Aggregation‐induced emission‐based fluorescence turn‐on
Authors: Meichen Guo, Hang Song, Kai Li, Minchao Ma, Yang Liu, Qiang Fu, Zhonggui He
Journal: Medicinal Research Reviews (2019)

Abstract Fluorescence imaging is a promising visualization tool and possesses the advantages of in situ response and facile operation; thus, it is widely exploited for bioassays. However, traditional fluorophores suffer from concentration limits because they are always quenched when they aggregate, which impedes applications, especially for trace analysis and real‐time monitoring. Recently, novel molecules with aggregation‐induced emission (AIE) characteristics were developed to solve the problems encountered when using traditional organic dyes, because these new molecules exhibit weak or even no fluorescence when they are in free movement states but emit intensely upon the restriction of intramolecular motions. Inspired by the excellent performances of AIE molecules, a substantial number of AIE‐based probes have been designed, synthesized, and applied to various fields to fulfill diverse detection tasks. According to numerous experiments, AIE probes are more practical than traditional fluorescent probes, especially when used in bioassays. To bridge bioimaging and materials engineering, this review provides a comprehensive understanding of the development of AIE bioprobes. It begins with a summary of mechanisms of the AIE phenomenon. Then, the strategies to realize accurate detection using AIE probes are discussed. In addition, typical examples of AIE‐active materials applied in diagnosis, treatment, and nanocarrier tracking are presented. In addition, some challenges are put forward to inspire more ideas in the promising field of AIE‐active materials.
Planes, trains, and poor medical students
Authors: Richard Pye
Journal: BMJ (2013)

Picture Tom: an enthusiastic fourth year medical student at the University of Glasgow; he is of a modest background, has two younger siblings, and receives little financial support from his cash strapped parents. He is therefore fully dependent on the Student Awards Agency for Scotland (SAAS), which provides him with a bursary and student loan.

This money covers his rent in Glasgow, utility bills, and general subsistence—barely. He works a part time job at the weekend to make life a little more comfortable. And he gets by as students do: economically, frugally, carefully.

Tom is allocated a 10 week surgery rotation at Inverclyde Royal Hospital, 25 miles from his …