tbuckley/cabot-search huggingface dataset:
Pediatric Emergency Department Visits Before and During the COVID-19 Pandemic — United States, January 2019–January 2022
Authors: Lakshmi Radhakrishnan, Kelly Carey, Kathleen P. Hartnett, Aaron Kite-Powell, Marissa Zwald, Kayla N. Anderson, Rebecca T. Leeb, Kristin M. Holland, Abigail Gates, Jourdan DeVies, Amanda R. Smith, Katharina L. van Santen, Sophia Crossen, Michael Sheppard, Samantha Wotiz, Amelia G. Johnson, Amber Winn, Hannah L. Kirking, Rashon I. Lane, Rashid Njai, Loren Rodgers, Craig W. Thomas, Karl Soetebier, Jennifer Adjemian
Journal: MMWR Morbidity and Mortality Weekly Report (2022)

Emergency departments (EDs) in the United States remain a frontline resource for pediatric health care emergencies during the COVID-19 pandemic; however, patterns of health-seeking behavior have changed during the pandemic (1,2). CDC examined changes in U.S. ED visit trends to assess the continued impact of the pandemic on visits among children and adolescents aged 0-17 years (pediatric ED visits). Compared with 2019, pediatric ED visits declined by 51% during 2020, 22% during 2021, and 23% during January 2022. Although visits for non-COVID-19 respiratory illnesses mostly declined, the proportion of visits for some respiratory conditions increased during January 2022 compared with 2019. Weekly number and proportion of ED visits increased for certain types of injuries (e.g., drug poisonings, self-harm, and firearm injuries) and some chronic diseases, with variation by pandemic year and age group. Visits related to behavioral concerns increased across pandemic years, particularly among older children and adolescents. Health care providers and families should remain vigilant for potential indirect impacts of the COVID-19 pandemic, including health conditions resulting from delayed care, and increasing emotional distress and behavioral health concerns among children and adolescents.
Abstract 109: Pediatric CPR in the Emergency Department: Initial Findings From the Videography in Pediatric Emergency Research Collaborative
Authors: Karen J O’Connell, Benjamin T Kerrey, Sage R Myers, Alexis B Sandler, Richard Hanna, Ichiro Watanabe, Mary E Frey, Aaron J Donoghue
Journal: Circulation (2018)

Introduction: Cardiopulmonary resuscitation (CPR) is frequently performed in a manner inconsistent with American Heart Association (AHA) guidelines. Published studies on CPR quality during pediatric cardiac arrest using chest compression (CC) monitor devices have reported data in aggregate form from entire CPR events. The addition of video review allows precise measurement of CPR quality at the level of individual providers. Hypothesis: To measure individual healthcare providers’ (HCP) CPR quality during pediatric cardiac arrest events in actual patients in the emergency department (PED) and describe adherence to AHA guidelines. Methods: A report from the Videography in Pediatric Emergency Resuscitation (VIPER) Collaborative, a prospective observational database from three tertiary PEDs. All study sites videorecord and review resuscitations and use a pressure sensor/monitor device during CPR. All events where chest compressions (CC) were performed under videorecorded conditions with the monitor device in use were eligible for inclusion. Data on CPR performance was collected by a combination of video review and monitor device; CC rate and depth and ventilation rate were extracted in time periods corresponding to individual CPR providers. CPR segments were defined as ‘high-quality’ if all AHA guidelines were achieved (CC rate 100-120 cpm; CC depth &gt;= 1.5 inches for infants or &gt;= 2 inches for children; ventilation rate 8-12 bpm, no pauses &gt; 10 seconds). Results: Between August 2016 and April 2018, complete data was available for 31 events (infants: n=5; older children: n=6). 279 compression segments were analyzed. Median CC rate was 119 cpm (IQR 110 – 129); median depth was 1.0 inches in infants (IQR 0.85 – 1.2) and 2.1 inches in older children (IQR 1.4 – 2.4). Median ventilation rate was 15 bpm (IQR 10 - 30). 22/279 (8%) compression segments met all criteria for high-quality CPR. Conclusions: PED HCPs infrequently met AHA guidelines for CPR quality. Future studies using video review and CC monitor data collection should examine the impact of specific training strategies on provider-level CPR performance during pediatric cardiac arrest.
Insights into N6-methyladenosine and programmed cell death in cancer
Authors: Li Liu, Hui Li, Dingyu Hu, Yanyan Wang, Wenjun Shao, Jing Zhong, Shudong Yang, Jing Liu, Ji Zhang
Journal: Molecular Cancer (2022)

Abstract N6-methyladenosine (m6A) methylation, the most common form of internal RNA modification in eukaryotes, has gained increasing attention and become a hot research topic in recent years. M6A plays multifunctional roles in normal and abnormal biological processes, and its role may vary greatly depending on the position of the m6A motif. Programmed cell death (PCD) includes apoptosis, autophagy, pyroptosis, necroptosis and ferroptosis, most of which involve the breakdown of the plasma membrane. Based on the implications of m6A methylation on PCD, the regulators and functional roles of m6A methylation were comprehensively studied and reported. In this review, we focus on the high-complexity links between m6A and different types of PCD pathways, which are then closely associated with the initiation, progression and resistance of cancer. Herein, clarifying the relationship between m6A and PCD is of great significance to provide novel strategies for cancer treatment, and has a great potential prospect of clinical application.
Clinical Lectures on Mental and Cerebral Diseases
Authors: J. C. Browne
Journal: BMJ (1871)

II.-HYSTERICAL MANIA.GENTLEMIEN,-Your reading and observation must already have taught you something of the intimate correlations which subsist between the brain and the reproductive organs; and your experience in the wards of our asylum will frequently illustrate these correlations, and impress them upon you.Your study of mental phenomena in health and dis- ease will speedily convince you that they are influenced in no slight degree by the sexual functions, and that they exercise a reciprocal con- trol.Jenner and Hunter showed that the ovaria and testes in birds enlarge during the breeding season, when their highest instinctive efforts are achieved, and waste again at the end of that season, when they sink down to a lower level of life.The period of the rut in animals is ac- companied by mental activity, which borders upon morbid excitement, while the gravid state of the uterus in females of our own species may lead not merely to change of temper, morbid appetites, and capricious eccentricity, but to chorea, somnambulism, amaurosis, convulsions, or mental derangement.On the other hand, a condition of mental agitation may derange the menstrual discharge, and ideas may modify the nutrition of the sexual apparatus.A very striking illustration of the power of a persistent delusion to induce changes in the vascularity of the uterus and ovaries was afforded lately by I. N., who is still an inmate of Ward 22.This woman, about whose exact age there seems to be some doubt, but who is certainly over fifty, was received here from Leeds on June 4th, I870.She is the mother of five children, the youngest of whom is fifteen years old, and was stated by her relatives to have passed through the change of life some four years ago.When admitted here she announced that, notwithstanding her age and other seeming improbabilities, she was two months advanced in pregnancy; and arguments and assurances, after a careful examination, failed to shake her belief in this fact.She very cogently remarked that she knew what it was to be in the family-way better than the doctors ; and for seven months, in spite of the absence of every recognised sign of her alleged condition, held firmly to her singular belief.At the end of that time -precisely nine months from the date of conception which she had fixed-she intimated that labour-pains had commenced.She went to bed, and insisted on observing all the formalities of the lying-in room.She had a dose of castor-oil and some gin; she had a sheet fastened to the top of her bed, and by that she held, at stated intervals, gradually diminishing in length, when she cried out as if in the pains of labour,
Post hoc pooled analysis of first-line (1L) pembrolizumab (pembro) for advanced urothelial carcinoma (UC): Outcomes by response at week nine in KEYNOTE-052 and KEYNOTE-361.
Authors: Thomas Powles, Ajjai Shivaram Alva, Mustafa Ozguroglu, Peter H. O'Donnell, Yohann Loriot, Tibor Csoszi, Jacqueline Vuky, Rafael Morales-Barrera, Elizabeth R. Plimack, Nobuaki Matsubara, Yves Fradet, Lajos Geczi, Seyda Gunduz, Ronac Mamtani, Dean F. Bajorin, Chih-Chin Liu, Kentaro Imai, Blanca Homet Moreno, Joaquim Bellmunt, Arjun Vasant Balar
Journal: Journal of Clinical Oncology (2022)

519 Background: Pembro is a 1L treatment for cisplatin-ineligible pts with UC. This post hoc landmark analysis evaluated clinical outcomes by response at 9 wk to 1L pembro monotherapy in pts with advanced/unresectable or metastatic UC from the single-arm phase 2 KEYNOTE-052 (NCT02335424) and the randomized phase 3 KEYNOTE-361 (NCT02853305) trials. Methods: Cisplatin-ineligible pts with advanced UC were enrolled in KEYNOTE-052 and received pembro (200 mg Q3W for ≤2 y). Platinum-eligible pts with advanced UC who had not previously received systemic chemotherapy (chemo) were enrolled in KEYNOTE-361 and randomly assigned 1:1:1 to receive pembro (200 mg Q3W for ≤2 y), pembro + chemo (1000 mg/m 2 gemcitabine on d1 and d8 + cisplatin [70 mg/m 2 ] or carboplatin [AUC 5] on d1 of each 3-wk cycle), or chemo. The primary analysis group included pembro monotherapy–treated pts; the sensitivity analysis group included pembro monotherapy–treated pts from KEYNOTE-052 and the choice of carboplatin subpopulation of pembro monotherapy–treated pts from KEYNOTE-361. Landmark analyses of OS by pts with CR, PR, SD, or PD per RECIST v1.1 by BICR at first imaging assessment (wk 9) were pooled for the ITT populations. Duration of CR/PR/SD and OS were estimated using the Kaplan-Meier method. Data cutoffs were Sep 26, 2020 (KEYNOTE-052) and Apr 29, 2020 (KEYNOTE-361). Results: The primary analysis group included 681 pembro-treated pts (KEYNOTE-052, N = 374; KEYNOTE-361, N = 307); the sensitivity analysis group included 544 pembro-treated pts (KEYNOTE-052, N = 374; KEYNOTE-361, N = 170). Median time from randomization to cutoff was 51.9 mo (range, 22.0-65.3) and 53.7 mo (range, 22.0-65.3) for the primary and sensitivity analysis groups, respectively. Twenty-five pts (4.6%) had CR and 135 (24.6%) had PR (primary group); 17 pts (3.9%) had CR and 105 (24.1%) had PR (sensitivity group). Median DOR was 25.9 mo for pts with CR/PR at wk 9; pts with CR/PR or SD at wk 9 had longer OS than pts with PD at wk 9 (Table). Conclusions: In this post hoc analysis, pts with advanced UC in KEYNOTE-052 and KEYNOTE-361 with CR/PR at wk 9 had better clinical outcomes with pembro monotherapy than pts with SD or PD; 1L pembro monotherapy continues to show efficacy in advanced UC. Clinical trial information: NCT02335424 and NCT02853305. [Table: see text]
Sexual Perversion.
Authors: Edwin L. Morgan
Journal: JAMA (1896)

Washington, D. C., Jan. 20, 1896. <h3>To the Editor:</h3> —Having noticed in two of your late issues that correspondents ask for the definition of the word<i>tribadism</i>, I will call attention to the very full and comprehensive article by Dr. Irving C. Rosse, of Washington, D. C., on "Unnatural Crimes," in vol. ii, p. 493, of Witthaus and Becker's "Medical Jurisprudence." In this valuable and instructive paper, your correspondents will find detailed information as to the various forms of sexual perversion as observed by neurologists and as treated from the view point of medico-legal knowledge. Trusting the reference, as already given above, may be of service to your corespondents. I remain, yours respectfully, 2315 Pennsylvania Avenue, N. W.
THE PHYSIOLOGIC STANDARDIZATION OF DRUGS.
Journal: JAMA (1906)

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
Colonoscopy.
Authors: C Williams, R Teague
Journal: Gut (1973)

Progress report ColonoscopyIn the three years since fibreoptic colonoscopes became generally available there have been a number of reportsl-12 and reviewsl3-14 describing the clinical value of colonoscopy.The technical difficulties and time involved in the procedure, the initial expense of the instruments, and the need for x-ray facilities have discouraged many centres from becoming involved in colono- scopy.Colonoscopy and biopsy has, however, been shown to be more accurate in diagnosis than barium enema89, ,12 and to remove the need for laparotomy in many cases; colonoscopic polypectomy15,61617p18p1 is now a practicable alternative to abdominal operation.It has therefore become mandatory on economic as well as clinical grounds that colonoscopy should be generally available, but because some technical difficulties remain it is also important that its indications, limitations, and relationship to radiological methods are understood.Much of the literature on colonoscopy has to date been in obscure or specialized journals, individual experience has been small, and variations in technique have been considerable.This review is therefore augmented by personal contacts with colonoscopists throughout the world and by experience of over a thousand colonoscopies.Because of the technical problems in- volved practical aspects of the procedure are covered in some detail. InstrumentsAn ACMI fibreoptic colonoscope was produced in 196320 but the first instruments with manoeuvrable tips appeared in Japan in 19667 and in Europe in 1969-1970 as the fibresigmoidoscopes of Olympus (CF-SB), Machida (FSS), and subsequently ACMI (Overholt 9000)-all now outdated.The current instruments have four-way tip angulation, air, water, and suction controls, and biopsy facilities but may be 'medium' (105-110 cm: Olympus CF-MB; Machida, FSM, ACMI 9000P) or 'long' colonoscopes (165-185 cm: Olympus CF-LB; ACMI 9000PL, Machida FCS).Fuller details are given elsewhere21.Of the commonly used colonoscopes the shorter instruments have proved easier to use, but limit the examination to the left colon.The ACMI instruments as a whole are more robust while those from Olympus have more convenient controls and sharper optics.A new generation of 'operating colonoscopes' is now being presented with either a single large channel, snare deflector, and CO2 control (Olympus CF-MB2, CF-LB) or two channels and integral stiffness control (ACMI F9A).Wolf, Saas-Wolf, and Storz endoscopes are not yet in general use A wide range of essential accessories is available including fibreoptic 'teaching aids', excellent spiked biopsy forceps (ACMI), cytology brushes (ACMI, Olympus), polypectomy snares (ACMI, Olympus, Storz), and the new stiffening tubes described later.Adaptors are available to interconnect ACMI instruments with Olympus light sources and cameras and it is hoped
Maternity services.
Authors: E. E. Rawlings
Journal: BMJ (1969)

try, knowing that consultant posts are not likely to be available for them, we should welcome them and use them.Their numbers may well diminish during the next ten years or so, but they at least give us a chance to adjust to the new situation gradually.If and when these most valuable Common- wealth doctors do stay at home our problem will become more difficult.I don't think the "medical assistant" grade will ever get off the ground, but the "assistant surgeon " with the promise of full status after a limited period-perhaps of only three or four years- may perhaps be more acceptable.Finally, there must be many hospitals where even now the resident strength is well below what has formerly been regarded as desirable, and it would be interesting to hear the views of the consultants involved.-Iam, etc.,
Abstract 289: Relationship Between Myocardial Glycogen Concentrations and Amplitude Spectrum Area During Ventricular Fibrillation in a Rat Model of Cardiac Arrest and Resuscitation
Authors: Qiaohua Hu, Xiangshao Fang, Zhengfei Yang, Wanchun Tang
Journal: Circulation (2018)

Introduction: Myocardial high-energy phosphate (ATP) levels has been demonstrated correlating with amplitude spectrum area (AMSA) during ventricular fibrillation (VF) in previous experimental studies. In the present study, we investigated the relationship between AMSA and myocardial glycogen content (MGC),which can be used to reflect the status of myocardial energy metabolism indirectly during VF. Hypothesis: AMSA has a significantly correlation with MGC during VF in a rat model of cardiac arrest and resuscitation. Methods: Twenty male Sprague-Dawley rats weighing 350 to 450 g were utilized and randomized into two groups: VF and cardiopulmonary resuscitation (CPR) (VF/CPR group) or untreated VF (VF group). 5 mins of CPR was performed after 10 mins of untreated VF in VF/CPR animals. Amplitude spectrum area (AMSA) at VF 5, 10 and 15 mins were calculated from ECG signals. The rats’ hearts were quickly removed at the predetermined time of 15 min for determines the glycogen contents by the anthrone reagent method using a glycogen assay kit. Results: AMSA values significantly decreased during untreated VF in both VF and VF/CPR animals. However, much greater AMSA during CPR was achieved by the VF/CPR group in comparison with the VF group. There was a marked and negative relationship between AMSA at VF 15 min and MGC. (Figure). Conclusion: MGC was significantly and negatively correlated with AMSA during VF in this rat model of cardiac arrest and resuscitation. In clinical practice, we can use AMSA to reflect the state of myocardial energy metabolism indirectly. Figure The changes of AMSA and relationship between AMSA and glycogen content:(A) The change of AMSA between VF/CRP group and VF group;(B) The relationship between AMSA and glycogen content. AMSA, amplitude spectrum area; V, time of ventricular fibrillation; # p &lt;0.05 vs. V4.
FDA regulation of prescription drug advertising
Authors: C. C. Peck
Journal: JAMA (1990)

Dr Kessler and Mr Pines<sup>1</sup>present a thoughtful and balanced review of the Food and Drug Administration's (FDA) regulation of prescription drug promotion. In their conclusion, the authors call to mind issues where the need for change is clear and other issues that have long vexed the agency. Mr Pines, a former FDA Associate Commissioner for Public Affairs, is intimately familiar with these issues and has chaired conferences on them in several forums. Many of the presentations from these conferences have been published.<sup>2,3</sup> The article makes some cogent observations. The need to revise the brief summary for use in advertising in a way that makes it readable and more useful is inescapable. The need for governmental oversight of promotional activities involving gifts and other financial inducements to health care providers, such as travel, was made clear in hearings conducted by Sen Edward Kennedy of Massachusetts as early as
Editorial: Vaccination against swine influenza.
Journal: BMJ (1976)

asthma than other forms of exercise, possibly because there is less shaking of the chest.Fitch and his colleagues in Australia have recently reported5 the effects of training on 46 asthmatic children who swam 3608 km in five months.Their training programme started with three sessions a week and was gradually increased to five one-hour sessions.This programme had no adverse effects and was enthusiastically accepted by both the children and their parents; and it led to a decrease in protective attitudes and a sense of liberation from previous restrictions.Non-specific indicators of physical fitness im- proved, but even more important was a fall in the need for drugs and a reduction in asthmatic symptom scores.Swimming may be recommended as part of the treatment for children with asthma.These two studies reflect the modern intensive approach to the investigation and treatment of childhood asthma.Such children can no longer be regarded as "delicate" or "nervous": they suffer from an organic disease requiring full investigation by a paediatrician; they also need encouragement and help to develop their strong desire to participate and compete in activities at which they can excel.