tbuckley/cabot-search huggingface dataset:
Abstract 266: Cardiac Arrest in the Intensive Care Unit: A Preventable Problem
Authors: Ari Moskowitz, Katherine M Berg, Anne V Grossestreuer, Michael N Cocchi, Jennifer Sarge, Donna Williams, Sharon O’Donoghue, Todd Sarge, Jesse X Yang, Maureen Chase, Michael W Donnino
Journal: Circulation (2018)

Introduction: Cardiac arrest occurring in the ICU is a relatively common and highly morbid event. Due to continuous monitoring, low nurse-to-patient ratios and close proximity of the physician team, ICU arrests are often considered an inevitable result of the underlying disease process. We sought to explore the preventability of ICU arrests and identify targets for future intervention. Methods: This was a single center, prospective study. For each ICU arrest occurring between 8/2017-3/2018, the clinical team (attending physician, trainee[s] and bedside nurse) were surveyed regarding arrest preventability. An expert team of critical care physicians and nurses also reviewed each arrest, providing a score from 0 (not at all preventable) to 5 (completely preventable). Median preventability scores were calculated and themes of preventability identified. Results: We reviewed 39 ICU arrests. Each was reviewed by a median of 7 (6, 8) expert reviewers and 88/159 (55%) surveys were returned. The median preventability rating was 1 (IQR: 0, 2) in the prospective surveys and 1 (0, 2.5) in the expert review. In the expert review, there were 10 (26%) arrests with a median score of &gt;2. Common themes included inadequate response to worsening shock, delays in intubation, failure to obtain help from the senior physician and use of narcotics/anxiolytics for agitation without recognizing or addressing clinical worsening (see Figure). When asked, ‘did you observe/were you informed of any clinical changes preceding the cardiac arrest?’—nurses and trainees responded affirmatively in 74% and 79% of cases, compared to 46% of cases for attending physicians (p=0.03). Conclusions: Cardiac arrests in the ICU may be preventable. Nurses and trainees indicated awareness of acute deterioration more often than attending physicians, highlighting an opportunity for improvement. Several clinical themes of preventability were identified which may help inform future data-driven interventions.
Renaudot and the First French Newspaper and Medical Journal
Journal: JAMA (2020)

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
MEDICAL COLOR TELEVISION-STORY OF PROGRESS
Journal: JAMA (1953)

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
Biopolymer‐Based Multilayer Microparticles for Probiotic Delivery to Colon
Authors: Sepehr Talebian, Timothy Schofield, Peter Valtchev, Aaron Schindeler, John M. Kavanagh, Qayyum Adil, Fariba Dehghani
Journal: Advanced Healthcare Materials (2022)

The potential health benefits of probiotics may not be realized because of the substantial reduction in their viability during food storage and gastrointestinal transit. Microencapsulation has been successfully utilized to improve the resistance of probiotics to critical conditions. Owing to the unique properties of biopolymers, they have been prevalently used for microencapsulation of probiotics. However, majority of microencapsulated products only contain a single layer of protection around probiotics, which is likely to be inferior to more sophisticated approaches. This review discusses emerging methods for the multilayer encapsulation of probiotic using biopolymers. Correlations are drawn between fabrication techniques and the resultant microparticle properties. Subsequently, multilayer microparticles are categorized based on their layer designs. Recent reports of specific biopolymeric formulations are examined regarding their physical and biological properties. In particular, animal models of gastrointestinal transit and disease are highlighted, with respect to trials of multilayer microencapsulated probiotics. To conclude, novel materials and approaches for fabrication of multilayer structures are highlighted.
Estimated Cost-effectiveness of Medical Therapy, Sleeve Gastrectomy, and Gastric Bypass in Patients With Severe Obesity and Type 2 Diabetes
Authors: Brianna N. Lauren, Francesca Lim, Abraham Krikhely, Elsie M. Taveras, Jennifer A. Woo Baidal, Brandon K. Bellows, Chin Hur
Journal: JAMA Network Open (2022)

Bariatric surgery is recommended for patients with severe obesity (body mass index ≥40) and type 2 diabetes (T2D). However, the most cost-effective treatment remains unclear and may depend on the patient's T2D severity.
Sequence determinants of human gene regulatory elements
Authors: Biswajyoti Sahu, Tuomo Hartonen, Päivi Pihlajamaa, Bei Wei, Kashyap Dave, Fangjie Zhu, Eevi Kaasinen, Katja Lidschreiber, Michael Lidschreiber, Carsten O. Daub, Patrick Cramer, Teemu Kivioja, Jussi Taipale
Journal: Nature Genetics (2022)

Abstract DNA can determine where and when genes are expressed, but the full set of sequence determinants that control gene expression is unknown. Here, we measured the transcriptional activity of DNA sequences that represent an ~100 times larger sequence space than the human genome using massively parallel reporter assays (MPRAs). Machine learning models revealed that transcription factors (TFs) generally act in an additive manner with weak grammar and that most enhancers increase expression from a promoter by a mechanism that does not appear to involve specific TF–TF interactions. The enhancers themselves can be classified into three types: classical, closed chromatin and chromatin dependent. We also show that few TFs are strongly active in a cell, with most activities being similar between cell types. Individual TFs can have multiple gene regulatory activities, including chromatin opening and enhancing, promoting and determining transcription start site (TSS) activity, consistent with the view that the TF binding motif is the key atomic unit of gene expression.
Psoriasis.
Authors: R H Champion
Journal: BMJ (1986)

metabolic needs or energy sparing mechanisms they were left with only one other possibility: the underestimation of food intake.They concluded-that the obese people must have be-en consuming an average of 530 kcal a day m6re than the lean controls in order to sustain their obesity.The cause of the obesity must, therefore, be sought in the control of food intake and eating behaviour.This raises several questions.Is the deception deliberate?In this study did the obese misread the scales when they weighed their food or did they "forget" to weigh and record some foods?The size of the postulated underestimation appears too great to countenance accidental omission-.-it is equivalent to nearly a third of all the food they did record.Apparently these obese-women were unable to admit to the experimenters (and probably to themselves) their actual food intake.Furthermore, the data from the lean group also included one substantial underestimation of intake; it might be difficult to prove that the lean were more consistent than the obese.The paper also adds to the growing evidence that energy expenditures in normal life are lower than the currently accepted estimates of energy requirements.6Nutritionists will need to bear this in mind ifobesity is not to become more common than it is.The central finding, however, is that this type of.obese patient should nolonger be able to claim inherently lower metabolic requirements.We should treat with -scepticism all claims from obese patients that their dietary intakes are modest.In such people, possibly evenrmore than in the lean ones, habitual intake is impossible to measure accurately, at -least with existing techniques-a message that needs to be appreciated much more widely.The measurement of food intake is so crucial that it might be argued that research on these techniques is more important than other more prestigious topics.
Abstract 25: Cost-Effectiveness of Public Automated External Defibrillators
Authors: Lars W Andersen, Mathias J Holmberg, Asger Granfeldt, Lyndon P James, Lisa Caulley
Journal: Circulation (2018)

Introduction: Despite a consistent association with improved outcomes, automated external defibrillators (AEDs) are used in only approximately 10% of public out-of-hospital cardiac arrest. One of the barriers towards increased use might be cost. The objective of this study was to provide a contemporary cost-effectiveness analysis on the use of public AEDs in the United States (US) to inform guidelines and public health initiatives. Methods: We compared the cost-effectiveness of public AEDs to no AEDs for out-of-hospital cardiac arrest in the US over a life-time horizon. The analysis assumed a societal perspective and results are presented as costs (in 2017 US dollars) per quality-adjusted life year (QALY). Model inputs were based on reviews of the literature. For the base case, we modelled an annual cardiac arrest incidence per AED of 20%. It was assumed that AED use was associated with a 52% relative increase in survival to hospital discharge with a favorable neurological outcome in those with a shockable rhythm. A probabilistic sensitivity analysis was conducted to account for joint parameter uncertainty. Consistent with recent guidelines from the American Heart Association, we used a willingness-to-pay threshold of $150,000 per QALY gained. Results: The no AED strategy resulted in 1.63 QALYs at a cost of $42,757. The AED strategy yielded an additional 0.26 QALYs for an incremental increase in cost of $13,793 per individual. The AED strategy yielded an incremental cost-effectiveness ratio of $53,797 per QALY gained. The yearly incidence of cardiac arrests occurring in the presence of an AED had minimal effect on the incremental cost-effectiveness ratio except at very low incidences. At an incidence of 1%, the incremental cost-effectiveness ratio was $101,040 per QALY gained. In sensitivity analyses across a plausible range of health-care and societal estimates, the AED strategy remained cost-effective. In the probabilistic sensitivity analysis, the AED strategy was cost-effective in 43%, 85%, and 91% of the scenarios at a threshold of $50,000, $100,000, and $150,000 per QALY gained, respectively. Conclusion: Public AEDs are a cost-effective public health intervention in the US. These findings support widespread dissemination of public AEDs.
Traumatic Malignancy
Authors: W. H. Cripps
Journal: BMJ (1882)

of the mediun line.In this performance he has " crowded " most of the abdominal contents beneath the diaphragm.In F, on the other hand, he has produced a " phantom tumour " by driving coils of in- testine within the weird and peculiar grasp of the rectus and oblique muscles.The " growth " is rounded, and dull on percussion, and, as he remarks, looks as if it wanted an exploratory puncture.Certainly it is most suggestive, and well worth an inspection.In conclusion, I would tender my best thanks to Mr. Jerrard of I07, Regent Street, for the time and skill which he placed at my disposal in the preparation of the excellent photographs from which the woodcuts have been prepared by which these notes are illustrated.
Pathogenesis of myasthenia gravis.
Authors: G A MacGregor
Journal: BMJ (1971)

771anterior muscle showed on histological examination extensive "vacuolar myopathy."Three months after stopping chloroquine the patient recovered the use of her legs; a second muscle biopsy showed an increased number of intact muscle fibres and almost complete disappearance of myopathic vacuoles.Unfortunately, owing to extensive damage of her retina by chloroquine, she obtained only slight visual improvement.Detectable amounts of chloroquine have been found in urine, red blood cells, and plasma of patients with chloroquine retinopathy for as long as five years after stopping the drug,2 and in experimental animals, such as albino rats, chloroquine was found to be present in the retina 14 months after stopping the administration of the drug.3In a large series of patients with rheumatoid arthritis treated with low doses of chloroquine for one to nine years, 10%' of patients were found to develop characteristic chloroquine corneal deposits.4Thus the use of even small doses of chloroquine for long periods of time cannot be recommended with confidence.-Iam, etc.
Corrigendum to ‘Role of cardiovascular imaging in cancer patients receiving cardiotoxic therapies: a position statement on behalf of the Heart Failure Association (HFA), the European Association of Cardiovascular Imaging (EACVI) and the Cardio‐Oncology Council of the European Society of Cardiology (ESC)’ [Eur J Heart Fail 2020;22:1504–1524]
Journal: European Journal of Heart Failure (2021)
STUDIES OF GENETIC TRANSMISSION OF MURINE LEUKEMIA VIRUS BY AKR MICE
Authors: Wallace P. Rowe, Janet W. Hartley
Journal: The Journal of Experimental Medicine (1972)

The transmission of murine leukemia virus (MLV) to hybrids between AKR and Fv-1b mice was studied in order to evaluate the effect of the Fv-1 gene on endogenous MLV infection and to attempt to determine if the genetic loci contributed by AKR carry viral genetic determinants. Fv-1 was shown to have a marked suppressive effect on time of appearance of detectable infectious virus and on the titers attained in vivo, but did not affect the ability of the cells to produce virus in vitro after induction with 5-iododeoxyuridine. The host range type of the virus detected in the hybrid mice was almost always of the type carried by AKR, although the low-virus Fv-1b parents carry the genome of a different host range type. This finding provides strong, but not conclusive, evidence that the virus-inducing loci of AKR contain MLV genetic determinants.
Intravenous glucagon.
Authors: J R Condon, M J Knight, J Day
Journal: BMJ (1972)

contacts had no clinical or radiological evidence of disease.Two, a mother and son, developed active pulmonary tuberculosis and were treated apparently successfully with chemotherapy and discharged from the chest unit as cured years before their deaths.Five cases of disseminated sclerosis over the years, though a fairly high percentage of my list, admittedly can prove nothing, but in my opinion they are suggestive of more than just coincidence.I think it likely that the vigorous immune reaction against a massive tubercular onslaught is directed against the lipoids of the tubercle bacillus and, having achieved its object, goes on to attack the myelin of the central nervous system, which has a similar chemical com- position.-Iam, etc.,
Survival outcomes comparing radical nephroureterectomy versus endoscopic treatment in solitary kidney patients diagnosed with upper tract urothelial carcinoma.
Authors: Ridwan Alam, Joseph G. Cheaib, Michael J. Biles, Jared S. Winoker, Nirmish Singla, Trinity Bivalacqua, Phillip M. Pierorazio, Max R. Kates, Sunil H. Patel
Journal: Journal of Clinical Oncology (2022)

477 Background: Solitary kidney patients who develop upper tract urothelial carcinoma (UTUC) present a significant management challenge. Radical nephroureterectomy (RNU) renders these patients anephric with a need for dialysis, which is associated with lower life expectancy and decreased quality of life. However, organ-sparing endoscopic treatment may result in undertreatment of the cancer process. We sought to compare survival outcomes between RNU and endoscopy in solitary kidney patients diagnosed with clinically localized UTUC. Methods: The Surveillance, Epidemiology, and End Results database was linked to Medicare records to identify patients diagnosed with UTUC through 2017. This data was then linked to the Medicare Provider Analysis and Review and National Claims History databases to identify patients with a solitary kidney. Only patients with an established diagnosis of solitary kidney prior to developing clinically node-negative and non-metastatic disease (cN0M0) UTUC were included. Patients were stratified by treatment with RNU versus endoscopy. Kaplan-Meier analysis was performed to estimate survival between the two groups. Results: A total of 2108 solitary kidney patients with cN0M0 UTUC were identified, with a median age of 75.3 years at diagnosis [IQR 69.3-81.1]. Median follow-up time was 2.8 years [IQR 1.7-4.4]. High-grade disease was present in 1531 patients (72.6%), of whom 1344 underwent RNU and 195 underwent endoscopy. Between the two treatments, there was no difference in either cancer-specific survival ( P=0.18) or overall survival ( P=0.10). When combining high- and low-grade UTUC patients, 1839 underwent RNU and 269 underwent endoscopy. Again, no difference was observed in cancer-specific survival ( P=0.31) or overall survival ( P=0.17). Patients with high-grade disease demonstrated higher rates of cancer-specific and overall mortality than those with low-grade disease (both P&lt;0.001). Conclusions: Solitary kidney patients diagnosed with clinically localized UTUC demonstrate no difference in survival outcomes when comparing RNU to endoscopic treatment. This potentially suggests that, when weighed against the option of endoscopic treatment, the benefits of RNU in these patients may not outweigh the risks of becoming anephric and therefore dependent on dialysis.
“Cascaded Rocket” Nanosystems with Spatiotemporal Separation for Triple‐Synergistic Therapy of Alzheimer's Disease
Authors: Ruiyuan Liu, Jun Yang, Xinyu Qiu, Weihong Ji, Jie Shen, Yan Li, Zhiguo Lu, Yanyue Wu, Wenli Wang, Jing Wang, Jifu Hao, Xin Zhang
Journal: Advanced Healthcare Materials (2022)

Alzheimer's disease (AD) remains an incurable disease due to the intricate pathogenesis. The neuropathological hallmarks include extracellular amyloid-β (Aβ) plaques, tau phosphorylation and extensive oxidative stress in neurons, which facilitate the progression of AD. Based on the complex etiology, a spatiotemporally "cascaded rocket" delivery system (DPH/TPGAS NPs) with metal ion/enzyme responses is established in this study for triple-synergistic AD treatment. After targeting and permeating the blood-brain barrier (BBB), the histidine units in the DPH chelate excess metal ions at the extracellular microenvironment, restraining the formation of Aβ aggregates, inducing the first-stage separation. Then, the remanent system targets neuronal cells and triggers the second separation with cathepsin B for reducing the level of phosphorylated tau and oxidative stress. Accordingly, the DPH/TPGAS NPs can achieve spatiotemporal drug release, which results in enhanced synergistic therapeutic effects both in the extracellular and intracellular region of the AD brain. After treating with DPH/TPGAS NPs, the memory deficits, levels of Aβ and phosphorylated tau, inflammation and neuron damages are remarkably ameliorated in 3 × Tg-AD mice. Therefore, this "cascaded rocket" delivery system has great potential to serve as a powerful platform and provides a new horizon to the therapeutic strategy for AD and other brain diseases' treatments.
Genetic variation at mouse and human ribosomal DNA influences associated epigenetic states
Authors: Francisco Rodriguez-Algarra, Robert A. E. Seaborne, Amy F. Danson, Selin Yildizoglu, Harunori Yoshikawa, Pui Pik Law, Zakaryya Ahmad, Victoria A. Maudsley, Ama Brew, Nadine Holmes, Mateus Ochôa, Alan Hodgkinson, Sarah J. Marzi, Madapura M. Pradeepa, Matthew Loose, Michelle L. Holland, Vardhman K. Rakyan
Journal: Genome biology (2022)

Abstract Background Ribosomal DNA (rDNA) displays substantial inter-individual genetic variation in human and mouse. A systematic analysis of how this variation impacts epigenetic states and expression of the rDNA has thus far not been performed. Results Using a combination of long- and short-read sequencing, we establish that 45S rDNA units in the C57BL/6J mouse strain exist as distinct genetic haplotypes that influence the epigenetic state and transcriptional output of any given unit. DNA methylation dynamics at these haplotypes are dichotomous and life-stage specific: at one haplotype, the DNA methylation state is sensitive to the in utero environment, but refractory to post-weaning influences, whereas other haplotypes entropically gain DNA methylation during aging only. On the other hand, individual rDNA units in human show limited evidence of genetic haplotypes, and hence little discernible correlation between genetic and epigenetic states. However, in both species, adjacent units show similar epigenetic profiles, and the overall epigenetic state at rDNA is strongly positively correlated with the total rDNA copy number. Analysis of different mouse inbred strains reveals that in some strains, such as 129S1/SvImJ, the rDNA copy number is only approximately 150 copies per diploid genome and DNA methylation levels are &lt; 5%. Conclusions Our work demonstrates that rDNA-associated genetic variation has a considerable influence on rDNA epigenetic state and consequently rRNA expression outcomes. In the future, it will be important to consider the impact of inter-individual rDNA (epi)genetic variation on mammalian phenotypes and diseases.
Hospital Interneships.
Authors: A Subscriber
Journal: JAMA (1897)

Chicago, Sept. 30, 1897. <h3>To the Editor:</h3> —I read with interest your editorial, "The Advantages of Hospital Interneship," in the last number of theJournal. My opinion is that all agree in acknowledging the benefit of hospital training. Why do more students not secure to themselves the advantages of such a training? Is it a want of appreciation on the part of the prospective physician? I think not. The average student, yes, 95 per cent., are anxious to secure a place in some good hospital, in fact in any hospital. Place the blame where it belongs. The fact is that there are too few places of this kind to be filled. The case you cite illustrates my point very nicely. You say fourteen students came up for examination to fill twelve vacancies. Out of that fourteen twelve got hospital positions and two were disappointed. Had there been forty come up