The Journal Of Clinical Investigation

If Atul Gawande were funny--or Jerome Groopman were a working mother--they might sound something like Michelle Au, M.D., author of this hilarious and poignant memoir of a medical residency. Michelle Au started medical school armed only with a surfeit of idealism, a handful of old ER episodes for reference, and some vague notion about "helping people." This Won't Hurt a Bit is the story of how she grew up and became a real doctor. It's a no-holds-barred account of what a modern medical education feels like, from the grim to the ridiculous, from the heartwarming to the obscene. Unlike most medical memoirs, however, this one details the author's struggles to maintain a life outside of the hospital, in the small amount of free time she had to live it. And, after she and her husband have a baby early in both their medical residencies, Au explores the demands of being a parent with those of a physician, two all-consuming jobs in which the lives of others are very literally in her hands. Au's stories range from hilarious to heartbreaking and hit every note in between, proving more than anything that the creation of a new doctor (and a new parent) is far messier, far more uncertain, and far more gratifying than one could ever expect.

This is an unusually comprehensive 2001 account of the broad range of medical implications of homocysteine.

Data sharing can accelerate new discoveries by avoiding duplicative trials, stimulating new ideas for research, and enabling the maximal scientific knowledge and benefits to be gained from the efforts of clinical trial participants and investigators. At the same time, sharing clinical trial data presents risks, burdens, and challenges. These include the need to protect the privacy and honor the consent of clinical trial participants; safeguard the legitimate economic interests of sponsors; and guard against invalid secondary analyses, which could undermine trust in clinical trials or otherwise harm public health. Sharing Clinical Trial Data presents activities and strategies for the responsible sharing of clinical trial data. With the goal of increasing scientific knowledge to lead to better therapies for patients, this book identifies guiding principles and makes recommendations to maximize the benefits and minimize risks. This report offers guidance on the types of clinical trial data available at different points in the process, the points in the process at which each type of data should be shared, methods for sharing data, what groups should have access to data, and future knowledge and infrastructure needs. Responsible sharing of clinical trial data will allow other investigators to replicate published findings and carry out additional analyses, strengthen the evidence base for regulatory and clinical decisions, and increase the scientific knowledge gained from investments by the funders of clinical trials. The recommendations of Sharing Clinical Trial Data will be useful both now and well into the future as improved sharing of data leads to a stronger evidence base for treatment. This book will be of interest to stakeholders across the spectrum of research--from funders, to researchers, to journals, to physicians, and ultimately, to patients.

A New York Times Bestseller, with an updated explanation of the 2010 Health Reform Bill "Important and powerful . . . a rich tour of health care around the world." —Nicholas Kristof, The New York Times Bringing to bear his talent for explaining complex issues in a clear, engaging way, New York Times bestselling author T. R. Reid visits industrialized democracies around the world--France, Britain, Germany, Japan, and beyond--to provide a revelatory tour of successful, affordable universal health care systems. Now updated with new statistics and a plain-English explanation of the 2010 health care reform bill, The Healing of America is required reading for all those hoping to understand the state of health care in our country, and around the world. T. R. Reid's latest book, A Fine Mess: A Global Quest for a Simpler, Fairer, and More Efficient Tax System, is also available from Penguin Press.

The compelling true story of Dr. Jonas Salk's quest to develop a vaccine for polio. In 1916, the United States was hit with one of the worst polio epidemics in history. The disease was a terrifying enigma: striking out of nowhere, it afflicted tens of thousands of children and left them—literally overnight—paralyzed. Others it simply killed. At the same time, a child named Jonas Salk was born.... When Franklin Delano Roosevelt was diagnosed with polio shortly before assuming the Presidency, Salk was given an impetus to study this deadly illness. After assisting in the creation of an influenza vaccine, Salk took up the challenge. His progress in combating the virus was hindered by the politics of medicine and by a rival researcher determined to discredit his proposed solution. But Salk's perseverance made history—and for close to seventy years his vaccine has saved countless lives, bringing humanity close to eradicating polio throughout the world. Splendid Solution chronicles Dr. Salk's race against time to achieve an unparalleled breakthrough that made him a cultural hero and icon of modern medicine.

Progressive reductions in vehicle emission requirements have forced the automotive industry to invest in research and development of alternative control strategies. Continual control action exerted by a dedicated electronic control unit ensures that best performance in terms of pollutant emissions and power density is married with driveability and diagnostics. Gasoline direct injection (GDI) engine technology is a way to attain these goals. This brief describes the functioning of a GDI engine equipped with a common rail (CR) system, and the devices necessary to run test-bench experiments in detail. The text should prove instructive to researchers in engine control and students are recommended to this brief as their first approach to this technology. Later chapters of the brief relate an innovative strategy designed to assist with the engine management system; injection pressure regulation for fuel pressure stabilization in the CR fuel line is proposed and validated by experiment. The resulting control scheme is composed of a feedback integral action and a static model-based feed-forward action, the gains of which are scheduled as a function of fundamental plant parameters. The tuning of closed-loop performance is supported by an analysis of the phase-margin and the sensitivity function. Experimental results confirm the effectiveness of the control algorithm in regulating the mean-value rail pressure independently from engine working conditions (engine speed and time of injection) with limited design effort.