Miracle-dz/UniFAR-FTUs huggingface dataset:
Self-Monitoring of Blood Glucose

A comprehensive examination by a panel of experts of a scientific or medical issue related to diabetes mellitus. A consensus conference is convened for the purpose of presenting expert opinion on an issue from which a consensus statement is developed. The statement represents the panel's collective analysis, evaluation, and opinion. The Consensus Statement is published in ADA journals and other scientific/medical journals, as appropriate. Once written by the panel, a Consensus Statement is not subject to subsequent review or approval and does not represent official association opinion.
The Study of Medical Education*

It is a great personal pleasure to be among you once more. I can only hope that your response at the conclusion of what I have to say today will be as warm as that you gave at the time of my last appearance some 30 months ago. But if it is not, I shall attribute the difference to the fact that the topic to which I have been asked to address myself on this occasion that is, the study of medical education may arouse somewhat stronger personal feelings than the more general issues of teaching and learning which provided the focus for those earlier remarks. Let me begin with a text drawn from a sixteenth century work of Niccolo Machiavelli: ‘There is nothing more difficult to carry out, nor more doubtful of success, nor more dangerous to handle than to initiate a new order of things’. The study of medical education is a new order of things, even though interested individuals have been thinking and writing for centuries about the means of preparing physicians for their professional tasks. Yet today you are celebrating only the 10th anniversary of this Association, which has drawn together in common cause those concerned for precise delineation of the educational problems in medicine faced by the United Kingdom, and the direction in which solutions might be sought. In the United States, 1968 also marks a 10th anniversary of almost simultaneous faculty decision in three medical schools to establish formal units of research in medical education.
Calcitonin Gene-Related Peptide in Cervicogenic Headache

Trigeminovascular activation is involved in the pathophysiology of migraine and cluster headache. The marker evaluated best for trigeminovascular activation is calcitonin gene-related peptide (CGRP) in the cranial circulation. It is unknown whether trigeminovascular activation plays any role in cervicogenic headache (CEH). The objective of this study was to investigate CGRP plasma levels in CEH patients in relation to headache state. To compare plasma CGRP levels between the peripheral and the cranial circulation. Blood from both external jugular veins and from the antecubital vein was drawn from 11 patients with CEH. Plasma CGRP levels were measured by radioimmunoassay. No difference was found between CGRP levels assessed on days with and without headache. There was no difference beween CGRP levels from the symptomatic and the asymptomatic external jugular vein and the antecubital vein. There is no evidence for an activation of the trigeminovascular system in CEH. In certain cases, clinical differentiation between CEH and migraine without aura is difficult. Plasma CGRP levels might serve as a biological marker to distinguish the two headache entities.
Obesity and Headache: Part II – Potential Mechanism and Treatment Considerations

Obesity and headache are both associated with a substantial personal and societal impact, and epidemiologic studies have consistently identified a positive association between obesity and headache in general, as well as obesity and migraine specifically (see part I). In the current manuscript, we will discuss the potential mechanisms for the migraine–obesity association, with a focus on the central and peripheral pathophysiological pathways which overlap between migraine and those modulating the drive to feed. We then discuss surgical, behavioral, and pharmacological treatment considerations for overweight and obese migraineurs as well as for those with idiopathic intracranial hypertension. We close by briefly discussing where future research may be headed in light of this data.
Biomechanical evaluation of different numbers, sizes and placement configurations of ligaclips required to secure cellophane bands.

OBJECTIVE To determine the number, size, and configuration of ligaclips most resistant to tensile forces when applied to cellophane bands. STUDY DESIGN In vitro mechanical evaluation. SAMPLE POPULATION Single-layer and triple-layer cellophane bands, 9.0 and 11.5 mm ligaclips. METHODS Triple-layer bands were secured with a different number (2-5), size (9.0 or 11.5 mm) or configuration (linear or alternating placement) of ligaclips and mechanically tested. Force-deformation curves were generated and yield load in Newtons (N) was determined for each variable. A 3-way analysis of variance with post hoc Tukey's tests was used for statistical comparisons. Yield load for single-layer and triple-layer bands secured with 4 alternating 11.5 mm ligaclips was compared using a paired-sample (independent) t-test with P<. 05 considered significant. RESULTS Mean yield load increased as the number of ligaclips applied increased, but this effect began to plateau after application of the 4th clip. Mean yield load for 11.5 mm ligaclips was significantly higher than for 9.0 mm ligaclips (P<.001) and for the alternating configuration compared with the linear configuration (P<.001). Yield load for 4 alternating 11.5 mm ligaclips applied to triple-layer cellophane bands was significantly greater than the same configuration applied to single-layer cellophane bands (P<.001). CONCLUSION 11.5 mm ligaclips applied in an alternating configuration and on triple-layer cellophane provided most resistance to tensile forces. The resistance to tensile forces increased significantly as the number of ligaclips applied increased from 1 to 4/band. CLINICAL RELEVANCE Surgeons should be aware that the number, size, and configuration of ligaclips and cellophane thickness affect their resistance to tensile forces.
Rosiglitazone increases matrix production and quenches inflammation: studies in human cells

Type 2 diabetes (T2D) is characterized by an accelerated atherogenesis, a process to which both proliferative and inflammatory responses contribute. Peroxisome proliferator‐activated receptors‐gamma (PPARγ) agonists have both anti‐proliferative and anti‐inflammatory properties. We tested the effect of therapeutic doses of rosiglitazone on proliferative and inflammatory pathways in fibroblasts (HF) from five controls (C) and five T2D patients, and in aortic smooth muscle cells (hSMC).
The acute and temporary modulation of PERIOD genes by hydrocortisone in healthy subjects

ABSTRACT The physiological stress system and the circadian clock system communicate with each other at different signaling levels. The steroid hormone cortisol, the end-effector of the hypothalamus–pituitary–adrenal axis, is released in response to stress and acts as a mediator in circadian rhythms. We determined the effect of escalating cortisol doses on the expression of PERIOD genes (PER1, PER2 and PER3) in healthy subjects and analyzed whether the glucocorticoid receptor (GR) is involved in the cortisol-mediated PERIOD gene expression. Forty participants (50% males and 50% females) were randomly assigned to groups receiving a saline placebo solution or 3 mg, 6 mg, 12 mg and 24 mg of hydrocortisone. Blood was drawn every 15 min to measure quantitative gene expression of PER1, PER2 and PER3. A potential role of the GR was determined by an ex vivo study stimulating whole blood with hydrocortisone and RU486 (a GR antagonist). As a result, moderate doses of hydrocortisone produced an acute and temporary induction of PER1 and PER3 mRNA levels, whereas PER2 was not responsive to the hormone administration. The cortisol-dependent induction of PER1 was blocked by the GR antagonist in whole blood after treatment with hydrocortisone and RU486 ex vivo. In conclusion, acute pharmacological stress modulated the expression of PER1 and PER3 in whole blood temporarily in our short-term sampling design, suggesting that these circadian genes mediate stable molecular mechanisms in the periphery.
Effect of Cardiac Resynchronization Therapy on Cardiac Sympathetic Nervous Dysfunction and Serum C‐reactive Protein Level

Background: Cardiac autonomic dysfunction is associated with a poor prognosis in patients with heart failure (HF). Systemic inflammation is elevated in patients with HF. We hypothesized that cardiac resynchronization therapy (CRT) improves cardiac sympathetic nervous dysfunction and systemic inflammation. To test our hypothesis, we evaluated cardiac sympathetic activity and serum levels of high sensitive C‐reactive protein (hs‐CRP) before and after CRT.
Factors associated with medication-related problems in ambulatory hemodialysis patients.

BACKGROUND Hemodialysis (HD) patients are at risk for medication-related problems. Patient characteristics associated with the number of medication-related problems in HD patients have not been investigated. METHODS Patient records were reviewed to identify medical problems, prescribed medications, medication indication(s), and medication-related problems. Medication classes and medication-related problems were compared between patients with and without diabetes mellitus (DM). Correlations were performed to determine whether associations exist between medication-related problems, number of medications, number of medication doses per day, number of comorbid conditions, patient age, and duration of end-stage renal disease while controlling for DM status. RESULTS Medical records of 133 patients were evaluated. Patients were 60.5 +/- 15.2 years old, prescribed 11.0 +/- 4.2 medications, and had 6.0 +/- 2.3 comorbidities. Medication-related problems were identified in 97.7% of patients. Four hundred seventy-five medication-related problems were identified, averaging 3.6 +/- 1.8 medication-related problems per patient. Patients with DM had more medication-related problems identified than those without DM (303 versus 172 medication-related problems, respectively; P < 0.05). Medication-related problems correlated positively with number of patient comorbidities (P < 0.001). CONCLUSION Medication-related problems are prevalent in virtually all HD patients. The number of medication-related problems in an individual patient increases as the number of comorbid conditions increases. The most frequent medication-related problems were drug without indication (30.9%), laboratory (27.6%), indication without drug use (17.5%), and dosing errors (15.4%). Patients with DM are at increased risk for medication-related problems. Health care providers taking care of HD patients should be aware of this problem, and efforts to avoid or resolve medication-related problems should be undertaken at all HD clinics.
Recombinant Attenuated Salmonella enterica Serovar Typhimurium Expressing the Carboxy-Terminal Domain of Alpha Toxin from Clostridium perfringens Induces Protective Responses against Necrotic Enteritis in Chickens

ABSTRACT Clostridium perfringens-induced necrotic enteritis (NE) is a widespread disease in chickens that causes high mortality and reduced growth performance. Traditionally, NE was controlled by the routine application of antimicrobials in the feed, a practice that currently is unpopular. Consequently, there has been an increase in the occurrence of NE, and it has become a threat to the current objective of antimicrobial-free farming. The pathogenesis of NE is associated with the proliferation of C. perfringens in the small intestine and the secretion of large amounts of alpha toxin, the major virulence factor. Since there is no vaccine for NE, we have developed a candidate live oral recombinant attenuated Salmonella enterica serovar Typhimurium vaccine (RASV) that delivers a nontoxic fragment of alpha toxin. The 3′ end of the plc gene, encoding the C-terminal domain of alpha toxin (PlcC), was cloned into plasmids that enable the expression and secretion of PlcC fused to a signal peptide. Plasmids were inserted into Salmonella enterica serovar Typhimurium host strain χ8914, which has attenuating pabA and pabB deletion mutations. Three-day-old broiler chicks were orally immunized with 109 CFU of the vaccine strain and developed alpha toxin-neutralizing serum antibodies. When serum from these chickens was added into C. perfringens broth cultures, bacterial growth was suppressed. In addition, immunofluorescent microscopy showed that serum antibodies bind to the bacterial surface. The immunoglobulin G (IgG) and IgA titers in RASV-immunized chickens were low; however, when the chickens were given a parenteral boost injection with a purified recombinant PlcC protein (rPlcC), the RASV-immunized chickens mounted rapid high serum IgG and bile IgA titers exceeding those primed by rPlcC injection. RASV-immunized chickens had reduced intestinal mucosal pathology after challenge with virulent C. perfringens. These results indicate that oral RASV expressing an alpha toxin C-terminal peptide induces protective immunity against NE.
Intraperitoneal Insulin in Diabetic CAPD Patients

In the growing number of patients with renal failure from diabetic nephropathy (1), CAPO offers definite advantages. It provides continuous control of fluid status and hypertension without inducing haemodynamic instability, maintains steady state levels of metabolites, avoids the need for vascular access and systemic heparinisation, and may retard the progression of neuropathy (2, 3). A further advantage of CAPO is that glycaemic control can be improved with intraperitoneal (IP) administration of insulin via the indwelling peritoneal catheter (3-6). At present 26% of all patients beginning CAPO in the U.S.A. have diabetic nephropathy (7). Although some authorities still advocate subcutaneous insulin in these patients (8), we believe that the intraperitoneal route has definite advantages and will become increasingly used. All endogenous insulin secreted by the pancreas reaches the liver by the portal vein and 50% of portal venous insulin is extracted by the liver before entering the systemic circulation (9). This relatively high concentration of insulin in the liver modulates the metabolism of absorbed nutrients before they enter the systemic circulation and may be important in glucose homeostasis (10). Insulin given intraperitoneally is absorbed mainly by diffusion into the portal venous circulation and directly through the capsule of the liver (11). It thus simulates physiological insulin secretion more closely than systemic insulin (12). IP insulin can also reach the systemic circulation directly by diffusion across the parietal peritoneum and by convective transfer via the peritoneal cavity lymphatics (13). The absorption kinetics of IP administration of regular insulin promote glycaemic control throughout the dwell time; IP insulin is absorbed along with the obligatory glucose load from the dialysate and insulin absorption continues until the end of the dwell (Fig. 1). Intraperitoneal insulin is rapidly absorbed and has been detected in the peripheral blood within 15 minThe International Journal Of Artificial Organs / Vol. 11 / no. 1, 1988/ pp. 9-12
The role of molecular biology in understanding ovarian cancer initiation and progression

In this review, we will present clinical and experimental data that the surface epithelial cells of the ovary are the most likely cell of origin of ovarian cancer. Using a rat model of the disease, we demonstrate the utility of the molecular techniques of Differential Display Genome Scanning and Suppression Subtractive Hybridization to detect gene expression and genetic differences between normal rat surface epithelial cells and their transformed counterpart. Lastly, we provide examples of how molecular techniques can be used to predict which tumors will respond to chemotherapy.
Upper‐Body Strength and Power Assessment in Women Using a Chest Pass

&NA; Cronin, J.B. , and G.J. Owen. Upper‐body strength and power assessment in women using a chest pass. J. Strength Cond. Res. 18(3):401–404. 2004. —Finding assessment methods that are reliable, valid, and easy to administer is important, especially when assessing large numbers of athletes. The purpose of this research therefore was to investigate whether assessment of the upper body using the chest pass throw was significantly related to strength and power as measured using the bench press. The chest pass distance of 12 experienced netball players was measured; thereafter, their bench press 1 repetition maximum and various kinematic and kinetic variables were calculated from a 10‐kg bench press throw performed on an instrumented Smith machine. Pearson correlation coefficients were used to establish the relationship between the strength/power variables and the chest pass. Of the kinematic and kinetic variables calculated from the bench press throws, impulse and power were the variables most highly correlated to chest pass distance (r = 0.775–0.810), whereas the measures of initial force production (F30ms and F100ms) were the lowest (r = 0.082–0.105). Four variables had a greater than 50% (R2) shared variance with the netball chest pass—impulse, peak power, mean power and maximal strength. Power and impulse are strong predictors of chest pass performance; however, the value of the chest pass as an assessment tool to map strength and power changes in an athlete needs to be investigated using a training study approach.
Biochemical Analysis of the Regulatory T Cell Protein Lymphocyte Activation Gene-3 (LAG-3; CD223)1

Lymphocyte activation gene-3 (LAG-3; CD223) is a CD4-related transmembrane protein that binds to MHC class II molecules. We have recently shown that LAG-3 is required for maximal regulatory T cell function, and that ectopic expression of LAG-3 is sufficient to confer regulatory activity. In this study we show that LAG-3 is cleaved within the D4 transmembrane domain connecting peptide into two fragments that remain membrane associated: a 54-kDa fragment that contains all the extracellular domains and oligomerizes with full-length LAG-3 (70 kDa) on the cell surface via the D1 domain, and a 16-kDa peptide that contains the transmembrane and cytoplasmic domains. This NH2-terminal fragment is subsequently released as soluble LAG-3 (sLAG-3), a process that is increased after T cell activation in vitro and in vivo, and is found in the sera of C57BL/6 and RAG-1−/− mice. Modulation of LAG-3 cleavage may contribute to the function of this key regulatory T cell protein.
Design of linear-phase IIR filters from FIR specifications

A simple method is presented for the characterization of a stable IIR filter matching a finite portion of the impulse response and autocorrelation coefficients of a given FIR filter. It is shown that the problem is reduced to the solution of a set of linear equations derived using the impulse response and autocorrelation data. The method is characterized by its computational simplicity and is illustrated by some examples to show its superior performance when compared to the existing methods. >
Attenuation of pain‐related behaviour evoked by carrageenan injection through blockade of neuropeptide Y Y1 and Y2 receptors

It is well known that neuropeptide Y (NPY) participates in the modulation of chronic pain, but its exact role has not yet been fully explained. In this study, we explored whether targeted delivery of NPY and its antagonists into dorsal root ganglion (DRG) modulates pain‐related behaviour in rats with experimentally induced inflammatory nociception.
EXERCISE PHYSIOLOGY AND PATHOPHYSIOLOGY OF LACTATE ACIDOSIS AND CLEARANCE

lactate acid, skeletal muscle, mortality Lactic acid is a naturally occurring molecule with original detection falling into a category of lactic acid-producing bacterial organisms. However first detected in foods, its increased concentration in muscles of hunted animals was later linked with lactate acidosis origin. Physiologically, high rate of ATP hydrolysis, occurring during anaerobic glycolysis, contributes to the formation of lactate acidosis. Not only skeletal muscles, despite of their large mass, but also brain, liver, kidney and adipose tissue function as consumers of lactate. Elevated metabolic rate during physical work promotes lactate clearance via accelerated rate of its oxidation. Strong evidence about the effects of certain diseases on lactate metabolism exists. In pathophysiology, elevated concentration of lactate in blood may be caused by its increased production, decreased clearance, or a combination of both. Abnormally increased blood lactate levels occur during hypoperfusion/hypoxemia or dysfunction of cellular metabolism. The rising body of literature demonstrating that the initial level and/or the rate of blood lactate clearance predicts the mortality following trauma, severe sepsis or cardiac surgery has accumulated.
Collagen arrangement in space of Disse correlates with fluid flow in normal and cirrhotic rat livers

Little is known about collagen arrangement in the space of Disse was related to the fluid flow both in normal and cirrhotic liver. We examined the changes in the arrangement of type‐I collagen in thioacetamide‐induced cirrhotic rat livers with immunohistochemistry and SEM after maceration of the noncollagenous tissues with NaOH. The sparse bundles of collagen fibers in the spaces of Disse were mostly elongated fibers with a disorganized arrangement in each nodule. They connected with the broad fibrous septa. Based on a comparison of the architecture of the collagen fibers and the established flow of fluid in the space of Disse, we hypothesize that the fluid in the space of Disse streams along collagen fibers in all directions to broad fibrous septa. The appearance of perinodular plexus in cirrhotic rat livers probably helps to reduce portal hypertension. Microsc. Res. Tech. 78:187–193, 2015. © 2014 Wiley Periodicals, Inc.
Describing gerontological nursing: an academic exercise or prerequisite for progress?

AIMS AND OBJECTIVES To develop a practitioner-led description of gerontological nursing and articulate the principles which underpin its practice. BACKGROUND As the population ages expertise in gerontological nursing will become increasingly important. However, a complete and widely accepted delineation of the rationale, philosophy, knowledge base and special skills for gerontological nursing is yet to be developed. METHODS As one cycle of a larger action research project informed by realistic evaluation, a representative sample of 30 Scottish nurses worked together as a Community of Practice to develop a description of gerontological nursing that would have utility in their practice and in the development of best practice care guidance. Data collection involved group interviews and records of on-line discussions. Data were analysed using content analysis. The emerging description was verified through external consultation with other nursing colleagues and older people. RESULTS Nursing older people within Scotland was perceived as low status and participants reported that a positive reframing of gerontological nursing was needed. A description and underlying principles were developed by nurses and used as a lens to shape best practice statements. The description embraces a person-centred and enabling approach to evidenced-based gerontological nursing. CONCLUSIONS Gerontological practice requires an accessible consensus view and description to support its development. Practising nurses developed such a view and its utility has been seen in the development of best practice statements. Relevance to clinical practice. The description and principles of gerontological nursing can be used to guide nursing practice, practice development and research.