Miracle-dz/UniFAR-FTUs huggingface dataset:
Audit of a Diabetes Clinic at Tawam Hospital, United Arab Emirates, 2004–2005

Abstract: The aim of this audit was to determine the current management of patients with diabetes compared to international standards and to benchmark the results against current international standards. A retrospective audit of medical records of diabetic patients attending Tawam Hospital, a tertiary healthcare facility in the Al Ain region in the Emirate of Abu Dhabi, United Arab Emirates was performed. A random sample of 30 patients (5% of the target group) was selected from the total number of 600 patients who visited the diabetes clinics in August 2005. An audit form was developed based on the priority aims and measures contained in the Institute for Clinical Systems Improvement (ICSI) Guidelines for the management of type 2 diabetes mellitus. Data analysis was carried out based on measurement specifications in the ICSI Guidelines. All patients had their blood pressure checked at their most recent appointment. All except one patient had an HbA1c test and a lipid profile performed during the study period. Although 75% of patients were referred for a dilated eye examination, only 47% complied. Approximately two‐thirds of all patients had evidence of self‐monitoring of blood glucose. Less than half of the patients were referred to the nutritionist and only a relatively small proportion of patients had advice on diet and exercise documented in their medical record. There was also lack of documentation, particularly for smoking status, foot examination, and body mass index (BMI). All patients received aspirin (ASA) treatment. The majority had a systolic blood pressure of 130 mmHg or less; just under half of patients had HbA1c of less than 7%. In comparison to the Center for Diseases Control (CDC) targets, we exceeded targets in three areas in relation to HbA1c testing, ASA treatment, and self‐report monitoring blood glucose. We did not meet the stated target of 75% for patients having a dilated eye exam due to lack of patient compliance (more than three‐quarters of all patients were referred but did not attend for appointment). Documentation of a comprehensive foot examination was present for only one‐quarter of all patients compared to the recommended target of three‐quarters of patients. Documentation of advice on diet and exercise was present for 40%, which did not meet the CDC target of 60%. Overall, the audit highlighted that Tawam Hospital is providing a good level of care to diabetic patients and compares favorably with international targets; however, key recommended actions have been identified for implementation to improve patient care and maintain a continuous improvement process through effective monitoring with prioritization to those related to preventative care.
The cytochemistry of the thyroid C cells and their relationship to calcitonin

(1) A population of cells exists in the thyroid gland (of the dog and other mammals) which is entirely distinct from the population of follicular or acinar cells. (2) The cells were originally described in 1877 by Baber, in the dog thyroid, and later by Hürthle (1894) and by Nonidez (1931). They are characterized cytochemieally by a content of basic protein or polypeptide, by argyrophilia, and by high α-glycerophosphate dehydrogenase. At the electron microscope level, their cytoplasm is seen to be filled with spherical vesicles 1500 to 2000°A in diameter, bounded by a single membrane, and their mitochondria are especially electron dense. (3) These cells, the C cells, respond to high blood calcium levels by increased secretion of the product contained in the spherical vesicles. (4) It is postulated that this product is thyrocalcitonin, the calcium regulating hormone of the thyroid gland. If this premise is correct the C cells constitute a new endocrine system.
The impact of gentle contacts on ease of handling, welfare, and growth of calves and on quality of veal meat.

It has been demonstrated previously that regularly stroking and letting calves suck fingers leads to less avoidance and more approach behavior of the calves toward people. To examine whether these positive contacts affect the welfare and productivity of calves and the quality of veal meat we used 22 veal calves housed in individual crates. Half of them received minimal contact with the stockperson (controls), and the other half were given additional gentle contacts around meals, by stroking the calves and allowing them to suck the stockperson's fingers, during the entire fattening period (21 wk). Welfare was assessed through behavioral reactivity (reactions to handling, to surprise stimuli, and to novelty), neuroendocrine responses to stress (cortisol in response to an ACTH challenge, catecholamine-synthesizing enzymes), and health (number of medical treatments, abomasal lesions). Calf productivity was assessed through growth rates and meat quality through glycolytic potential (an estimator of resting glycogen level in muscle), pH, and color. Calves that received gentle contacts were less agitated (P < .01) and tended to defecate less (P = .08) when handled in a cart on wheels than the control calves, but no treatment effects were found in reactivity to novelty and surprise stimuli, responses to ACTH, and catecholamine synthetic potential. Calves given gentle contacts had fewer abomasal lesions than controls (0/11 vs 4/11, P = .05). The glycolytic potential of the semimembranosus muscle was higher in calves that received gentle contacts than in controls (172.6 vs 154.1 micromol/g, P < .05), but no treatment effects were observed on meat pH, meat color, or growth rates. It is concluded that gentling veal calves reduces their reactions to handling. Gentle contacts reduce the reaction to transport shown by differences in glycolytic potential. In addition, the reduction in reactions to handling and the decreased incidence of abomasal lesions can contribute to an improvement of the calves' welfare.
Chemoprotective Effects of Zataria multiflora Against Genotoxicity Induced by Cyclophosphamide in Mice Bone Marrow Cells

The preventive effective of Zataria multiflora (ZM) extract was investigated in mouse bone marrow cells against genotoxicity induced by cyclophosphamide (CP). Mice were orally (gavaged) pretreated with solutions of ZM extract prepared at 3 different doses (50, 100, and 200 mg/kg body weight) for 7 consecutive days. They were injected with CP (50 mg/kg body weight) on the seventh day of treatment and killed after 24 hours for the evaluation of micronucleated polychromatic erythrocytes (MnPCEs) and the ratio of PCE/(PCE + NCE), where PCE refers to polychromatic erythrocyte, and NCE refers to normochromatic erythrocyte. All 3 doses of extract significantly reduced MnPCEs induced by CP (P < .0001). Zataria extract at a dose of 200 mg/kg body weight reduced MnPCEs 7.8 fold and also completely normalized the PCE/ (PCE + NCE) ratio. Administration of ZM inhibited bone marrow suppression induced by CP. Zataria extract exhibited concentration-dependent antioxidant activity on 1, 1-diphenyl 2-picryl hydrazyl free radical and lipid peroxidation. It appeared that ZM with antioxidative activity reduced the oxidative stress and genotoxicity induced by CP in mouse bone marrow cells.
A major responder to ipilimumab and nivolumab in metastatic uveal melanoma with concomitant autoimmunity

The use of immune checkpoint inhibition has led to major improvements in outcome for patients with metastatic cutaneous melanoma. The combination of ipilimumab and nivolumab has demonstrated greater activity over single‐agent immunotherapy in phase III trials. Clinical trials of combination CTLA‐4 and PD‐1 inhibition are underway in uveal melanoma, for which there are currently no data. Here, we present the case of a 74‐year‐old male patient with metastatic uveal melanoma, who was treated with a combination of ipilimumab and nivolumab. He developed sequential autoimmune transaminitis, diabetes and uveitis, which necessitated discontinuation of maintenance nivolumab 3 months after commencement of treatment. The patient continues to demonstrate an ongoing partial response 10 months from the initial combination immunotherapy, with the evidence of depigmentation of the primary ocular tumour.
The effects of goal orientations on knowledge management system usage, knowledge sourcing and learning outcome

This research investigates individual differences in the context of knowledge management system (KMS) usage, knowledge sourcing and learning outcome. Individual differences are measured for mastery, performance and avoidance goal orientations. Individuals with high mastery goal orientations prefer to master and develop new skills and knowledge. Those with high performance goal orientations prefer to compare their performances with others. Lastly, those with high avoidance goal orientations prefer to avoid a new task if they feel incompetent. User posting and reading activities in a KMS are examined over a 3month period. Consistent with goal orientation theory, the results show that mastery goal orientation has an effect on reading, knowledge sourcing and learning outcome. In contrast, performance goal orientation has an effect only on posting, but not on reading. To a lesser degree than mastery goal orientation, avoidance goal orientation has an effect on reading, but not posting. These findings have important implications for both knowledge management researchers and practitioners.
Healthy lifestyle status, antihypertensive treatment and the risk of heart failure among Finnish men and women

Objective: To compare the association between antihypertensive drug treatment and heart failure (HF) risk with the association between engaging in a healthy lifestyle and HF risk. Methods: We prospectively investigated the single and joint associations of lifestyle factors and awareness, treatment, blood pressure control status with HF risk among 38 075 Finns, who were 25–74 years old and free of HF at baseline. Results: During a median follow-up of 14.1 years, 638 men and 445 women developed HF. Engaging in a healthy lifestyle was associated with an decreased risk of HF. Compared with normotensive people, hypertensive patients with and without antihypertensive treatment had a higher risk of HF. Hypertensive patients who used antihypertensive drugs but did not engage in a healthy lifestyle had a significantly higher risk of HF [HR 1.75; 95% confidence interval (CI) 1.39–2.21] than hypertensive patients who did not use antihypertensive drugs but engaged in a healthy lifestyle. In addition, compared with hypertensive patients who used antihypertensive drugs and engaged in a healthy lifestyle, hypertensive patients who did not use antihypertensive drug or engage in a healthy lifestyle had a significantly higher risk of HF (HR 1.55; 95% CI 1.24–1.95). Conclusion: The present study demonstrates that HF risk was lower in hypertensive patients who engaged in a healthy lifestyle but higher in hypertensive people using antihypertensive drug treatment.
Water Absorption Enhances the Uptake of Mannitol and Decreases Cr-EDTA/Mannitol Permeability Ratios in Cat Small Intestine In Situ

Background: Recently, we hypothesized that mannitol absorption in human intestinal permeability tests is a reflection of small intestinal water absorption and is dependent mainly on the efficiency of the countercurrent multiplier in the villi. This may affect the outcome of clinical double-sugar permeability tests. We tested the hypothesis in cats, another species with an efficient countercurrent multiplier. Methods: The lumen-to-tissue transport of [ 14 C]mannitol and [ 51 Cr]EDTA was studied in in situ perfused jejunum of eight anaesthetized cats using four isotonic perfusion solutions with varying sodium and glucose content. The transport of water was monitored, and the absorption rate of the probes was calculated by their disappearance from the perfusate. Results: There was a significant positive correlation between water absorption and [ 14 C]mannitol clearance from the different perfusates ( r = 0.99; P < 0.01), whereas this correlation was absent for [ 51 Cr]EDTA clearance ( r = 0.05; P = 0.95). There was also a significant negative correlation between water absorption and [ 51 Cr]EDTA/[ 14 C]mannitol clearance ratios ( r = 0.98; P < 0.02). Conclusions: The results show a prominent effect of water absorption on mannitol uptake through pores which, also during glucose transport, exclude Cr-EDTA. The difference in water absorption from the solutions used in cat small intestine is dependent on the effectiveness of the countercurrent multiplier; we conclude that the capability of this mechanism influences mannitol absorption in vivo. Qualitatively comparable results were obtained using oral test solutions with varying NaCl and glucose concentrations in human volunteers. We propose that the functioning of the countercurrent multiplier is essential for the interpretation of double-sugar tests in clinical studies.
Extremely low-volume, high-intensity interval training improves exercise capacity and increases mitochondrial protein content in human skeletal muscle

Purpose: The purpose of the present study was to evaluate whole-muscle content of several proteins involved in the regulation of skeletal muscle mitochondrial protein content and anaerobic capacity following 4 weeks of extremely low-volume high-intensity interval training (HIT). Methods: Young, healthy, recreationally active adult males (n = 8) trained 4 times a week for 4 weeks on a cycle ergometer. Each session involved 4 min of total exercise comprised of eight 20 s intervals at ~170% of peak aerobic power separated by 10 s rest. Muscle biopsies were taken prior to (pre) and ~72 hrs post-training (post). Par- ticipants completed an incremental peak oxygen up- take (VO2peak) test and a Wingate test pre-, mid-, and post-training. Results: VO2peak was elevated (p p -1·min-1, mid: 43.4 ± 2.5 ml·kg-1·min-1, post-: 47.2 ± 2.9 ml·kg-1·min-1). Wingate mean power also increased with training (pre-: 701.0 ± 73.0 W, mid-: 745.5 ± 73.3 W, post-: 786.8 ± 80.0 W). While maximal citrate synthase activity was unchanged, protein expression of the mitochondrial protein cytochrome c oxidase (COX) subunit I (+27%; p p p = 0.08) increased. Increases (p α (+19%), and nuclear PGC-1α (+46%) were also observed after 4 weeks of HIT. No changes were observed in the whole-muscle contents of PDHe1a, PDK4, SIRT1, mTOR, S6K1, MCT1, or PFK protein. Conclusions: These results demonstrate that several mitochondrial protein (but not citrate synthase activity), PGC-1α protein content, and exercise capacity can be improved in only 4 min of total training time per day, 4 days per wk using HIT cycle training.
Backbone dynamics of a short PU.1 ETS domain.

The resonance assignments, secondary structure and backbone dynamics of the ETS domain of the transcription factor PU.1 have been determined for the free protein in solution by NMR spectroscopy. The secondary structure for the free ETS domain is similar to that observed in the crystal structure of the PU.1 protein complexed with DNA, except that helix alpha2 and recognition helix alpha3 are shorter for the free protein in solution. Backbone dynamics of the protein have been examined using amide hydrogen-deuterium exchange and (15)N laboratory-frame spin relaxation measurements. A significant probability of local unfolding of helix alpha2, which precedes the loop-helix-loop DNA recognition domain, is inferred from the very fast hydrogen-deuterium exchange for amide protons in this helix. The (15)N relaxation measurements indicate that the protein is partially oligomerized at a concentration of 2.5 mM, but monomeric at a concentration of 0.3 mM. The (15)N relaxation data for the low concentration sample were interpreted, using the model-free formalism, to provide insight into protein dynamics on picosecond-nanosecond and microsecond-millisecond time scales. High flexibility of the protein backbone is observed for the residues in the loop between alpha2 and alpha3. This loop is variable in length and in structure within the class of winged helix proteins and is partially responsible for binding to DNA. The dynamic properties observed for alpha2, alpha3 and the intervening loop may indicate a correlation between protein plasticity in particular structural elements and recognition of specific DNA sequences.
T-Cell-Dependent Antibody Response to the Dominant Epitope of Streptococcal Polysaccharide,N-Acetyl-Glucosamine, Is Cross-Reactive with Cardiac Myosin

ABSTRACT Autoantibodies against myosin are associated with myocarditis and rheumatic heart disease. In this study, the antigenic cross-reactivity of myosin and N-acetyl-glucosamine (GlcNAc), the dominant epitope of Group A streptococcal polysaccharide, was examined. Six antimyosin monoclonal antibodies (MAbs) derived from mice with cardiac myosin-induced myocarditis were characterized. All MAbs cross-reacted with GlcNAc, mimicking a subset of MAbs derived from rheumatic carditis patients that bind both myosin and streptococcal polysaccharide. Variable (V) region gene usage was diverse, with five of six MAb heavy-chain V regions encoded by distinct members of the J558 family and the sixth encoded by a member of the VGAM3.8 family. Light-chain V-region segments were derived from the Vk1, Vk4/5, Vk10, and Vk21 families. These antimyosin, anti-GlcNac MAbs demonstrated several T-cell-dependent features: they were predominantly immunoglobulin G, were encoded by V-region genes expressed late in development, and displayed somatic mutation. A direct correlation between the extent of somatic mutation and the affinity for myosin was observed. Affinity for GlcNAc also increased with the frequency of mutation, demonstrating that affinity maturation can occur simultaneously for both self antigen and foreign antigen. Based on these observations, we immunized mice with GlcNAc coupled to bovine serum albumin and demonstrated that a T-cell-dependent response to GlcNAc leads to antimyosin reactivity. We speculate that the pathogenic antibody response in rheumatic carditis may reflect the conversion of a T-cell-independent response to GlcNAc to a T-cell-dependent cross-reactive response to GlcNAc and myosin.
Longitudinal association between respiratory muscle strength and cough capacity in persons with spinal cord injury: An explorative analysis of data from a randomized controlled trial.

OBJECTIVE To assess the longitudinal association between respiratory muscle strength and cough capacity in persons with recent spinal cord injury. DESIGN Longitudinal analyses. SUBJECTS Forty persons with recent spinal cord injury and impaired pulmonary function. METHODS Measurements were performed 4 weeks after the start of rehabilitation, 9 and 17 weeks after the first measurement, and one year after discharge from inpatient rehabilitation. Peak cough flow was measured with a spirometer. Maximum inspiratory and expiratory pressures (MIP and MEP), expressed in cmH2O, were measured at the mouth. RESULTS Both MIP and MEP were significantly positively associated with peak cough flow. After correction for confounders and time 10 cmH2O higher MIP was associated with a 0.32 l/s higher peak cough flow, and a 10 cmH2O higher MEP was associated with a 0.15 l/s higher peak cough flow. The association between MIP and peak cough flow was mainly based on within-subject variance. The association between MIP and peak cough flow was stronger than between MEP and peak cough flow. CONCLUSION Improvement in respiratory muscle strength is associated with improvement in cough capacity in persons with recent spinal cord injury who have impaired pulmonary function.
Addition of panitumumab to irinotecan: Results of PICCOLO, a randomized controlled trial in advanced colorectal cancer (aCRC).

3523 Background: Phase III trials show inconsistent effects when anti-EGFR drugs are added to cytotoxic therapy in aCRC. Benefits, when present, are confined to patients (pts) determined retrospectively to have KRAS wild-type (wt) tumours. PICCOLO is a multicentre randomized controlled trial, amended in June 2008 to include prospective KRAS testing, to evaluate the addition of panitumumab (Pan) to single-agent irinotecan (Ir) as second- or subsequent-line therapy for KRAS-wt aCRC. METHODS Eligible pts had: measurable aCRC progressing during/after ≥1 prior regimen with fluoropyrimidines ± other drugs; no prior Ir; WHO PS 0-2. Until June '08, pts were allocated 1:1:1 to Ir, IrPan or Ir/ciclosporin, with retrospective KRAS analysis. Thereafter, KRAS was tested prospectively (by pyrosequencing of c.12-13 and 61) and pts with KRAS-wt were allocated 1:1 to Ir (Ir 350 mg/m2 [300 mg/m2 if ≥70 yrs or PS2], q3w) or IrPan (same Ir plus Pan 9 mg/kg, q3w). Primary analysis is ITT overall survival (OS) in KRAS-wt pts not pretreated with anti-EGFR therapy (80% power, HR 0.70, α=0.05, 2-sided). Secondary endpoints include % progression-free at 12 wks, PFS, RR, toxicity and QL. Planned molecular subgroups include BRAF, NRAS, KRAS c.146 and PIK3CA. RESULTS 460 KRAS-wt pts were recruited to the primary analysis (324 after June '08, KRAS-tested prospectively); median age 63 yrs; 94% PS0-1; 95% had received prior oxaliplatin. With 312 events and median follow-up of survivors 10.2 mo, OS was not improved: median IrPan = 10.4 mo, Ir = 10.5 mo, HR 0.91 (95%CI [0.73, 1.14], p=0.44), but trended towards improved survival after 12 mo. Planned subgroup analysis shows worse survival, and disbenefit with Pan in BRAF-mut pts (n=63, HR=1.87, [95%CI 1.07, 3.27]); conversely, KRAS/BRAF-wt pts show a stronger but still non-significant trend towards benefit (n=348, HR=0.86 [0.66, 1.11]). CONCLUSIONS PICCOLO did not meet its primary endpoint of improved OS with panitumumab in KRAS-wt aCRC, but a trend was seen towards survival benefit after 12 months, especially in KRAS/BRAF-wt pts. Conversely, pts with BRAF-mut tumours had significant disbenefit with Pan. Full results, including PFS and planned molecular subgroups, will be presented.
Relative humidity and the killing of bacteria: the variation of cellular water content with external relative humidity or osmolality.

SUMMARY: The paper deals with the relationship betweeen the water content of washed Serratia marcescens and the thermodynamic activity of water, a w, over the range 0 < a w < 1.0. Two overlapping types of measurement are used: osmotic water exchange and water-vapour sorption. The data are given in terms of the equation w = Bm -r where w is water content, m is external osmolality (actual or effective, depending upon the technique used), B is a constant and r has values which can be interpreted in terms of the type of process involved: e.g. in the initial stages of osmotic dehydration, r of unity would indicate ideal solution behaviour; in the final stages of drying, any constant value of r would conform to an adsorption function like that of Halsey (1948). The data obtained by the two techniques used fall on a single curve with several zones including (a) non-ideal solution behaviour at high a w, (b) two intersecting ‘co-operative adsorption’ zones at very low a w, and (c) a region of variable r where processes such as dissolution of small molecules and ‘saturated’ swelling of interlinked polymeric structures are presumed to occur. It is thought that detailed interpretation of the unified water uptake curves would be valuable in understanding mechanisms of humidity-dependent loss of viability, in particular the zones of exceptionally rapid attenuation.
GENETIC FACTORS FAMILY HISTORY OF TYPE 1 DIABETES

Dr. Marian Rewers is Professor of Pediatrics and Medicine at the Barbara Davis Center for Childhood Diabetes, University of Colorado School of Medicine, Aurora, CO. Dr. Lars C. Stene is Senior Scientist at the Department of Child Health, Norwegian Institute of Public Health, Oslo, Norway. Dr. Jill M. Norris is Professor of Epidemiology at the Colorado School of Public Health, University of Colorado, Aurora, CO.