Miracle-dz/UniFAR-FTUs huggingface dataset:
Management of Diabetes and Hyperglycemia in Hospitalized Patients

Diabetes is a prevalent metabolic disorder that affects more than 415 million people globally [1]. Globally, diabetes care has been estimated at $1.31trillion [2]. Further, according to the International Diabetes Federation, 1 in 10 adults will have diabetes by 2040 [1]. In the United States, data from the National Diabetes Statistics reported in 2012 that a total of 29.1 million Americans, or 9.3% of the population, had diabetes [3]. The percentage of the population with diagnosed diabetes is expected to rise, with one study projecting that as many as one in three U.S. adults will have diabetes by 2050 [4]. Patients with diabetes have a 3-fold greater chance of hospitalization compared to those without diabetes [5,6], and it is estimated that more than 20% of all adults discharged have diabetes, with 30% of them requiring 2 or more hospitalizations in any given year [5-7]. In 2012 in the U.S., there were over 7.7 million hospital stays for patients with diabetes (i.e., diabetes as either a principal diagnosis for hospitalization or as a secondary diagnosis, coexisting condition) and in the UK the 2016 National Diabetes Inpatient Audit suggested that the prevalence of diabetes amongst inpatients had risen from 15% in 2010 to 17% in 2016 [8]. In addition, patients hospitalized with a diagnosis of diabetes stay in the hospital for longer than those without a diagnosis of diabetes admitted for the same condition [9]. Diabetes remains the 7th leading cause of death in the United States in 2014, with 76,488 death certificates listing it as the underlying cause of death, accouting for 24 deaths per 100,000 of the population [10]. The care of patients with diabetes imposes a substantial burden on the economy, with a total estimated cost of diagnosed diabetes in the United States in 2012 was $245 billion; including $176 billion in direct medical costs and $69 billion in reduced productivity [11]. The largest component of this medical expenditure is hospital inpatient care , accounting for 43% of the total medical cost [11]. Hyperglycemia is defined as a blood glucose greater than 140 mg/dl (7.8 mmol/l) [12,13]. It is reported in 22% to 46% of non-critically ill hospitalized patients [7,12]. Extensive observational and trial data indicate that inpatient hyperglycemia, in patients with or without a prior diagnosis of diabetes, is associated with an increased risk of complications and mortality, a longer hospital stay, a higher admission rate to the intensive care unit (ICU), and a higher need for transitional or nursing home care after hospital discharge [7].
Effects of leptin on insulin sensitivity in normal rats.

To determine whether leptin has insulin sensitizing effects in normal rodents, we measured plasma glucose and insulin concentrations in male Sprague-Dawley rats treated with leptin or vehicle by continuous s.c. infusion for 48 h. In additional experiments, we examined the acute effect of i.v. leptin upon insulin sensitivity under conditions of clamped glycemia. Subcutaneous leptin was administered at 10.0 and 1.0 microg/h. To avoid confounding effects of differences in food intake, both leptin- and vehicle-treated rats were fasted during the 48-h period of infusion. Infusion of leptin, 10 microg/h, significantly reduced both plasma glucose and insulin. Leptin, 1.0 microg/h, also decreased plasma glucose and insulin, although the effects on insulin did not achieve statistical significance. Leptin at either dose did not alter body weight or epididymal fat mass compared with vehicle treated controls. Leptin, 10 microg/h, decreased circulating insulin-like growth factor-1 levels. No differences in GLUT-4 content in either in brown or epididymal fat were observed as a result of leptin-treatment. Leptin, 10 microg/h, significantly decreased urine osmolality, increased water intake, and reduced renal potassium excretion compared with vehicle-infused rats. In additional rats, we measured the acute effect of i.v. leptin on insulin sensitivity determined as whole body glucose utilization during hyperinsulinemic glucose clamps performed at glucose targets of 60 and 90 mg/100 ml. Glucose utilization was increased by 29% during the last 135 min of glycemia clamped at 60 mg/100 ml (P < 0.05) and by 30% during the last 135 min of glycemia clamped at 90 mg/dl (P < 0.01) in rats infused with leptin compared with vehicle. In summary, leptin increased insulin sensitivity in normal rats both under fasting conditions and in the presence of hyperinsulinemia at clamped glucose. These effects did not appear dependent on altered body weight. Leptin also altered salt and water metabolism under fasting conditions resulting in increased water intake and more dilute urine.
Denitrification, Dissimilatory Reduction of Nitrate to Ammonium, and Nitrification in a Bioturbated Estuarine Sediment as Measured with 15N and Microsensor Techniques

Nitrogen and oxygen transformations were studied in a bioturbated (reworked by animals) estuarine sediment (Norsminde Fjord, Denmark) by using a combination of 15N isotope (NO3-), specific inhibitor (C2H2), and microsensor (N2O and O2) techniques in a continuous-flow core system. The estuarine water was NO3- rich (125 to 600 μM), and NO3- was consistently taken up by the sediment on the four occasions studied. Total NO3- uptake (3.6 to 34.0 mmol of N m-2 day-1) corresponded closely to N2 production (denitrification) during the experimental steady state, which indicated that dissimilatory, as well as assimilatory, NO3- reduction to NH4+ was insignificant. When C2H2 was applied in the flow system, denitrification measured as N2O production was often less (58 to 100%) than the NO3- uptake because of incomplete inhibition of N2O reduction. The NO3- formed by nitrification and not immediately denitrified but released to the overlying water, uncoupled nitrification, was calculated both from 15NO3- dilution and from changes in NO3- uptake before and after C2H2 addition. These two approaches gave similar results, with rates ranging between 0 and 8.1 mmol of N m-2 day-1 on the four occasions. Attempts to measure total nitrification activity by the difference between NH4+ fluxes before and after C2H2 addition failed because of non-steady-state NH4+ fluxes. The vertical distribution of denitrification and oxygen consumption was studied by use of N2O and O2 microelectrodes. The N2O profiles measured during the experimental steady state were often irregularly shaped, and the buildup of N2O after C2H2 was added was much too fast to be described by a simple diffusion model. Only bioturbation by a dense population of infauna could explain these observations. This was corroborated by the relationship between diffusive and total fluxes, which showed that only 19 to 36 and 29 to 62% of the total O2 uptake and denitrification, respectively, were due to diffusion-reaction processes at the regular sediment surface, excluding animal burrows.
Utility of culture redox potential for identifying metabolic state changes in Amino acid fermentation

We investigated the relationship of dissolved oxygen and culture redox potential (CRP) on amino acid production. Corynebacterium glutamicum ATCC 14296 was used for all experiments. The fermentation can be divided into a growth phase and a production phase. Our results indicate that in order to get higher amino acid production, a lower oxygen supply during the exponential phase is favored. A higher oxygen supply rate appears to be necessary during the production phase. Culture redox potential (CRP) was used to monitor the fermentation. CRP readings were observed to drop to a characteristic minimum value as the metabolic state changed from a growth to production phase. This was evidenced by the commencement of amino acid production and a simultaneous uptake of lactate. Upon lactate exhaustion, the CRP increased abruptly. At the same time, maximal amino acid yields were observed. By the use of minimum CRP as an indication of metabolic phase changes, the agitation rate was changed to increase oxygen supply during the production phase. This significantly increased amino acid production. These results show that culture redox potential measurements can be used to monitor and optimize amino acid production by process manipulation.
PLASMA TOCOPHEROL AND LIPID LEVELS IN PREGNANCY AND ORAL CONTRACEPTIVE USERS

Plasma tocopherol (vitamin E), cholesterol and triglycerides were estimated in normal non pregnant women and in women throughout pregnancy. All three constituents were increased in the later stages of pregnancy. There was a significant statistical correlation between tocopherol and cholesterol levels, but not between the vitamin and triglycerides. The data suggest that the increase in tocopherol may be associated with a corresponding increase in cholesterol since both are known to share a common transport system, but the association was evident only during pregnancy. Compared to controls, plasma vitamin E levels were not altered in pre‐eclampsia nor in oral contraceptive users.
Antidepressant Use among Blacks and Whites in the United States

Objective—The study objective was to estimate the prevalence and correlates of antidepressant use by black and white Americans. Methods—Data from the Collaborative Psychiatric Epidemiology Surveys (CPES) were analyzed to calculate nationally representative estimates of antidepressant use by black and white Americans. Setting—The 48 coterminous United States was the setting. Participants—Household residents ages 18 years and older (N=9,723) participated in the study. Main Outcomes—The primary outcome was past-year antidepressant use (n=1,004). Results—Among individuals with 12-month depressive and anxiety disorders (n=516), blacks (14.6%) had significantly lower (p < 0.001) antidepressant use than whites (32.4%). Depression severity was significantly associated with higher antidepressant use for whites, but not blacks. Psychiatric disorders and vascular disease significantly increased the odds of past-year antidepressant use. The increased prevalence of antidepressant use associated with vascular disease was independent of diagnosable psychiatric disorders. Among respondents not meeting criteria for 12-month depressive and anxiety disorders, lifetime depressive and anxiety disorders and vascular disease significantly increased the odds of antidepressant use. Conclusions—Few white and fewer black Americans with depressive and anxiety disorders receive antidepressant treatment. Higher depression severity was associated with more antidepressant use for whites, but not blacks. Antidepressant use was associated with medical conditions related to vascular disease, and these medical conditions were independent of coexisting psychiatric conditions. The results also indicate that many antidepressants are used for maintenance pharmacotherapy for Corresponding Author: Hector M. González, Institute of Gerontology, Wayne State University, 87 East Ferry Street, 226 Knapp Building, Detroit, MI 48202, Phone: (313) 577-2297, Fax: (313) 875-0127 Email: hmgonzalez@med.wayne. edu. Financial Disclosures: The authors report no conflicts of interest that could inappropriately influence, or be perceived to influence, this work. Disclosures: None for any author. NIH Public Access Author Manuscript Psychiatr Serv. Author manuscript; available in PMC 2008 November 12. Published in final edited form as: Psychiatr Serv. 2008 October ; 59(10): 1131–1138. doi:10.1176/appi.ps. 59.10. 1131. N IH PA Athor M anscript N IH PA Athor M anscript N IH PA Athor M anscript depressive and anxiety disorders as well as common medical conditions associated with vascular disease.
Automatic assessment of the degree of TB-infection using images of ZN-stained sputum smear: New results

We present new results in the context of automatic assessment of the presence of acid fast bacilli (AFB) in images of ZN-stained sputum smears. Specifically, the first phase involving color segmentation in the HSV space is improved in terms of quality by using a decision-tree classifier. Further, we have recognized the possibility of staining artifacts of large size, and propose a method of discriminating the same from clumps of AFB. The method involves the use of Haralick's texture features. Its importance lies in the fact that the presence of large clumps or even several small clumps in an image of a sputum smear generally indicates a higher degree of infection. The results of segmentation - as assessed by the Sorenson-Dice coefficient & the Hausdorff distance - are better than those pertaining to our previous work. The counts of AFB are close to those based on visual inspection, and the clumps could be separated from large staining artifacts successfully.
Diagnostic tests for asthma in firefighters.

BACKGROUND Subjects with asthma do not meet medical requirements for professions such as firefighting. OBJECTIVE To prospectively determine the diagnostic value of respiratory symptoms and various tests used in the assessment of asthma in a cohort of firefighters. METHODS A questionnaire, spirometry, direct and indirect airway challenge tests, exhaled nitric oxide, and skin-prick tests were administered prospectively to 101 of 107 firefighters employed in Basel, Switzerland. Asthma was defined as the combination of respiratory symptoms with airway hyperresponsiveness. RESULTS Six of 101 firefighters (6%) had physician-diagnosed asthma, which could be confirmed in 4 firefighters. In contrast, asthma was diagnosed in 14% (14 of 101 firefighters). Wheezing was the most sensitive symptom for the diagnosis of asthma (sensitivity, 78%; specificity, 93%). Other respiratory symptoms showed a higher specificity than wheezing but a markedly lower sensitivity. Bronchial airway challenge with mannitol was the most sensitive (92%) and specific (97%) diagnostic test for asthma. Using a cutoff point of 47 parts per billion, nitric oxide had a similar specificity (96%) but lower sensitivity (42%) compared to the direct (methacholine) and indirect (mannitol) airway challenge tests. CONCLUSION Asthma was considerably underdiagnosed in firefighters. The combination of a structured symptom questionnaire with a bronchial challenge test allows to identify patients with asthma and should routinely be used in the assessment of active firefighters and may be of help when evaluating candidates for this profession.
Interleukin‐21 in chronic inflammatory diseases

Interleukin‐21 (IL‐21), a cytokine produced by various subsets of activated CD4+ T cells, regulates multiple innate and adaptive immune responses. Indeed, IL‐21 controls the proliferation and function of CD4+ and CD8+ T lymphocytes, drives the differentiation of B cells into memory cells and Ig‐secreting plasma cells, enhances the activity of natural killer cells and negatively regulates the differentiation and activity of regulatory T cells. Moroever, IL‐21 can stimulate nonimmune cells to synthesize various inflammatory molecules. Excessive production of IL‐21 has been described in many human chronic inflammatory disorders and there is evidence that blockade of IL‐21 helps attenuate detrimental responses in mouse models of immune‐mediated diseases. In this article we briefly review data supporting the pathogenic role of IL‐21 in immune‐inflammatory pathologies and discuss the benefits and risks of IL‐21 neutralization in patients with such diseases. © 2013 BioFactors, 39(4):368–373, 2013
MANNOSE-BINDING LECTIN POLYMORPHISMS IN SEVERE SEPSIS: RELATIONSHIP TO LEVELS, INCIDENCE, AND OUTCOME

Mannose-binding lectin (MBL) genetic polymorphisms result in deficiency of the encoded protein and increased susceptibility to infection, especially in children and the immunocompromised. The objective of this study was to investigate the relationship between MBL-2 exon 1 and promoter −221 polymorphisms, plasma levels of the encoded protein, and the incidence and outcome of severe sepsis and septic shock. One hundred seventy-four white adult patients with severe sepsis or septic shock were recruited in a prospective multicenter study across eight intensive care units in the South of England, UK. Genotype and haplotype frequencies were compared between normal population controls and patients, and between survivors and nonsurvivors. Plasma levels of encoded protein were related to genotype and outcome. The exon 1 polymorphisms (A/O or O/O) were significantly more common in the patients with severe sepsis and septic shock than in normal healthy adults (54.6% vs. 39.7%, P = 0.001), and there was a significant difference in haplotype frequency between controls and septic patients (P < 0.0001). There was no significant difference in MBL-2 genotype or haplotype frequency between survivors and nonsurvivors. There was a strong relationship between MBL-2 haplotype and plasma MBL concentration (P < 0.001). Individual plasma levels were variable and increased between days 1 and 7. The mortality rate was higher in those with MBL levels <1000 μg/L than in those patients with levels >1000 μg/L (47.2 vs. 22.2%, P = 0.05). We conclude that genetic polymorphisms resulting in mannose-binding lectin deficiency are associated with increased susceptibility to sepsis. The close relationship between polymorphic variants and plasma MBL concentration persists during sepsis but individual levels vary widely. Lower circulating MBL levels are associated with a poor outcome.
Purification and Kinetics of a Raw Starch‐Hydrolyzing, Thermostable, and Neutral Glucoamylase of the Thermophilic Mold Thermomucor indicae‐seudaticae

The purified glucoamylase of the thermophilic mold Thermomucor indicae‐seudaticaehad a molecular mass of 42 kDa with a pI of 8.2. It is a glycoprotein with 9–10.5% carbohydrate content, which acted optimally at 60 °C and pH 7.0, with a t1/2 of 12 h at 60 °C and 7 h at 80 °C. Its experimental activation energy was 43 KJ mol‐1 with temperature quotient (Q10) of 1.35, while the values predicted by response surface methodology (RSM) were 43 KJ mol‐1 and 1.28, respectively. The enzyme hydrolyzed soluble starch at 50 °C (Km 0.50 mg mL‐1 and Vmax 109 μmol mg‐1 protein min‐1) and at 60 °C (Km 0.40 and Vmax 143 μmol mg‐1 protein min‐1). The experimental Km and Vmax values are in agreement with the predicted values at 50 °C (Km 0.45 mg mL‐1 and Vmax 111.11 μmol mg‐1 protein min‐1) and at 60 °C (Km 0.36 mg mL‐1and Vmax 142.85 μmol mg‐1 protein min‐1). An Arrhenius plot indicated thermal activation up to 60 °C, and thereafter, inactivation. The enzyme was strongly stimulated by Co2+, Fe2+, Ag2+, and Ca2+, slightly stimulated by Cu2+ and Mg2+, and inhibited by Hg2+, Zn2+, Ni2+, and Mn2+. Among additives, dextran and trehalose slightly enhanced the activity. Glucoamylase activity was inhibited by EDTA, β‐mercaptoethanol, dithiothreitol, and n‐bromosuccinimide, and n‐ethylmaleimide inhibited its activity completely. This suggested the involvement of tryptophan and cysteine in catalytic activity and the critical role of disulfide linkages in maintaining the conformation of the enzyme. The enzyme hydrolyzed around 82% of soluble starch and 65% of raw starch (Km 2.4 mg mL‐1, Vmax 50 μmol mg‐1 protein min‐1), and it was remarkably insensitive to glucose, suggesting its applicability in starch saccharification.
Repression of Hedgehog signal transduction in T-lineage cells increases TCR-induced activation and proliferation

Hedgehog proteins signal for differentiation, survival and proliferation of the earliest thymocyte progenitors, but their functions at later stages of thymocyte development and in peripheral T-cell function are controversial. Here we show that repression of Hedgehog (Hh) pathway activation in T-lineage cells, by expression of a transgenic repressor form of Gli2 (Gli2δC2), increased T-cell differentiation and activation in response to TCR signalling. Expression of the Gli2δC2 transgene increased differentiation from CD4+CD8+ to single positive thymocyte, and increased peripheral T cell populations. Gli2δC2 T-cells were hyper-responsive to activation by ligation of CD3 and CD28: they expressed cell surface activation markers CD69 and CD25 more quickly, and proliferated more than wild-type T-cells. These data show that Hedgehog pathway activation in thymocytes and T-cells negatively regulates TCR-dependent differentiation and proliferation. Thus, as negative regulators of TCR-dependent events, Hh proteins provide an environmental influence on T-cell fate.
Temporal and Spatial Variation of Hematozoans in Scandinavian Willow Warblers

We examined temporal and geographical distribution of Haemoproteus sp. and Plasmodium sp. parasites in Swedish willow warblers, Phylloscopus trochilus. Parasite lineages were detected with molecular methods in 556 birds from 41 sites distributed at distances up to 1,500 km. Two mitochondrial lineages of Haemoproteus sp. were detected, WW1 in 56 birds and WW2 in 75 birds, that differed by 5.2% sequence divergence. We discuss the reasons behind the observed pattern of variation and identify 3 possible causes: (1) variation in the geographic distribution of the vector species, (2) the degree of parasite sharing with other bird species coexisting with the willow warbler, and (3) timing of transmission. Our results support a fundamental and rarely tested assumption of the now classical Hamilton–Zuk hypothesis of sexual selection, namely, that these parasites vary in both time and space. Such fluctuations of parasites and the selection pressure they supposedly impose on the host population are likely to maintain variation in immune system genes in the host population.