Miracle-dz/UniFAR-FTUs huggingface dataset:
Use of an Electronic Medical Record (EMR) to Identify Glycemic Intensification Strategies in Type 2 Diabetes

Background: Current treatment guidelines for type 2 diabetes (T2D) recommend individualized intensification of therapy for glycated hemoglobin (A1C) ≥ 7% in most patients. The purpose of this investigation was to explore the ability of an electronic medical record (EMR) to identify glycemic intensification strategies among T2D patients receiving pharmacologic therapy. Methods: Patient records between 2005 and 2011 with documentation of A1C and active prescriptions for any diabetes medications were queried to identify potential candidates for intensification based on A1C ≥ 7% while on 1-2 oral diabetes medications (ODM). Patients with follow-up A1C values within 1 year of index A1C were grouped according to intensification with insulin, GLP-1 receptor agonists (GLP-1RA), a new class of ODM, or no intensification. Changes in A1C and continuation of intensification therapy were determined. Results: A total of 4921 patients meeting inclusion criteria were intensified with insulin (n = 416), GLP-1RA (n = 68), ODM (n = 1408), or no additional therapy (n = 3029). Patients receiving insulin had higher baseline (9.3 ± 2.0 vs 8.3 ± 1.2 vs 8.3 ± 1.3 vs 7.6 ± 1.0%, P < .0001) and follow-up A1C (8.1 ± 1.6 vs 7.5 ± 1.2 vs 7.6 ± 1.3 vs 7.2 ± 1.1%, P < .0001) despite experiencing larger absolute A1C reductions (−1.2 ± 2.1 vs −0.8 ± 1.4 vs −0.7 ± 1.4 vs −0.3 ± 1.1%, P < .0001). Patients receiving GLP-1RA were more obese at baseline (BMI: 33.6 ± 7.1 vs 37.7 ± 6.1 vs 33.7 ± 6.8 vs 32.9 ± 7.1 kg/m2, P < .0001) and follow-up (BMI: 33.9 ± 7.3 vs 36.6 ± 6.1 vs 33.8 ± 7.0 vs 32.4 ± 7.0 kg/m2, P < .0001) despite experiencing more absolute weight reduction. Insulin was the most and GLP-1RA the least likely therapy to be continued. Conclusions: An EMR allows identification of prescribing practices and compliance with T2D treatment guidelines. Patients receiving intensification of glycemic medications had baseline A1C >8% suggesting that treatment recommendations are not being followed.
Indigenous higher degree research students making a difference to the Indigenous health agenda

Abstract While research has been seen to perpetuate rather than improve the ongoing health disadvantage of Indigenous Australians, more recently we have witnessed a transformation in the way research is undertaken with Indigenous people. A more collaborative and inclusive approach has made research more appropriate to the needs of Indigenous people and more Indigenous people undertaking higher degree research study. Insights about research with Indigenous people are provided by four Indigenous students undertaking research in health and nursing who discuss ‘closing the gap’, cultural care, and the current situation surrounding access to and experiences in the health service in Australia for Indigenous people.
Modular production networks: a new American model of industrial organization

This paper uses the case of contract manufacturing in the electronics industry to illustrate an emergent American model of industrial organization, the modular production network. Lead firms in the modular production network concentrate on the creation, penetration and defense of markets for end products—and increasingly the provision of services to go with them—while manufacturing capacity is shifted out-of-house to globally operating turn-key suppliers . T he modular production network relies on codified inter-firm links and the generic manufacturing capacity residing in turn-key suppliers to reduce transaction costs, build large external economies of scale and reduce risk for network actors. Itest the modular production network model against some of the key theoretical tools that have been developed to predict and explain industry structure: Joseph Schumpeter’s notion of innovation in the giant firm; Alfred Chandler’s ideas about economies of speed and the rise of the modern corporation; Oliver Williamson’s transaction cost framework; and a range of other production network models that appear in the literature. Iargue that the modular production network yields better economic performance in the context of globalization than more spatially and socially embedded network models. Iview the emergence of the modular production network as part of a historical process of industrial transformation in which nationally specific models of industrial organization co-evolve in intensifying rounds of competition, diffusion and adaptation.
Numerical analysis of pile behaviour under lateral loads in layered elastic–plastic soils

This paper presents results from a finite element study on the behaviour of a single pile in elastic–plastic soils. Pile behaviour in uniform sand and clay soils as well as cases with sand layer in clay deposit and clay layer in sand deposit were analysed and cross compared to investigate layering effects. Finite element results were used to generate p–y curves and then compared with those obtained from methods commonly used in practice. Copyright © 2002 John Wiley & Sons, Ltd.
Spatially Varying Material Properties of the Rat Caudal Intervertebral Disc

Study Design. The use of a microscopy based material testing technique to assess the local material properties of rat caudal intervertebral discs under uniaxial compression. Objectives. To better understand the cell environment of rat caudal intervertebral discs during mechanical loading and elucidate better the role of the nucleus pulposus to the overall disc material properties. Summary of Background Data. Rat tail models of disc degeneration have been widely used for their similarity with the degeneration phenomena in human beings. Degenerative patterns in the disc are often inhomogeneous, however, only average material properties of rodent discs have been studied. Knowledge of the spatially varying properties within the disc is necessary to understand the disc cell milieu during tissue loading. Methods. Rat caudal motion segments were tested intact, sectioned, and with alterations of nucleus pulposus using microscopy based techniques. Local displacements and strains were obtained using digital image correlation. Strains and load measurements were used to get the average apparent Young’s modulus, peak stress, local Young’s modulus, and local Poisson’s ratio. Results. There was no difference observed in the average apparent Young’s modulus among experimental groups. Peak stresses decreased significantly when the nucleus pulposus was replaced with extremely fluid-like materials. The axial displacement field showed 3 distinct linear distributions in samples which were sectioned. The center region in all groups had significantly smaller axial strain and showed a higher local Young’s modulus. Conclusions. The average equilibrium Young’s modulus may be dependent on short-range ultrastructural organization. Spatially varying material properties within the intervertebral disc may be caused by orientation of fiber bundles in the different regions of the anulus fibrosus. The fiber bundles are better able to resist compressive loads when oriented parallel rather than perpendicular to the loading direction. At equilibrium, the anulus fibrosus also appears to have a shielding effect independent of the material filling up the nucleus pulposus space.
Effects of constant rate infusion of lidocaine and ketamine, with or without morphine, on isoflurane MAC in horses.

REASONS FOR PERFORMING STUDY Lidocaine and ketamine are administered to horses as a constant rate infusion (CRI) during inhalation anaesthesia to reduce anaesthetic requirements. Morphine decreases the minimum alveolar concentration (MAC) in some domestic animals; when administered as a CRI in horses, morphine does not promote haemodynamic and ventilatory changes and exerts a positive effect on recovery. Isoflurane-sparing effect of lidocaine, ketamine and morphine coadministration has been evaluated in small animals but not in horses. OBJECTIVES To determine the reduction in isoflurane MAC produced by a CRI of lidocaine and ketamine, with or without morphine. HYPOTHESIS Addition of morphine to a lidocaine-ketamine infusion reduces isoflurane requirement and morphine does not impair the anaesthetic recovery of horses. METHODS Six healthy adult horses were anaesthetised 3 times with xylazine (1.1 mg/kg bwt i.v.), ketamine (3 mg/kg bwt i.v.) and isoflurane and received a CRI of lidocaine-ketamine (LK), morphine-lidocaine-ketamine (MLK) or saline (CTL). The loading doses of morphine and lidocaine were 0.15 mg/kg bwt i.v and 2 mg/kg bwt i.v. followed by a CRI at 0.1 mg/kg bwt/h and 3 mg/kg bwt/h, respectively. Ketamine was given as a CRI at 3 mg/kg bwt/h. Changes in MAC characterised the anaesthetic-sparing effect of the drug infusions under study and quality of recovery was assessed using a scoring system. RESULTS Mean isoflurane MAC (mean ± s.d.) in the CTL, LK and MLK groups was 1.25 ± 0.14%, 0.64 ± 0.20% and 0.59 ± 0.14%, respectively, with MAC reduction in the LK and MLK groups being 49 and 53% (P<0.001), respectively. No significant differences were observed between groups in recovery from anaesthesia. CONCLUSIONS AND CLINICAL RELEVANCE Administration of lidocaine and ketamine via CRI decreases isoflurane requirements. Coadministration of morphine does not provide further reduction in anaesthetic requirements and does not impair recovery.
Identification and Characterization of a Lysophosphatidylcholine Acyltransferase That is Primarily Expressed in Metabolic Tissues

Phosphatidylcholine (PC) is synthesized through the Kennedy pathway but more than 50% of PC is remodeled through Lands cycle, i.e. the deacylation and reacylation of PC to attain the final and proper fatty acids within PC. The reacylation step is catalyzed by lysophosphatidylcholine (LPC) acyltransferase (LPCAT) and we report here the identification of a novel LPCAT, which we named LPCAT3. LPCAT3 belongs to the membrane bound Oacyltransferase (MBOAT) family and encodes a protein of 487 amino acids with a calculated molecular weight of 56 kD. Membranes from HEK293 cells overexpressing LPCAT3 showed significantly increased LPCAT activity as assessed by thin layer chromatography analysis with substrate preference towards unsaturated fatty acids. LPCAT3 is localized within endoplasmic reticulum (ER) and is primarily expressed in metabolic tissues including liver, adipose and pancreas. In a human hepatoma cell line Huh7 cells, RNA interference (RNAi) mediated knockdown of LPCAT3 resulted in virtually complete loss of membrane LPCAT activity suggesting that LPCAT3 is primarily responsible for hepatic LPCAT activity. Furthermore, peroxisome proliferator-activator receptor α (PPARα) agonists dose-dependently regulated LPCAT3 in liver in a PPARα-dependent fashion, implicating a role of LPCAT3 in lipid homeostasis. Our studies identify a long-sought enzyme that plays a critical role in PC remodeling in metabolic tissues and provide an invaluable tool for future investigations on how PC remodeling may potentially impact glucose and lipid homeostasis. Introduction The biomembrane lipid bilayer serves as an important structure that compartmentalizes living cells and also forms organized intracellular membrane organelles for various physiological functions. The major and essential structural components of membrane lipid bilayers are phospholipids (PLs) including phosphatidylcholine (PC), phosphatidylserine (PS) and phosphatidylethanolamine (PE), among which PC is the most abundant in mammals. Besides the fundamental role in maintaining the membrane structure, some PLs such as phosphatidylinositol (PI) and diacylglycerol (DG) play important roles in signal transduction. The pathway of P http://www.jbc. org/cgi/doi/10.1074/jbc.M710422200 The latest version is at JBC Papers in Press. Published on January 14, 2008 as Manuscript M710422200 Copyright 2008 by The American Society for Biochemistry and Molecular Biology, Inc. by gest on July 9, 2020 hp://w w w . jb.org/ D ow nladed from
Glucose tolerance factor extracted from yeast: oral insulin-mimetic and insulin-potentiating agent: in vivo and in vitro studies

In search for an effective oral treatment for diabetes, we examined the capacity of glucose tolerance factor (GTF) extracted from yeast and administered orally to reduce hyperglycaemia in rat models exhibiting insulin deficiency. The cellular effect of GTF on the insulin signalling pathway was investigated in vitro. GTF (oral bolus), insulin (intraperitoneal) or their combination was administered to streptozotocin-diabetic (STZ) or hyperglycaemic Cohen diabetic-sensitive (hyp-CDs) rats. Blood glucose (BG) and insulin levels were measured in the postprandial (PP) state and during an oral glucose tolerance test. Deoxy-glucose transport and insulin signal transduction were assessed in 3T3-L1 adipocytes and myoblasts incubated with the GTF. Low dose of insulin produced a 34 and 12·5 % reduction in the PP-BG levels of hyp-CDs and STZ rats, respectively. GTF induced a 33 and 17 % reduction in the PP-BG levels of hyp-CDs and STZ rats, respectively. When combined with insulin, a respective decrease (58 and 42 %) in BG levels was observed, suggesting a partially additive (hyp-CDs) or synergistic (STZ rats) effect of the GTF and insulin. GTF did not induce insulin secretion in hyp-CDs rats, yet it lowered their BG levels, proposing an effect on glucose clearance by peripheral tissues. GTF induced a dose-dependent increase in deoxy-glucose transport into myoblasts and fat cells similar to insulin, while the combined treatment resulted in augmented transport rate. GTF induced a dose- and time-dependent phosphorylation of insulin receptor substrate 1, Akt and mitogen-activated protein kinase independent of insulin receptor phosphorylation. GTF exerts remarkable insulin-mimetic and insulin-potentiating effects, both in vivo and in vitro. It produces an insulin-like effect by acting on cellular signals downstream of the insulin receptor. These results demonstrate a potential source for a novel oral medication for diabetes.
Molecular Typing of Mycobacterium chelonae Isolates From a Pseudo-outbreak Involving an Automated Bronchoscope Washer

We describe a pseudo-outbreak of Mycobacterium chelonae infection in bronchoalveolar lavage fluid from 9 patients that was traced to contamination of an automated bronchoscope washer. Molecular typing using repetitive extragenic palindromic polymerase chain reaction was helpful in confirming epidemiologic and clinical findings.
Revisiting Shop Stewards and Workplace Bargaining: Opportunities, Resources and Dynamics in Two Case Studies

3 ACKNOWLEDGEMENTS . 5 CHAPTER 1: INTRODUCTION . 11 What do shop stewards do? 11 A note on terminology . 14 Why study shop stewards? 15 1.1 RESEARCH QUESTIONS . 17 1.2 OVERVIEW OF THE RESEARCH . 19 Research design . 19 Summary of the argument . 21 Structure of the thesis . 22 Two assumptions . 23 CONCLUSION . 24 CHAPTER 2: TWO VIEWS OF SHOP STEWARDS . 27 Setting the scene . 27 2.1 THE CURRENT STANDARD VIEW ASSESSED . 29 The current standard view . 29 Negotiation and consultation . 31 Collective issues and individual representation . 35 Problems of methodology . 36 2.2 THE CLASSIC ACCOUNTS . 38 The shop steward as workplace bargainer . 39 Shop steward typologies . 41 CONCLUSION . 45 CHAPTER 3: BARGAINING AND WORKPLACE RELATIONS . 47 3.1 TOWARDS AN ALTERNATIVE ACCOUNT . 49 The employment relationship, effort bargain, and frontier of control . 49 Bargaining opportunities and bargaining resources . 51 3.2 THEORETICAL CONSIDERATIONS . 57 Conflict, cooperation, and managerial relations . 58 Interests . 65
On the inheritance of hand and foot anomalies in six families.

Malformations of the hands and feet are common and of many kinds. According to Gates (1946) there probably are more abnormalities of the hands and feet than of any other part of the body, with the exception of the eye. It is true that some hand and foot anomalies are the result of accident and disease but it is equally true that many are the result of variation in heredity. The extent to which the latter is true and the mode of inheritance of those variations which have some genetic basis are questions which are not completely answered. Hence when an opportunity presented itself to study a number of different hand and foot anomalies which appeared to have a hereditary basis, it seemed worthwhile to investigate them and to present the findings. The malformations which are included are syndactyly and split hand and foot, polydactyly, and brachydactyly. Each will be considered more or less independently and in the order indicated.
Structural Determinants for the Selective Anti-HIV-1 Activity of the All-β Alternative Conformer of XCL1

ABSTRACT HIV-1 replication is regulated in vivo by a complex network of cytokines and chemokines. XCL1/lymphotactin, a unique metamorphic chemokine, was recently identified as a broad-spectrum endogenous HIV-1 inhibitor that blocks viral entry via direct interaction with the gp120 envelope glycoprotein. HIV-1 inhibition by XCL1 requires access to the alternative all-β conformation, which interacts with glycosaminoglycans (GAGs) but not with the specific XCL1 receptor, XCR1. To investigate the structural determinants of the HIV-inhibitory function of XCL1, we performed a detailed structure-function analysis of a stabilized all-β variant, XCL1 W55D. Individual alanine substitutions of two basic residues within the 40s' loop, K42 and R43, abrogated the ability of XCL1 to bind to the viral envelope and block HIV-1 infection; moreover, a loss of HIV-inhibitory function, albeit less marked, was seen upon individual mutation of three additional basic residues: R18, R35, and K46. In contrast, mutation of K42 to arginine did not cause any loss of function, suggesting that the interaction with gp120 is primarily electrostatic in nature. Strikingly, four of these five residues cluster to form a large (∼350 Å2) positively charged surface in the all-β XCL1 conformation, whereas they are dissociated in the classic chemokine fold, which is inactive against HIV-1, providing a structural basis for the selective antiviral activity of the alternatively folded XCL1. Furthermore, we observed that changes to the N-terminal domain, which is proximal to the cluster of putative HIV-1 gp120-interacting residues, also affect the antiviral activity of XCL1. Interestingly, the complement of residues involved in HIV-1 blockade is partially overlapping, but distinct from those involved in the GAG-binding function of XCL1. These data identify key structural determinants of anti-HIV activity in XCL1, providing new templates for the development of HIV-1 entry inhibitors. IMPORTANCE The host immune system controls HIV-1 infection through a wide array of inhibitory responses, including the induction of cytotoxic effector cells and the secretion of noncytolytic soluble antiviral factors such as cytokines and chemokines. We recently identified XCL1/lymphotactin, a chemokine primarily produced by CD8+ T cells, as a novel endogenous factor with broad anti-HIV activity. Strikingly, only one of the two conformations that XCL1 can adopt in solution, the alternative all-β fold, mediates antiviral activity. At variance with the classic HIV-inhibitory chemokines such as CCL5/RANTES, XCL1 acts via direct interaction with the external viral envelope glycoprotein, gp120. Here, we identify the interactive surface of XCL1 that is implicated in binding to the HIV-1 envelope and HIV-1 inhibition, providing a structural basis to explain why only the all-β XCL1 conformer is effective against HIV-1. Our findings may be useful in guiding the rational design of new inhibitors of HIV-1 entry.
Exploring psychological abuse in childhood: II. Association with other abuse and adult clinical depression.

A new retrospective interview assessment of childhood psychological abuse, an extension to the Childhood Experience of Care and Abuse (CECA) instrument, is described in a companion article (Moran, Bifulco, Ball, Jacobs, & Benaim, 2002). The purpose of the present article is to examine the relationship of childhood psychological abuse to other adverse childhood experiences and to major depression and suicidal behavior in adult life. Childhood experience and lifetime disorder were assessed retrospectively in a high-risk, community series of London women (n = 204). Psychological abuse from parents was examined in relation to seven other parental behaviors (neglect, antipathy, role reversal, discipline, supervision, physical abuse, and sexual abuse). Psychological abuse was significantly related to all seven behaviors. The highest associations found were to antipathy (gamma = .76), neglect (.73), and sexual abuse (.72). Factor analysis showed the existence of two factors reflecting care and control, with psychological abuse associated with both factors. Childhood psychological abuse was highly related to chronic or recurrent adult depression, with a "dose-response" evident for severity of abuse. The rates ranged from 83% for "marked" to 55% for "mild" abuse and 37% for "little/no" psychological abuse (p < .002). Psychological abuse was also related to lifetime suicidal behavior but here any level of abuse from marked to mild had similar rates (36% overall vs. 18% with no psychological abuse, p < .04). There was no evidence of specificity of childhood experience to adult depression; nearly all types of childhood adversity examined were significantly related. An analysis using an index of multiple abuse, including psychological abuse, showed a clear dose-response relationship to disorder. Somewhat fewer forms of maltreatment were related to suicidal behavior, but again multiples showed a clear dose-response effect.
Propensities, probabilities, and the Boltzmann hypothesis

The relative strengths of interactions involving polypeptide chains can be estimated with reasonable accuracy with statistical potentials, free‐energy functions derived from the frequency of occurrence of structural arrangements of residues or atoms in collections of protein structures. Recent published work has shown that the energetics of side‐chain/backbone interactions can be modeled by the ϕ/Ψ propensities of the 20 amino acids. In this report, the more commonly used ϕ/Ψ probabilities are demonstrated to fail in evaluating the free energies of protein conformations because of an overriding preference for all helical structures. Comparison of the hypothetical reactions implied by these two different statistics—propensities versus probabilities—leads to the conclusion that the Boltzmann hypothesis may only be applicable for the calculation of statistical potentials after the starting conformation has been specified. This conclusion supports a simple conjecture: The surprising success of the Boltzmann hypothesis in explaining the energetics of protein structures is a direct consequence of a real equilibrium, one extending over evolutionary time that has maintained the stability of each protein within a narrow range of values.