Miracle-dz/UniFAR-FTUs huggingface dataset:
Seasonal changes in dry matter yield from Karst pastures as influenced by morphoclimatic features

Pastures are strongly affected by local environmental variables in terms of their species richness, plant composition and herbage production. A multi-site monitoring study was conducted over three years to investigate the influence of morphoclimatic factors on the seasonal variations in dry matter (DM) yield from Karst pastures. Seven sites located on the Italian and Slovenian Karst regions were investigated that differed in terms of their geological and geomorphological features, as well as their soil types. At each site, the daily DM yield (kg ha-1 d-1) was determined using Corral-Fenlon method which permits to simulate herbage utilization from grazing herds. The morphoclimatic features were also analysed, with the aim to evaluate the link between seasonal DM yield and geomorphological and environmental factors. Generalized non-linear mixed models were built to study the observed seasonal variations in DM yield, using day of the year (DOY), growing degree days (GDD), and cumulative rainfall. Furthermore, environmental descriptors were included in the model in order to evaluate their effects on DM yield. The seasonal variations in yield showed two growing periods (spring and late summer), which were described by Gaussian curves. For the spring growing period, the model improved when the interaction between soil granulometry and growing degree days corresponding to the curve peak was taken into account. This confirms the influence of soil type and air temperature on pasture yield. For the late summer growing period, the interaction between the sand classes and the number of rainy days from the beginning of the period to the peak of the curve improved the model. The curve parameters of our models are correlated with environmental descriptors depending on the lithology and particle size of soils. The results are essential for the optimization of pasture management and avoiding degradation due to over- or under-grazing.
Markedly Decreasing Incidence of Blindness in People With and Without Diabetes in Southern Germany

OBJECTIVE Studies comparing the incidence of blindness in persons with and without diabetes are scarce worldwide. In Germany, a decline in the incidence of blindness was found during the 1990s. The aim of this study was to analyze the recent time trend. RESEARCH DESIGN AND METHODS Data were based on administrative files in southern Germany to assess recipients of blindness allowance newly registered between 1 January 2008 and 31 December 2012. We estimated age- and sex-standardized incidence of blindness in people with and people without diabetes and the corresponding relative risk. Poisson regression was used to examine age- and sex-adjusted time trends. RESULTS We identified 1,897 new cases of blindness (23.7% of which were associated with diabetes). We observed a strong decrease in incidence in both the population with diabetes (2008, 17.3 per 100,000 person-years [95% CI 13.6–21.1], and 2012, 8.9 per 100,000 person-years [6.3–11.6]: 16% decrease [10–22] per year) and that without diabetes (2008, 9.3 per 100,000 person-years [8.3–10.3], and 2012, 6.6 [5.8–7.4]: 9% decrease [5–13] per year). The relative risk comparing those incidences was 1.70 (95% CI 1.32–2.16) and remained constant in the observation period. Regarding time trend, we found similar results for both sexes. CONCLUSIONS We found a significant reduction in incidence of blindness in the populations with and without diabetes, which was more prominent among individuals with diabetes compared with the 1990s. Our findings may be explained by effective secondary prevention therapies and improved ophthalmologic care beyond diabetic retinopathy, particularly regarding macular degeneration, which means earlier detection and earlier and better treatment.
Preliminary survey of attitudes to, and factors affecting perceived success or failure among adults attending a hospital lipid clinic

A questionnaire for self-completion was given to 40 patients attending follow up appointments at the Lipid Clinic at Hope Hospital, over an 8 week period. The questions were designed to assess the importance placed by patients on both blood cholesterol levels and diet, and the patients' perceived ability to comply with the lipid lowering diet. Opportunity was given for patients to comment on services offered, and to suggest improvements. Most patients appeared well motivated (although some by fear) and believed that changes in diet are effective, and perceived that they followed the dietary advice ‘quite well’. Many patients thought in terms of ‘good’ and ‘bad’ foods, and ‘sticking to the diet’. This was shown by comments of feeling deprived of favourite foods and being ‘forced’ to eat boring or unpopular foods. Recommendations are made that instead of focusing on motivation or compliance, health professionals should facilitate behaviour change by identifying obstacles to compliance and enabling patients to set their own dietary targets and self-monitoT their diets.
Comparative Effects of Aqueous Leaf Extract of Viscum album (Mistletoe) and Aloe vera gel in the Management of Streptozotocin - Induced Diabetes Mellitus

This study was aimed at comparing the efficacy of leaf extract of mistletoe with that of Aloe vera gel in the management of type 1 diabetes mellitus (T1DM). Thirty six albino wistar rats weighing 180 - 220 g were randomly divided into 6 groups of 6 rats each, thus; Group 1 - control; group 2 - diabetic untreated group; group 3 - diabetic group, treated with 0.4 ml/100g Aloe vera gel; group 4 - diabetic group, treated with 150 mg/kg mistletoe leaf extract; group 5 - control animals, treated with 0.4 ml/100g Aloe vera gel; group 6 - control animals, treated with 150 mg/kg mistletoe leaf extract. Administration of extracts was done per oral route and lasted for 21 days. Fasting blood glucose, water intake, food intake and body weight were measured during the study. Mistletoe treated diabetic group had a significantly (P<0.001) lower fasting blood glucose (FBG) level compared to diabetic untreated group. Aloe vera treated diabetic group had a significantly (P<0.001) lower FBG level compared to mistletoe treated diabetic group. Both extracts significantly (P<0.001) reduced mean daily water and food intake in the diabetic rats. Aloe vera treated diabetic group had a significantly (P<0.05) lower mean daily food and water intake compared to mistletoe treated diabetic group. Both extracts significantly (P<0.001) increased body weight in the diabetic rats. Aloe vera treated diabetic group had a significantly (P<0.001) higher body weight compared to mistletoe treated diabetic group. The Aloe vera treated control group had a significantly (P<0.001) higher body weight compared to mistletoe treated control group. Unlike Aloe vera gel which increased the body weight of diabetic and normal animals significantly, mistletoe leaf extract was found to increase the body weight of diabetic animals minimally and reduced the body weight of normal animals significantly (P<0.05) compared to control. On the basis of the results obtained from this study, we therefore conclude that Aloe vera gel proved to be more beneficial in the management of type 1 DM compared to mistletoe leaf extract.
Gestational Diabetes Mellitus and Diet: A Systematic Review and Meta-analysis of Randomized Controlled Trials Examining the Impact of Modified Dietary Interventions on Maternal Glucose Control and Neonatal Birth Weight

OBJECTIVE Medical nutrition therapy is a mainstay of gestational diabetes mellitus (GDM) treatment. However, data are limited regarding the optimal diet for achieving euglycemia and improved perinatal outcomes. This study aims to investigate whether modified dietary interventions are associated with improved glycemia and/or improved birth weight outcomes in women with GDM when compared with control dietary interventions. RESEARCH DESIGN AND METHODS Data from published randomized controlled trials that reported on dietary components, maternal glycemia, and birth weight were gathered from 12 databases. Data were extracted in duplicate using prespecified forms. RESULTS From 2,269 records screened, 18 randomized controlled trials involving 1,151 women were included. Pooled analysis demonstrated that for modified dietary interventions when compared with control subjects, there was a larger decrease in fasting and postprandial glucose (−4.07 mg/dL [95% CI −7.58, −0.57]; P = 0.02 and −7.78 mg/dL [95% CI −12.27, −3.29]; P = 0.0007, respectively) and a lower need for medication treatment (relative risk 0.65 [95% CI 0.47, 0.88]; P = 0.006). For neonatal outcomes, analysis of 16 randomized controlled trials including 841 participants showed that modified dietary interventions were associated with lower infant birth weight (−170.62 g [95% CI −333.64, −7.60]; P = 0.04) and less macrosomia (relative risk 0.49 [95% CI 0.27, 0.88]; P = 0.02). The quality of evidence for these outcomes was low to very low. Baseline differences between groups in postprandial glucose may have influenced glucose-related outcomes. As well, relatively small numbers of study participants limit between-diet comparison. CONCLUSIONS Modified dietary interventions favorably influenced outcomes related to maternal glycemia and birth weight. This indicates that there is room for improvement in usual dietary advice for women with GDM.
A Type 1 Diabetes Genetic Risk Score Can Identify Patients With GAD65 Autoantibody–Positive Type 2 Diabetes Who Rapidly Progress to Insulin Therapy

OBJECTIVE Progression to insulin therapy in clinically diagnosed type 2 diabetes is highly variable. GAD65 autoantibodies (GADA) are associated with faster progression, but their predictive value is limited. We aimed to determine if a type 1 diabetes genetic risk score (T1D GRS) could predict rapid progression to insulin treatment over and above GADA testing. RESEARCH DESIGN AND METHODS We examined the relationship between T1D GRS, GADA (negative or positive), and rapid insulin requirement (within 5 years) using Kaplan-Meier survival analysis and Cox regression in 8,608 participants with clinical type 2 diabetes (onset >35 years and treated without insulin for ≥6 months). T1D GRS was both analyzed continuously (as standardized scores) and categorized based on previously reported centiles of a population with type 1 diabetes (<5th [low], 5th–50th [medium], and >50th [high]). RESULTS In GADA-positive participants (3.3%), those with higher T1D GRS progressed to insulin more quickly: probability of insulin requirement at 5 years (95% CI): 47.9% (35.0%, 62.78%) (high T1D GRS) vs. 27.6% (20.5%, 36.5%) (medium T1D GRS) vs. 17.6% (11.2%, 27.2%) (low T1D GRS); P = 0.001. In contrast, T1D GRS did not predict rapid insulin requirement in GADA-negative participants (P = 0.4). In Cox regression analysis with adjustment for age of diagnosis, BMI, and cohort, T1D GRS was independently associated with time to insulin only in the presence of GADA: hazard ratio per SD increase was 1.48 (1.15, 1.90); P = 0.002. CONCLUSIONS A T1D GRS alters the clinical implications of a positive GADA test in patients with clinical type 2 diabetes and is independent of and additive to clinical features.
On the problems of mixing RCTs with qualitative research: the case of the MRC framework for the evaluation of complex healthcare interventions

In the perceived hierarchy of research designs, the results from randomised controlled trials are considered to provide the highest level of evidence. Indeed, these trials have been upheld as the gold standard in research. The benefits and limitations of the randomised controlled trial as a method of evaluating the effectiveness of healthcare interventions are presented. The paper then examines the different levels of complexity within healthcare interventions and the problems this poses in determining effectiveness. In an effort to provide a solution to this problem, the Medical Research Council produced a framework to assist investigators to develop and evaluate complex healthcare interventions. The framework is described with reference to an example of implementing and evaluating protocols for weaning patients in the intensive care unit. The framework is critiqued on the basis that it involves an ambiguous or contradictory ontology, which fails to articulate the relationship between the positivism of randomised controlled trials with the relativism of qualitative approaches. It is concluded that the use of realist strategies in combination with randomised controlled trials provides the most coherent solution to this quandary.
High frequency of mutations in 'dyshormonogenesis genes' in severe congenital hypothyroidism

Objective Results of the screening of disease causative mutations in congenital hypothyroidism (CH) vary significantly, depending on the sequence strategy, patients’ inclusion criteria and bioinformatics. The objective was to study the molecular basis of severe congenital hypothyroidism, using the next generation sequencing (NGS) and the recent guidelines for assessment of sequence variants. Design 243 patients with CH (TSH levels at neonatal screening or retesting greater than 90 mU/l) and 56 control subjects were included in the study. Methods A custom NGS panel targeting 12 CH causative genes was used for sequencing. The sequence variants were rated according to American College of Medical Genetics and Genomics (ACMG) guidelines. Results In total, 48 pathogenic, 7 likely pathogenic and 57 variants of uncertain significance were identified in 92/243 patients (37.9%), while 4 variants of uncertain significance were found in 4/56 control subjects (7.1%). 13.1% (12/92) of the cases showed variants in ‘thyroid dysgenesis’ (TD) genes: TSHR, n = 6; NKX2-1, n = 2; NKX2-5, n = 1; PAX8, n = 3. The variants in ‘dyshormonogenesis’ (DH) genes were found in 84.8% (78/92) of cases: TPO, n = 30; DUOX2, n = 24; TG, n = 8; SLC5A5, n = 3; SLC26A4, n = 6; IYD, n = 1. 8 patients showed oligonenic variants. The majority of variants identified in DH genes were monoallelic. Conclusions In contrast to earlier studies demonstrating the predominance of TD in severe CH, the majority of variants identified in our study were in DH genes. A large proportion of monoallelic variants detected among DH genes suggests that non-mendelian mechanisms may play a role in the development of CH.
Biofilm formation and potential virulence factors of Salmonella strains isolated from ready-to-eat shrimps

Salmonella species is an important foodborne pathogen with the non-typhoidal serovars such as Enteritidis and Typhimurium as the most predominant strains. This study examines the biofilm formation, phenotypic virulence factors and cell surface characteristics of Salmonella strains from ready-to-eat shrimps. The ready-to-eat shrimps were obtained from open markets between November 2016 and October 2017 in Edo and Delta States, Nigeria. The occurrence of Salmonella strains in this study was 210/1440 (14.58%) of the ready-to-eat shrimp’s samples. The identified strains comprise of Salmonella Enteritidis 11, Salmonella Typhimurium 14 and other Salmonella spp. 20. The 45 identified Salmonella strains revealed the following virulence properties: swimming and swarming motility 45(100%); S-layer 39(86.67%); haemolytic activity 40(88.89%); lipase activity 43(95.56%); protease activity 43(95.56%); gelatinase production 43(95.56%); and DNA degrading activity 41(91.11%). The variation in the formation of biofilm-based on the diversity of Salmonella species was observed with higher percentage of Salmonella Typhimurium strains as strong biofilms producers under different environmental conditions. For surface hydrophobicity using bacterial adherence to hydrocarbons, 25(55.56%) were hydrophilic while 20(44.44%) were moderately hydrophobic from the 45 Salmonella isolates. Using salting aggregation test for surface hydrophobicity, all selected isolates 45(100%) was hydrophilic. Autoaggregation index for the 12 selected Salmonella isolates ranged from 15.2–47.2%, while the autoaggragation index for the 12 selected test bacteria ranged from 26.2–71.3%. Coaggragation between the 12 selected test bacteria and 12 Salmonella isolates ranged from 12.5–81.0%. The occurrence of pathogenic species of Salmonella from ready-to-eat shrimps could be detrimental to the consumers. Findings on the physiological conditions of biofilms formed by the foodborne pathogenic Salmonella and the cell surface characteristics therein are crucial for the advancement of methods for controlling Salmonella from ready-to-eat foods.
The Effect of Wolffia globosa Mankai, a Green Aquatic Plant, on Postprandial Glycemic Response: A Randomized Crossover Controlled Trial

OBJECTIVE To compare the postprandial and overnight glycemic response using a novel green aquatic plant thought to provide a dietary source for high-quality protein, with an iso-carbohydrate/protein/caloric dairy shake. RESEARCH DESIGN AND METHODS This is a randomized controlled crossover trial among 20 abdominally obese participants (age 51.4 years; fasting plasma glucose 110.9 mg/dL), who were allocated to replace dinner with either, first, a green shake containing Wolffia globosa duckweed (Mankai: specific-strain) or an iso-carbohydrate/protein/calorie yogurt shake. A 2-week flash glucose-monitoring system was used to assess postmeal glucose dynamics (6 net administration days; 97 observation days in total). We further obtained from each participant dietary/daily activity/satiety scale/sleep logs. Participants were recruited from the green-Mediterranean diet arm of the 18-month Dietary Intervention Randomized Controlled Trial-Polyphenols Unprocessed (DIRECT-PLUS) study. RESULTS Wolffia globosa Mankai elicited a lower postprandial glucose peak compared with yogurt (∆peak = 13.4 ± 9.2 vs. 19.3 ± 15.1 mg/dL; P = 0.044), which occurred later (77.5 ± 29.2 vs. 59.2 ± 28.4 min; P = 0.037) and returned faster to baseline glucose levels (135.8 ± 53.1 vs. 197.5 ± 70.2 min; P = 0.012). The mean post–net incremental area under the curve (netAUC) was lower with Wolffia globosa up to 60 and 180 min (netAUC 60 min: 185.1 ± 340.1 vs. 441.4 ± 336.5 mg/dL/min, P = 0.005; netAUC 180 min: 707.9 ± 1,428.5 vs. 1,576.6 ± 1,810.1 mg/dL/min, P = 0.037). A Wolffia globosa–based shake replacing dinner resulted in lower next-morning fasting glucose levels (83.2 ± 0.8 vs. 86.6 ± 13 mg/dL; P = 0.041). Overall, postprandial glucose levels from the shake administration until the next morning were lower in the Wolffia globosa Mankai green shake compared with the yogurt shake (P < 0.001). Overnight sleep duration was similar (378.2 ± 22.4 vs. 375.9 ± 28.4 min; P = 0.72), and satiety rank was slightly higher for the Wolffia globosa shake compared with the yogurt shake (7.5 vs. 6.5; P = 0.035). CONCLUSIONS Wolffia globosa Mankai duckweed may serve as an emerging alternative plant protein source with potential beneficial postprandial glycemic effects.
Dental Health Status in Hospitalized Psychiatric Patients in Sistan and Baluchestan Province, Iran

Background: Psychiatric disorders to various reasons such side effects of psychiatric drugs, poor oral hygiene and poor diet and are known as risk factors for development oral health problems. Objectives: This study was conducted to determine the dental status in hospitalized psychiatric patients in Sistan and Baluchestan province, Iran. Patients and Methods: This cross-sectional study was conducted on 120 patients in the only psychiatric hospital in this province. Dental status was assessed through measuring the mean of the number of decayed, missing and filled teeth (DMFT index). The collected data was analyzed using t-test, analysis of variance and Tukey test. Results: The mean DMFT score among the patients was 13.75 ± 7.8. There were statistically significant associations between age, duration of mental illness, duration of medication usage, education level, and tooth brushing frequency and DMFT index (P < 0.05). Differences of DMFT Indexes with sex and type of psychiatric disorders were not statistically significant. Conclusions: The results of this study indicated that effective dental care is needed for improvement of the dental health status of hospitalized patients with psychiatric disorders.
School Safety Planning: Barriers to Implementation Perceived by District Leadership and First Responders

This study explored the perceptions of district and first responder leadership (N = 6) with respect to school crisis preparedness. Semi-structured interviews were conducted with a stratified purposeful sampling of school, police, and fire/rescue personnel who were primarily responsible for the planning, training, and implementation of district safety policies. Overarching themes were: desire for coherence among procedures with guidance from the state level; and, ambiguity of roles and responsibilities in the event of a crisis. Participants believed the onus to foster inter-agency partnerships was the responsibility of either the state, or the partnering agencies. In addition, while the importance of school safety was seen as a priority, gaps in communication and collaboration were noted both within and among organizations. Introduction On April 10, 1999, two students entered their high school; and, through the use of semiautomatic weapons and explosive devices, they killed 14 students and a teacher. An additional 160 people were injured. This tragedy occurred at Columbine High School, in Littleton, Colorado. The school did not have an emergency management plan in place when this assault occurred (Erickson, 2001). Furthermore, the required multi-agency response to this tragedy consisting of law enforcement, fire, and rescue personnel had never before been managed (Mell & Sztajnkrycer, 2005). During the incident, not all responders were able to access the communication frequency in use; a firefighter was mistaken for one of the assailants and almost shot by a police sniper; and, while the assailants committed suicide at approximately 12:00 p.m. , paramedics did not reach a
New diagnostic horizons with sonar

Since Lord Rutherford gave the first lecture in memory of Sir James Mackenzie Davidson in 1920 the list of lecturers who have followed him has included men of science and of medicine who may be counted among the intellectual giants of this century. A simple clinical gynaecologist like myself can hardly contribute significantly to such illustrious memory. There are two ways of looking at the extending horizons of sonar. One is to take account of the ever-increasing range of applications and the other depends upon the exploitation of fresh technical developments. It is important to recognize not only the scope of the technique but also its limitations. In a quantitative sense, the greatest clinical impact so far has been in the field of obstetrics and with pelvic masses provided in gynaecology. This is where we ourselves started about twenty years ago (Donald et al., 1958) but the subject now has diverse applications including all types of abdominal echography (Barnet and Morley, 1974), ultrasound cardiolog.
13. Management of Diabetes in Pregnancy: Standards of Medical Care in Diabetes—2018

The American Diabetes Association (ADA) “Standards of Medical Care in Diabetes” includes ADA’s current clinical practice recommendations and is intended to provide the components of diabetes care, general treatment goals and guidelines, and tools to evaluate quality of care. Members of the ADA Professional Practice Committee, a multidisciplinary expert committee, are responsible for updating the Standards of Care annually, or more frequently as warranted. For a detailed description of ADA standards, statements, and reports, as well as the evidence-grading system for ADA’s clinical practice recommendations, please refer to the Standards of Care Introduction. Readers who wish to comment on the Standards of Care are invited to do so at professional.diabetes. org/SOC.