Miracle-dz/UniFAR-FTUs huggingface dataset:
Integrating Population Health Concepts, Clinical Guidelines, and Ambulatory Medical Systems To Improve Diabetes Care

The integration of clinical guidelines with office systems has great potential to improve population health. This article shows how simple office systems can be developed and applied to expand the impact of clinical guidelines on the health of populations of patients enrolled in managed care organizations, using diabetes as an example. The basic tools needed to improve population health include (1) clinical guidelines that clearly articulate important and specific health goats; (2) a clinical database that can identity patients who are eligible for guideline-recommended care, monitor this group of patients, and classify patients who need different levels of intervention; and (3) clinics that are organized in a way that facilitates provision of guideline-directed clinical care based on cues from the clinical database. This article illustrates a successful application of this strategy to improve the care of a population of patients with diabetes enrolled in health maintenance organization-owned clinics.
The association of waist circumference with ambulatory blood pressure is independent of alternative adiposity indices

Aim The relationship between waist circumference (WC) and conventional blood pressure (BP) is independent of other clinical indices of adiposity. As ambulatory BP may offer more prognostic information than conventional BP, we aimed to identify whether indices of central adiposity are associated with ambulatory BP independent of other indices of adiposity. Methods The relationship between indices of adiposity [WC, waist-to-hip ratio, body mass index (BMI) or skin-fold thickness] and ambulatory or conventional BP was determined in 300 randomly selected individuals of African descent living in an urban developing community in South Africa. Relationships were determined with multiple indices of adiposity in the same regression model and after adjusting for age, gender, alcohol and tobacco intake, the presence or absence of diabetes mellitus or inappropriate blood glucose control [haemoglobin A1c (HbA1c)], antihypertensive therapy and menopausal status. Results Sixty-five per cent of participants were overweight or obese. With respect to the relationships between indices of adiposity, BMI and WC showed the strongest correlation (r = 0.84, P < 0.0001). After including all indices of adiposity and confounders in the model, WC was the only clinical index of adiposity which independently predicted 24-h (partial r = 0.15, P < 0.005) and conventional (partial r = 0.14, P < 0.005) systolic BP and 24-h (partial r = 0.13, P < 0.02) and conventional (partial r = 0.40, P < 0.0001) diastolic BP. After adjusting for other adiposity indices and confounders, every 1 SD (15 cm) increase in WC resulted in a 4.04 mmHg increase in 24-h systolic BP and a 4.33 mmHg increase in 24-h diastolic BP. Similar results were obtained in the subgroup of 237 participants not receiving antihypertensive therapy. Conclusion WC is the only clinical index of adiposity that is associated with 24-h and conventional BP independent of other adiposity indices in a community with a high prevalence of obesity.
Quantitation of emphysema with three-dimensional CT densitometry: comparison with two-dimensional analysis, visual emphysema scores, and pulmonary function test results.

PURPOSE To compare lung densitometric measurements that use a three-dimensional (3D) reconstruction of the lungs with those obtained from analysis of two-dimensional (2D) computed tomographic (CT) images, visual emphysema scores, and data from pulmonary function tests. MATERIALS AND METHODS Thoracic helical CT scans were obtained in 60 adult patients (35 with no visual evidence of emphysema and 25 with emphysema). The lungs were reconstructed as a 3D model on a commercial workstation, with a threshold of -600 HU. By analysis of histograms, the proportions of lung volumes with attenuation values below -950, -910, and -900 HU were measured, in addition to mean lung attenuation. These values were compared with lung densitometric results obtained from 2D CT images, visual emphysema scores, and data from pulmonary function tests. RESULTS Quantitation of emphysema with 3D reconstruction was efficient and accurate. Correlation was good among densitometric quantitation with 3D analysis, that obtained with 2D analysis (r = 0.98-0.99), and visual scoring (r = 0.74-0.82). Correlation was reasonable between 3D densitometric quantitation and the diffusing capacity of the lungs for carbon monoxide (DLCO) (r = -0.57 to -0.64), total lung capacity (r = 0.62-0.71), forced expiratory volume in 1 second (FEV1) (r = -0.57 to -0.60), and the ratio of FEV1 to forced vital capacity (FVC) (r = -0.75 to -0.82). The visual CT quantitation of emphysema correlated best with DLCO (r = -0.82) and FEV1/FVC (r = -0.89). CONCLUSION Lung densitometry with 3D reconstruction of helical CT data is a fast and accurate method for quantifying emphysema.
Textbook Pages to Salary Wages: An Examination of the Relationship between Cooperative Education and Early Employment Outcomes.

_______________________________________ A Dissertation presented to the Faculty of the Graduate School at the University of Missouri-Columbia _______________________________________________________ In Partial Fulfillment of the Requirements for the Degree Ed. D. in Education Leadership and Policy Analysis _____________________________________________________ by EDNA M. GROVER-BISKER Dr. Bradley Curs, Dissertation Advisor
Characterization of nerve and microvessel damage and recovery in type 1 diabetic mice after permanent femoral artery ligation

Neuropathy is the most common complication of the peripheral nervous system during the progression of diabetes. The pathophysiology is unclear but may involve microangiopathy, reduced endoneurial blood flow, and tissue ischemia. We used a mouse model of type 1 diabetes to study parallel alterations of nerves and microvessels following tissue ischemia. We designed an easily reproducible model of ischemic neuropathy induced by irreversible ligation of the femoral artery. We studied the evolution of behavioral function, epineurial and endoneurial vessel impairment, and large nerve myelinated fiber as well as small cutaneous unmyelinated fiber impairment for 1 month following the onset of ischemia. We observed a more severe hindlimb dysfunction and delayed recovery in diabetic animals. This was associated with reduced density of large arteries in the hindlimb and reduced sciatic nerve epineurial blood flow. A reduction in sciatic nerve endoneurial capillary density was also observed, associated with a reduction in small unmyelinated epidermal fiber number and large myelinated sciatic nerve fiber dysfunction. Moreover, vascular recovery was delayed, and nerve dysfunction was still present in diabetic animals at day 28. This easily reproducible model provides clear insight into the evolution over time of the impact of ischemia on nerve and microvessel homeostasis in the setting of diabetes. © 2015 Wiley Periodicals, Inc.
A Comparative Analysis of Soft Power in the MENA Region: The Impact of Ethnic, Sectarian, and Religious Identity on Soft Power in Iraq and Egypt

This study explores the relationship between ethnic, sectarian, and religious identities and soft power in the Middle East and North Africa (MENA) region in the immediate aftermath of the Arab Uprisings. Utilizing original public opinion surveys conducted in Egypt and Iraq in 2012, we find that identity-based allegiances play a major role in groups’ choices regarding which countries’ increasing involvement in the region are seen favorably and which countries are seen as an ideal model for the region. Sunnis are likely to view Turkey and Saudi Arabia positively in both regards, whereas Shiites are more supportive of Iran. But our results also suggest that crosscutting cleavages should not be overlooked: Sunni Kurds are less likely to hold positive attitudes toward Turkey and Saudi Arabia. Our findings also show that Copts, a religious minority in Egypt, hold positive attitudes toward the United States and negative ones toward Saudi Arabia and Iran. These findings contribute to both the theoretical literature on soft power and the debates on international competition for influence in the MENA region by emphasizing the role of ethnic and religious identities in shaping attitudes toward international actors.
Action of ornithine alpha-ketoglutarate, ornithine hydrochloride, and calcium alpha-ketoglutarate on plasma amino acid and hormonal patterns in healthy subjects.

Ornithine alpha-ketoglutarate (OKG) has been useful as an adjuvant of enteral and parenteral nutrition. However, its metabolism and mechanism of action remain unclear although it is known that alpha-ketoglutarate (alpha KG) and ornithine (ORN) follow, in part, common metabolic pathways. Six fasting healthy male subjects underwent three separate oral load tests: (i) they received 10 g of OKG (i.e., 3.6 g of alpha KG and 6.4 g of ORN); (ii) 6.4 g of ORN as ornithine hydrochloride, and (iii) 3.6 g of alpha KG as calcium alpha-ketoglutarate. Blood was drawn 15 times over a five-hour period for measurements of plasma amino acids, alpha KG, insulin, and glucagon. After OKG and ORN administration, plasma ORN peaked at 60-75 min (494 +/- 91 and 541 +/- 85 mumol/L). The increase in plasma alpha KG was very small. OKG, alpha KG, and ORN all increased glutamate concentrations at 60 min (mean: +43%, +68%, +68%, respectively, p less than 0.05 compared to basal values). However, only OKG increased proline and arginine levels at 60 min (mean: +35%, p less than 0.01 and mean: +41%, p less than 0.05). Furthermore, glutamate, proline, and arginine concentrations correlated linearly with ornithine levels at 60 min. Finally, OKG increased insulinemia and glucagonemia (mean: +24% at 15 min, p less than 0.05 and +30% at 60 min, p less than 0.01, respectively). These data provide evidence that the combination of ORN and alpha KG modifies amino acid metabolism in a way which is not observed when they are administered separately. In addition, the OKG-mediated increase in insulin levels probably does not appear to result from a direct action of ORN on pancreatic secretion.
Neuropeptide Regulation of Immunity: The Immunosuppressive Activity of Alpha‐Melanocyte‐Stimulating Hormone (α‐MSH)

Abstract: The ocular microenvironment is an extreme example of regional immunity. Within its microenvironment, expression of delayed type hypersensitivity (DTH) is suppressed. This immunosuppression is mediated in part by the constitutive expression of α‐MSH. Previously we have found that α‐MSH suppresses the production of IFN‐γ by activated effector T cells. Recently we have found that α‐MSH can mediate induction of TGF‐β‐producing T cells that act as regulatory T cells. This has encouraged us to further examine the potential for α‐MSH to suppress T cell‐mediated inflammation (autoimmune disease) and to regulate lymphokine production by effector T cells. When α‐MSH was injected i.v. into mice at the time of peak retinal inflammation, the severity of experimental autoimmune uveitis (EAU) was significantly suppressed. Effector T cells activated in vitro in the presence of α‐MSH proliferated and produced IL‐4 and enhanced levels of TGF‐β while their IFN‐γ and IL‐10 production was suppressed. The α‐MSH‐treated T cells functioned as regulatory T cells by suppressing in vitro IFN‐γ production by other inflammatory T cells. This regulatory activity was the function of α‐MSH‐treated CD4+ CD25+ T cells. Therefore, α‐MSH mediates immunosuppression by inducing a differential expression of lymphokine production and by inducing activation of regulatory functions in T cells. This implies that α‐MSH may take part in regional mechanisms of immunosuppression and possibly peripheral tolerance. Thus, α‐MSH can be used to suppress autoimmune disease and possibly reestablish tolerance to autoantigens.
Release of vasoactive substances from endothelial cells by shear stress and purinergic mechanosensory transduction

The evidence for release of vasoactive substances from endothelial cells in response to shear stress caused by the viscous drag of passing fluids is reviewed and, in particular, its physiological significance both in short‐term regulation of blood vessel tone and in long‐term regulation of cell growth, differentiation, proliferation, and cell death in pathophysiological conditions is discussed. A new concept of purinergic mechanosensory transduction, particularly in relation to nociception, is introduced. It is proposed that distension of tubes (including ureter, vagina, salivary and bile ducts, gut) and sacs (including urinary and gall bladders, and lung) leads to release of ATP from the lining epithelium, which then acts on P2X2/3 receptors on subepithelial sensory nerves to convey information to the CNS.
Murine Norovirus Infection Has No Significant Effect on Adaptive Immunity to Vaccinia Virus or Influenza A Virus

ABSTRACT Murine norovirus (MNV) is endemic in many research mouse colonies. Although MNV infections are typically asymptomatic in immunocompetent mice, the effects of MNV infection on subsequent experimental viral infections are poorly documented. Here, we infected C57BL/6 mice with MNV and then with either vaccinia virus or influenza A virus. MNV infection had no effect on CD8+ T-cell or antibody responses to secondary viruses or to secondary virus-induced morbidity or mortality. While our findings suggest that MNV has little influence on host immunity in immunocompetent mice, we would urge caution regarding the potential effects of MNV on immune responses to viruses and other pathogens, which must be determined on a system-by-system basis.
Fast maximum likelihood decoder for half-rate orthogonal space-time block codes

Orthogonal space-time block codes (OSTBC) are powerful codes that provide high performance at low decoder complexity. The systematically designed half-rate OSTBCs by Tarokh et al, make a particularly important class of these codes because they can be systematically constructed for an arbitrary number of transmit antennas. In this paper, we propose a new formulation of the maximum likelihood (ML) decoder for general OSTBCs, and use the specific structure of the above half-rate OSTBCs to reduce the number of computations for their ML decoder. When the product of the number of transmitters and the receivers is much larger than the constellation size, this method reduces the number of computations by a factor of two. This reduction of the number of computations is achieved while maintaining the optimality of the decoder.
Distinct Protein Arginine Methyltransferases Promote ATP-Dependent Chromatin Remodeling Function at Different Stages of Skeletal Muscle Differentiation

ABSTRACT Temporal regulation of gene expression is a hallmark of cellular differentiation pathways, yet the mechanisms controlling the timing of expression for different classes of differentiation-specific genes are not well understood. We previously demonstrated that the class II arginine methyltransferase Prmt5 was required for skeletal muscle differentiation at the early stages of myogenesis (C. S. Dacwag, Y. Ohkawa, S. Pal, S. Sif, and A. N. Imbalzano, Mol. Cell. Biol. 27:384-394, 2007). Specifically, when Prmt5 levels were reduced, the ATP-dependent SWI/SNF chromatin-remodeling enzymes could not interact with or remodel the promoter of myogenin, an essential early gene. Here we investigated the requirement for Prmt5 and the class I arginine methyltransferase Carm1/Prmt4 in the temporal control of myogenesis. Both arginine methyltransferases could bind to and modify histones at late-gene regulatory sequences. However, the two enzymes showed sequential requirements for gene expression. Prmt5 was required for early-gene expression but dispensable for late-gene expression. Carm1/Prmt4 was required for late- but not for early-gene expression. The reason for the requirement for Carm1/Prmt4 at late genes was to facilitate SWI/SNF chromatin-remodeling enzyme interaction and remodeling at late-gene loci. Thus, distinct arginine methyltransferases are employed at different times of skeletal muscle differentiation for the purpose of facilitating ATP-dependent chromatin-remodeling enzyme interaction and function at myogenic genes.
[Treatment of obstetric cholestasis with polyunsaturated phosphatidylcholine and ursodeoxycholic acid].

OBJECTIVE Analysis of obstetric outcomes and laboratory results depending on blood serum level of bile acids (BA) in patients with obstetric cholestasis before treatment. MATERIAL AND METHODS The study was conducted among 43 pregnant women with obstetric cholestasis. The study population was divided into 3 groups, depending on blood serum level of bile acids before treatment: I group (n = 15)--BA 11-15 micromol/l, II group (n = 13)--BA 15-20 micromol/1 and III group (n = 15)--BA > 20 micromol/. Polyunsaturated phosphatidylcholine (PPC) treatment was used in I group, ursodeoxycholic acid (UDCA) in II group and combination of them in III group. Blood serum levels of transaminases, alkaline phosphatase and bilirubin were determined before treatment and during delivery Bile acids concentrations were also assessed during delivery in maternal serum and cord blood. RESULTS No significant statistical difference was observed in patients age, number of primiparas, delivery method, neonatal birth weight and Apgar score. The earliest obstetric cholestasis diagnosis was observed in III group. Earlier pregnancy termination, higher transaminases and bile acids levels before treatment, larger differences (A) of transaminases and bile acids levels before treatment and during delivery as well as larger A in bile acids levels before treatment and in cord blood during delivery were observed in III group in comparison to I group. CONCLUSIONS It seems that combined therapy with UDCA and PPC could be considered in obstetric cholestasis, especially in case of its early onset and/or severe course.
Sex Differences in Associations of Hostile and Non-hostile Criticism with Relationship Quality

ABSTRACT Three studies examine whether the type of criticism (hostile vs. non-hostile) or the sex of the person perceiving criticism affect the association of criticism with relationship satisfaction. Analyses of the samples of undergraduates (Studies 1 and 2) and community couples (Study 3) indicated that hostile criticism was negatively associated with relationship functioning, whereas non-hostile criticism was positively associated with relationship functioning. The former association was stronger for women than for men (Studies 2 and 3), while the latter association was stronger for men than for women (Study 1). The results also suggest that hostile criticism may be more strongly associated with negative relationship processes in women than men, whereas non-hostile criticism may be more strongly associated with positive relationship processes for men than women.
Attitude of pregnant women towards HIV testing in Abidjan, Côte d'Ivoire and Bobo‐Dioulasso, Burkina Faso

Objective:To evaluate the attitude of pregnant women towards HIV testing in two cities of West Africa: Abidjan, Côte d'Ivoire and Bobo-Dioulasso, Burkina Faso. Methods:In the context of a clinical trial to prevent HIV vertical transmission, HIV counselling and testing was offered systematically to women attending antenatal clinics. Informed consent was obtained and test results were given anonymously. Multiple logistic regression was performed to identify factors associated with refusal for testing and failure to return for test results. Results:A total of 9724 pregnant women were interviewed from January 1995 to September 1996. In Abidjan (n = 5766) and Bobo-Dioulasso (n = 3958), 78 and 92.4% of the women consented to HIV testing, respectively, and 58.4 and 81.8% of them returned for the test results disclosure, respectively. In the two sites, the counsellors themselves and high educational level of the women appeared to be related to refusal of the test, whereas last trimester gestation was associated with failure to return for test results. In Abidjan, foreigners and employees were more likely to refuse testing, and HIV-infected women were three times less likely to return for results than uninfected women.
Real World Research: Combining Qualitative and Quantitative Research for Adult ESL 1

As in other fields of education, adult education and literacy faces great pressure to conduct more scientifically based research to identify effective instructional practices to guide teaching and inform policy. Educational research, especially in adult literacy, has been criticized for employing weak methodologies that do not allow for valid and reliable conclusions. To address this issue in the U.S., the Department of Education began an ambitious agenda to improve the quality of research, in part by establishing strict methodology guidelines for educational research that accepts only studies with experimental or quasi-experimental designs. At the same time, adult educational researchers face increasing demands to be more responsive to the field by designing studies and presenting findings that are more accessible to teachers and other practitioners, who need to know research-based practices that will improve the literacy and language skills of adult learners. To this end, several research to practice initiatives have arisen, including those led by the NRDC in England and NCSALL in the U.S, the major adult literacy research organizations in their respective countries. False Dichotomies
From Sentiment to Reputation: ILPS at RepLab 2012

We report on our participation in the profiling task of the first edition of the CLEF RepLab evaluation initiative. We assume that a statement - such as a tweet - that carries negative sentiment can have a positive impact on the reputation of the entity it talks about (and vice versa). Our model directly captures this impact by observing the reactions - such as replies - the statement solicits. We present the assumptions behind our model and the model itself. We find that given the current setting, results on the test set are strongly entity-dependent and that the test data is very different from the trial data. We conclude with a proposal on how to create a task that avoids such dataset dependent problems.
Transient neonatal cystinuria.

BACKGROUND Cystinuria is an inherited disorder of luminal reabsorptive transport for cystine and dibasic amino acids in the renal proximal tubule. Two cystinuria genes have been identified. Mutations of SLC7A9, which encodes the luminal transport channel itself, tend to be dominant and mutations of SLC3A1 (rBAT), which encodes a transporter subunit, are always recessive. Patients who inherit two recessive mutations or two dominant mutations have equally severe forms of cystinuria. Heterozygotes excrete cystine in the normal (type I), moderate (type III), or high stone-forming (type II) range. METHODS Infants with cystinuria were identified via the Quebec Newborn Urinary Screening Program. In a subgroup of these infants, cystinuria was severe in the first months of life, but partially resolved by 2 to 4 years postnatally. We assigned each patient a final cystinuria phenotype at 3 to 4 years. In addition, we characterized SLC3A1 gene expression in fetal and postnatal human kidney. RESULTS Most infants with transient neonatal cystinuria are eventually classified as type III heterozygotes. All infants with mutant cystinuria genes have exaggerated neonatal cystine excretion except those who inherit two SLC3A1 mutations (type I/I cystinuria); these children have persistent severe cystinuria, implying that wildtype SLC3A1 is required for the maturational effect. Expression of SLC3A1 mRNA was found to be tenfold higher in postnatal vs. fetal kidney; SLC3A1 expression is doubled by the proximal tubule transcription factor, PAX8. rBAT is expressed in the proximal convoluted and straight tubules in both fetal and adult kidney. CONCLUSION Maturation of SLC3A1 gene expression between midgestation and 4.5 years postnatal age may account for transient neonatal cystinuria.