Effect of obesity and insulin resistance on diabetic control

Diabetes Mellitus in obese and non-obese Indian individuals.AIMS: Effect of Obesity and insulin resistance on diabetic control.SETTINGS AND DESIGN: 50 each groups Diabetic individuals obese and non-obese.METHODS AND MATERIAL: On selected 50 each group diabetic patient and normal, following blood investigations has been performed—Plasma Glucose, Glycohemoglobin and Serum Insulin.STATISTICAL ANALYSIS USED: Individuals patient’s results were analyzed and compared with the normal controls.RESULTS AND CONCLUSION: The changes in glycosylated haemoglobin are mainly proportional to the post lunch glucose level (r=0.773) (p<0.01) and not correlated to circulating insulin or the body mass index. However the levels were higher in obese diabetes (Type I and II both) than in non-obese. Mechanism of resistance in insulin receptor interactions due to obesity is well known. However, obesity does not seem to affect directly glycosylated haemoglobin. Under such circumstances, the reduction of weight for a diabetic person can improve sugar control by minimizing insulin resistance and thereby can improve glycosylated haemoglobin levels.     

Troponin T and Heart Type Fatty Acid Binding Protein (h-Fabp) as Biomarkers in Patients Presenting with Chest Pain

Acute coronary syndrome (ACS) is a term for a range of clinical signs and symptoms suggestive of myocardial ischemia. It results in functional and structural changes and ultimately releasing protein from injured cardiomyocytes. These cardiac markers play a major role in diagnosis and prognosis of ACS. This study aims to assess the efficacy of heart type fatty acid binding protein (h-FABP) as a marker for ACS along with the routinely used hs-TropT. In our observational study, plasma h-FABP (cut-off 6.32 ng/ml) and routinely done hs-Trop T (cutoff 0.1 and 0.014 ng/ml) were estimated by immunometric laboratory assays in 88 patients with acute chest pain. Based on the clinical and laboratory test findings the patients were grouped into ACS (n = 41) and non-ACS (n = 47). The diagnostic sensitivity, specificity, NPV, PPV and ROC curve at 95 % CI were determined. Sensitivity of hs-TropT (0.1 ng/ml), hs-TropT (0.014 ng/ml) and h-FABP were 53, 86 and 78 % respectively and specificity for the same were 98, 73 and 70 % respectively. Sensitivity, specificity and NPV calculated for a cut-off combination of hs-TropT 0.014 ng/ml and h-FABP was 100, 51 and 100 % respectively. These results were substantiated by ROC analysis. Measurement of plasma h-FABP and hs-TropT together on admission appears to be more precise predictor of ACS rather than either hs-Trop T or h-FABP.     

The effect of extremely high glucose concentrations on 21 routine chemistry and thyroid Abbott assays: interference study

Introduction

Extremely high glucose concentrations have been shown to interfere with creatinine assays especially with Jaffe method in peritoneal dialysate. Because diabetes is the fastest growing chronic disease in the world, laboratories study with varying glucose concentrations. We investigated whether different levels of glucose spiked in serum interfere with 21 routine chemistry and thyroid assays at glucose concentrations between 17-51 mmol/L.

Materials and methods

Baseline (group I) serum pool with glucose concentration of 5.55 (5.44-5.61) mmol/L was prepared from patient sera. Spiking with 20% dextrose solution, sample groups were obtained with glucose concentrations: 17.09, 34.52, and 50.95 mmol/L (group II, III, IV, respectively). Total of 21 biochemistry analytes and thyroid tests were studied on Abbott c8000 and i2000sr with commercial reagents. Bias from baseline value was checked statistically and clinically.

Results

Creatinine increased significantly by 8.74%, 31.66%, 55.31% at groups II, III, IV, respectively with P values of < 0.001. At the median glucose concentration of 50.95 mmol/L, calcium, albumin, chloride and FT4 biased significantly clinically (-0.85%, 1.63%, 0.65%, 7.4% with P values 0.138, 0.214, 0.004, < 0.001, respectively). Remaining assays were free of interference.

Conclusion

Among the numerous biochemical parameters studied, only a few parameters are affected by dramatically increased glucose concentration. The creatinine measurements obtained in human sera with the Jaffe alkaline method at high glucose concentrations should be interpreted with caution. Other tests that were affected with extremely high glucose concentrations were calcium, albumin, chloride and FT4, hence results should be taken into consideration in patients with poor diabetic control.Key words: assay interference, glucose interference, preanalytical phase, creatinine, Jaffe kinetic assay, thyroid function tests     

Using the web to encourage student-generated questions in large-format introductory biology classes

Students rarely ask questions related to course content in large-format introductory classes. The use of a Web-based forum devoted to student-generated questions was explored in a second-semester introductory biology course. Approximately 80% of the enrolled students asked at least one question about course content during each of three semesters during which this approach was implemented. About 95% of the students who posted questions reported reading the instructor's response to their questions. Although doing so did not contribute to their grade in the course, approximately 75% of the students reported reading questions posted by other students in the class. Approximately 60% of the students reported that the Web-based question-asking activity contributed to their learning of biology.     

ISM-CMAP-Combine (ICMC) for hierarchical knowledge scenario in quality engineering education

Quality assurance in engineering education is a multifaceted problem further augmented by the stakeholders of engineering education. Students, parents and employers are rightfully questioning the quality of the curriculum, the instructional delivery, the learning environment, accessibility to learning technologies and equipment, employability as well as the possibilities of lifelong learning and the improvement of knowledge (Karapetrovic 2002 Karapetrovic, S. 2002. Why and how to develop a meaningful quality assurance system in engineering schools. Int. J. Engg. Educ, 18(3): 285–294. [Web of Science ®] [Google Scholar]). The purpose of the study is, therefore, to identify the parameters that influence the quality of an engineering education system and develop an integrated model of hierarchical structuring and a concept map for pre-identified concept elements through a process of iterative-interactive consensus-driven methodology, as advocated by second-generation system design paradigm for evolving knowledge scenario of concepts related to quality engineering education.     

Trends and practices in functional behavior assessments completed by school psychologists

Functional Behavior Assessments (FBAs) utilize direct and indirect methods to collect data on student behavior to generate a functional hypothesis and drive intervention development. School psychologists are trained to conduct FBAs and use them regularly in schools. However, no evidence exists describing the specific practices used by school psychologists when they conduct FBAs. In this study, 199 respondents completed a web‐based survey developed using expert review and cognitive pretesting. Most respondents reported their gender as female (87%), were between 30 and 39 years old (50%), and practiced at the Specialist level (57%). Respondents reported receiving training in FBA across multiple sources and utilizing multi‐method data collection methods when conducting FBAs. A large amount of variability was observed in the specific instruments used by school psychologists, with a substantial proportion using forms that were not standardized or pre‐constructed. Implications for current practitioners, trainers, and researchers are described.     

罗斯书库

今年（1944年,译者注）二月末,我奉台湾总督府之命到广州出差,对驻广州意大利总领事罗斯的书库做了调查。罗斯收藏了为数众多的珍贵图书和标本,固这在很早以前就在我国的专业领域中广为人知,也有不少学者慕名前去拜访,然而毕竟是私人书库,迄今为止能有幸观摩到书库全貌的还没有一个人。罗斯也曾几度忍痛割爱,将书库的一部分珍藏品转卖出去,     

Evolution and distribution of medullary bone: evidence from a new Early Cretaceous enantiornithine bird

Living birds are unique among vertebrates in the formation of a female-specific bone tissue called medullary bone (MB) that is strictly associated with reproductive activity. MB is a rapidly mobilized source of calcium and phosphorus for the production of eggshell. Among living taxa, its skeletal distribution can be highly extensive such that it even exists in the ribs of some species. Due to its ephemeral nature, MB is rarely fossilized and so little is understood with regard to the origin of MB and its skeletal distribution in early taxa. Here we describe a new Early Cretaceous enantiornithine bird, Mirusavis parvus, gen. et. sp. nov., indicating that skeleton-wide distribution of MB appeared early in avian evolution. We suggest that this represents the plesiomorphic condition for the Aves and that the distribution of MB observed among extant neornithines is a product of increased pneumatization in this lineage and natural selection for more efficient distribution of MB.     

Process Re-Design For Enhanced Human Performance

Faced with sophisticated global competition, companies arc busily reinventing themselves. This offers an opportunity for performance technologists t.o re-think the value added component of their contribution to enhanc-ing human performance. In this eval u-ation. the four values of speed, simplicity, stretch, and self-conlidenco assume a central role. Design, as in the past, is key, but design must, be founded on the assumption that all human performance involves a process or combination of processes. Furthermore, processes are subject to variability of one kind or another, variability that is either predictable or random. It is argued that a process orientation, rather than a focus on inputs and outputs, offers performance technologists a more direct way of contributing to the realization of key business goals and more effectively focuses training and development on performance issues. Process re-design is a key strategy in the realization of these two goals.