People with type 2 diabetes mellitus experience an increased prevalence of non-alcoholic fatty liver disease (NAFLD) compared with the general population and often with worse outcomes. As part of the ...ABCD Liraglutide Nationwide Audit Programme, we obtained and analysed data from 2009 to 2018 to assess the impact of liraglutide on alanine aminotransferase (ALT) levels as a marker of liver inflammation (often used in clinical trials as a marker of NAFLD). After excluding those with insufficient or incomplete data, we analysed the results from 1,759 patients treated in the real-world clinical setting. Our results demonstrated an overall significant decrease in median ALT (−1 U/L, 95% CI −1 to −2, p<0.001) compared with baseline, which was more pronounced in patients with elevated ALT based on gender- specific ranges (male: −4 U/L, 95% CI −3 to −6, p<0.001; female: −3 U/L, 95% CI −2 to −4, p<0.001). There was no correlation between weight loss and degree of ALT change (rho=−0.0002, p=0.41). Our data mirror outcomes from large randomised controlled trials and show that the impact of liraglutide on ALT is likely generalisable to real-world practice. Some of our data suggest that there may be a slight increase in ALT in those with normal levels at baseline, although the clinical significance of this is uncertain.
To measure and compare the frequency and content of online social networking among 2 cohorts of medical students and residents (2007 and 2009).
Using the online social networking application ...Facebook, we evaluated social networking profiles for 2 cohorts of medical students (n = 528) and residents (n = 712) at the University of Florida in Gainesville. Objective measures included existence of a profile, whether it was made private, and whether any personally identifiable information was included. Subjective outcomes included photographic content, affiliated social groups, and personal information not generally disclosed in a doctor-patient encounter. We compared our results to our previously published and reported data from 2007.
Social networking continues to be common amongst physicians-in-training, with 39.8% of residents and 69.5% of medical students maintaining Facebook accounts. Residents' participation significantly increased (P < .01) when compared to the 2007 data. Individuals in the 2009 cohort had significantly more "friends" (P < .01), belonged to more "groups" (P < .01), and were more likely to limit public access to their profiles through the use of privacy settings (P < .01) than the individuals in the 2007 cohort.
Online social networking application use by physicians-in-training remains common. While most now limit access to their profiles, personal profiles that still allow public access exhibited a few instances of unprofessional behavior. Concerns remain related to the discovery of content in violation of patient privacy and the expansive and impersonal networks of online "friends" who may view profiles.
Associations were evaluated between plasma B12 (low in many Guatemalan infants), development at 12 mo, and responses to 9 mo supplemental B12 or beef. Recruitment criteria were age 12 mo, not wasted ...or stunted, Hb >95 g/L. Infants were randomized to 3 supervised interventions: beef (72 g/d, 0.56 ug B12, n=97); B12 fortified, equicaloric fruit & veg (0.86 ug/d, n=102); or placebo (unfortified fruit & veg, n=105), 5 d/wk from 12–21 mo. B12, ferritin and CBC were measured at baseline and 21 mo. Growth and development (Bayley, language, temperament, atypical behaviors, activity) were assessed at 12, 15, 18, 21 mo. At baseline 30% were B12 deficient (plasma <150 pmol/L), 21% had marginal status (150–221 pmol/L), and fewer deficient vs adequate infants were standing, walking alone or squatting (P<0.01). Change in plasma B12 (pmol/L) was −13 (placebo), +61 (B12) and +24 (beef) (NS) with no treatment effects on any outcomes. Moreover at 21 mo, plasma B12 remained correlated with plasma B12 of the infant (r=0.54, P<0.001) and mother (0.22, P<0.001) at 12 mo; and with cows milk intake at 12 (r=0.46, P<0.001) and 21 (r=0.40, P<0.0001) mo. Infants with deficient or marginal vs. adequate status at 21 mo had lower weight and length (P<0.001), and deficient infants had lower Bayley Motor scores (P<0.01) and more dysregulation (P<0.02). National Cattlemen's Beef Association and USAID Global Livestock CRSP PCE‐G‐00036‐00.
Board certification is an important professional qualification and a prerequisite for credentialing, and the Accreditation Council for Graduate Medical Education (ACGME) assesses board certification ...rates as a component of residency program effectiveness. To date, research has shown that preresidency measures, including National Board of Medical Examiners scores, Alpha Omega Alpha Honor Medical Society membership, or medical school grades poorly predict postresidency board examination scores. However, learning styles and temperament have been identified as factors that 5 affect test-taking performance. The purpose of this study is to characterize the learning styles and temperaments of pediatric residents and to evaluate their relationships to yearly in-service and postresidency board examination scores.
This cross-sectional study analyzed the learning styles and temperaments of current and past pediatric residents by administration of 3 validated tools: the Kolb Learning Style Inventory, the Keirsey Temperament Sorter, and the Felder-Silverman Learning Style test. These results were compared with known, normative, general and medical population data and evaluated for correlation to in-service examination and postresidency board examination scores.
The predominant learning style for pediatric residents was converging 44% (33 of 75 residents) and the predominant temperament was guardian 61% (34 of 56 residents). The learning style and temperament distribution of the residents was significantly different from published population data (P = .002 and .04, respectively). Learning styles, with one exception, were found to be unrelated to standardized test scores.
The predominant learning style and temperament of pediatric residents is significantly different than that of the populations of general and medical trainees. However, learning styles and temperament do not predict outcomes on standardized in-service and board examinations in pediatric residents.
The study of bacteriophage T4 assembly has revealed regulatory mechanisms pertinent not only to viruses but also to macromolecular complexes. The capsid of bacteriophage T4 is composed of the major ...capsid protein gp23, and a minor capsid protein gp24, which is arranged as pentamers at the vertices of the capsid. In this study the T4 capsid protein gp24 and its mutant forms were overexpressed and purified to homogeneity. The overexpression from plasmid vectors of all the constructs in
Escherichia coli yields biologically active protein
in vivo as determined by assembly of active virus following infection with inactivated gene
24 mutant viruses. The gp24 mutant was subjected to surface entropy reduction by mutagenesis and reductive alkylation in order to improve its crystallization properties and diffraction quality. To determine if surface mutagenesis targeting would result in diffractable crystals, two glutamate to alanine mutations (E89A,E90A) were introduced. We report here the biochemical observations and consequent mutagenesis experiment that resulted in improvements in the stability, crystallizability and crystal quality of gp24 without affecting the overall folding. Rational modification of the protein surface to achieve crystallization appears promising for improving crystallization behavior and crystal diffracting qualities. The crystal of gp24(E89A,E90A) diffracted to 2.6
Å resolution compared to wild-type gp24 at 3.80
Å resolution under the same experimental conditions. Surface mutation proved to be a better method than reductive methylation for improving diffraction quality of the gp24 crystals.
The Second Canadian Conference on Education was the result of several years of determined effort by representatives of organizations concerned with education. Le deuxième Conférence canadienne sur ...l'éducation a été le résultat de plusieurs années d'efforts résolus par les représentants d'organisations intéressées à l'éducation.
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