Effects of tryptophan on glucose tolerance in DIO mice.

<p>A-C. Body weights (A), basal blood glucose (B), and serum insulin (C) levels in the mice fed with standard diet (SD) and 60% high fat diet (HFD) for eighteen weeks. D, G. Blood glucose levels after oral glucose load (1.0 g/kg) with tryptophan (150mM, 0.5g/kg, Trp) or vehicle (Veh) in 18-week-old mice fed with standard diet (SD, D) or high fat diet (HFD, G). E, H. Area under the curve (AUC) of glucose levels in D and G. F, I, J-M. Serum insulin (F, I), plasma GIP (J), GLP-1(K), acylated ghrelin (L), and desacyl ghrelin (M) concentrations 15 minutes after glucose load in the mice fed with standard diet (SD) or high fat diet (HFD). n = 6–7 per group, **: p<0.01, *: p<0.05.</p

Effects of feeding status and body weight on expression levels of GPR142 mRNA.

<p>A-F. The effects of overnight fasting (A, and D) and 2-hours re-feeding (B, and E) on GPR142 expression levels in the stomach (A, and B) and pancreas (D, and E) of nine-week old C57BL / 6 male mice. n = 6, *: p<0.05. C, and F. The effects of tryptophan gavage on GPR142 expression levels in the stomach (C) and pancreas (F). n = 7, *: p<0.05. G, H. GPR142 expression levels in the stomach (G) and pancreas (H) of mice fed with standard diet (SD) and 60% high fat diet (HFD) for eighteen weeks. n = 6, **: p<0.01, *: p<0.05. I, J. GPR142 expression levels in the stomach (I) and pancreas (J) of ad libitum-fed 11-week-old ob/ob and their control (con) littermates. n = 9, **: p<0.01, *: p<0.05.</p

Effects of tryptophan on glucose tolerance in ob/ob mice.

<p>A-C. Body weights (A), basal blood glucose (B), and serum insulin (C) levels in 11-weeks old male ob/ob mice and their control littermates. D, G. Blood glucose levels after oral glucose load (1.0 g/kg) with tryptophan (150mM, 0.5g/kg, Trp) or vehicle (Veh) in ob/ob (E) or control mice (G). E, H. Area under the curve (AUC) of glucose levels in D and G. F, I, J-M. Serum insulin (F, I), plasma GIP (J), GLP-1(K), acylated ghrelin (L), and desacyl ghrelin (M) concentrations 15 minutes after glucose load in ob/ob and control (con) mice. n = 6–7 per group, **: p<0.01, *: p<0.05.</p

Role of CaSR signaling on the effects of tryptophan in GPR142KO mice.

<p>A, B. CaSR mRNA expression levels determined by quantitative RT-PCR in (A) the stomach and pancreas (B) of C57/BL6 mice fed with standard diet (SD) or high fat diet (HFD). n = 6, **: p<0.01.C. CaSR mRNA expression levels in pancreas of GPR142KO mice fed with standard diet (SD) or high fat diet (HFD). n = 6, *: p<0.05. D. Glucose levels after oral glucose load in GPR142KO (22–24 weeks old) mice fed with HFD with L-tryptophan (150 mM, 0.5g/kg, Trp) and NPS 2143(1μM) or NPS2143 alone. E. Area under the curve (AUC) of glucose levels in D. F. Serum insulin concentrations 15 minutes after glucose load. n = 8–9 per group, *: p<0.05.</p

Expression levels of GPR 142 mRNA in the various mouse tissues.

<p>GPR142 expression levels determined by quantitative RT-PCR in (A) the various tissues and isolated pancreatic islets (B) of 8-week old wild type C57BL / 6 male mice. n = 6, A.U.: Arbitrary Units.</p

Effects of tryptophan on glucose tolerance in GPR142KO mice.

<p>A. Body weight changes of GPR142KO and their wild type littermate mice on standard (SD) and 60% high fat diet (HFD). B. Food intake of 12 weeks-old GPR142KO mice and their wild type littermates. C. Blood glucose levels after oral glucose load (1.0 g/kg) with tryptophan (150mM, 0.5g/kg, Trp) or vehicle (Veh) in GPR142KO (24–26 weeks old) fed with standard diet (C) or high fat diet (F). D, G. Area under the curve (AUC) of glucose levels in C and F. E, H. Serum insulin (E, H) concentrations 15 minutes after glucose load. n = 6–7 per group, *: p<0.05.</p

Identifying Patients with Bacteremia in Community-Hospital Emergency Rooms: A Retrospective Cohort Study

<div><p>Objectives</p><p>(1) To develop a clinical prediction rule to identify patients with bacteremia, using only information that is readily available in the emergency room (ER) of community hospitals, and (2) to test the validity of that rule with a separate, independent set of data.</p><p>Design</p><p>Multicenter retrospective cohort study.</p><p>Setting</p><p>To derive the clinical prediction rule we used data from 3 community hospitals in Japan (derivation). We tested the rule using data from one other community hospital (validation), which was not among the three “derivation” hospitals.</p><p>Participants</p><p>Adults (age ≥ 16 years old) who had undergone blood-culture testing while in the ER between April 2011 and March 2012. For the derivation data, n = 1515 (randomly sampled from 7026 patients), and for the validation data n = 467 (from 823 patients).</p><p>Analysis</p><p>We analyzed 28 candidate predictors of bacteremia, including demographic data, signs and symptoms, comorbid conditions, and basic laboratory data. Chi-square tests and multiple logistic regression were used to derive an integer risk score (the “ID-BactER” score). Sensitivity, specificity, likelihood ratios, and the area under the receiver operating characteristic curve (i.e., the AUC) were computed.</p><p>Results</p><p>There were 241 cases of bacteremia in the derivation data. Eleven candidate predictors were used in the ID-BactER score: age, chills, vomiting, mental status, temperature, systolic blood pressure, abdominal sign, white blood-cell count, platelets, blood urea nitrogen, and C-reactive protein. The AUCs was 0.80 (derivation) and 0.74 (validation). For ID-BactER scores ≥ 2, the sensitivities for derivation and validation data were 98% and 97%, and specificities were 20% and 14%, respectively.</p><p>Conclusions</p><p>The ID-BactER score can be computed from information that is readily available in the ERs of community hospitals. Future studies should focus on developing a score with a higher specificity while maintaining the desired sensitivity.</p></div

Percentages of patients with true bacteremia, by ID-BactER score.

<p>Fig 2 shows, for each of five categories defined by ID-BactER score, the percentage of patients in that category who had true bacteremia.</p

Demographic and clinical characteristics.

<p>Demographic and clinical characteristics.</p

Fig 3 shows the ROC curves for the ID-BactER score.

<p><b>ROC curves of ID-BactER score.</b> The ●s indicate results from the derivation set, and the ○s indicate results from the validation set. The areas under the curves are 0.80 (95% CI, 0.77–0.83) for the derivation set and 0.74 (0.68–0.80) for the validation set.</p