Mitigating Diabetic Foot Ulcers: The Effect of Diet and Microbiome

To truly eliminate the possibility of diabetic foot ulcers, the elimination of the symptoms of diabetes is essential. There are many forms of diabetes and there is no one diet that is effective for all patients. It is essential that a proper diet is utilized and for most diabetic patients a reduction in weight and the restoration of a properly balanced microbiota can eliminate the devastating effects of diabetes including foot ulcers. This review examines in detail the different types of diets, and how they affect the host and the microbiota to eliminate as much as possible the risk of foot ulcers. Microbiota, diet, incretins, and insulin all directly affect the deposition of fats which causes insulin insensitivity and diabetes in most patients

Evolution of Nuclear Spectra with Nuclear Forces

We first define a series of NN interaction models ranging from very simple to fully realistic. We then present Green's function Monte Carlo calculations of light nuclei to show how nuclear spectra evolve as the nuclear forces are made increasingly sophisticated. We find that the absence of stable five- and eight-body nuclei depends crucially on the spin, isospin, and tensor components of the nuclear force.Comment: 5 pages, 2 figures, submitted to Phys. Rev. Let

The three-nucleon bound state using realistic potential models

The bound states of $^3$H and $^3$He have been calculated using the Argonne $v_{18}$ plus the Urbana three-nucleon potential. The isospin $T=3/2$ state have been included in the calculations as well as the $n$-$p$ mass difference. The $^3$H-$^3$He mass difference has been evaluated through the charge dependent terms explicitly included in the two-body potential. The calculations have been performed using two different methods: the solution of the Faddeev equations in momentum space and the expansion on the correlated hyperspherical harmonic basis. The results are in agreement within 0.1% and can be used as benchmark tests. Results for the CD-Bonn interaction are also presented. It is shown that the $^3$H and $^3$He binding energy difference can be predicted model independently.Comment: 5 pages REVTeX 4, 1 figures, 6 table

Susceptibility scoring in family-based association testing

BACKGROUND: Family-based association testing is an important part of genetic epidemiology. Tests are available to include multiple siblings, unaffected offspring, and to adjust for environmental covariates. We explore a susceptibility residual method of adjustment for covariates. RESULTS: Through simulation, we show that environmental adjustments that down-weight persons who are "destined" to be affected decrease the power to detect genetic association. We used the residual adjusted method on the Framingham Heart Study offspring data, provided for Genetic Analysis Workshop 13, and got mixed results. CONCLUSION: When the genetic effect and environmental effects are independent, a susceptibility residual method of adjustment for environmental covariates reduces the power of the association test. Further study is necessary to determine if residual adjustment is appropriate in more complex disease models

Analysis of gene × environment interactions in sibships using mixed models

BACKGROUND: Gene × environment models are widely used to assess genetic and environmental risks and their association with a phenotype of interest for many complex diseases. Mixed generalized linear models were used to assess gene × environment interactions with respect to systolic blood pressure on sibships adjusting for repeated measures and hierarchical nesting structures. A data set containing 410 sibships from the Framingham Heart Study offspring cohort (part of the Genetic Analysis Workshop 13 data) was used for all analyses. Three mixed gene × environment models, all adjusting for repeated measurement and varying levels of nesting, were compared for precision of estimates: 1) all sibships with adjustment for two levels of nesting (sibs within sibships and sibs within pedigrees), 2) all sibships with adjustment for one level of nesting (sibs within sibships), and 3) 100 data sets containing random draws of one sibship per extended pedigree adjusting for one level of nesting. RESULTS: The main effects were: gender, baseline age, body mass index (BMI), hypertensive treatment, cigarettes per day, grams of alcohol per day, and marker GATA48G07A. The interaction fixed effects were: baseline age by gender, baseline age by cigarettes per day, baseline age by hypertensive treatment, baseline age by BMI, hypertensive treatment by BMI, and baseline age by marker GATA48G07A. The estimates for all three nesting techniques were not widely discrepant, but precision of estimates and determination of significant effects did change with the change in adjustment for nesting. CONCLUSION: Our results show the importance of the adjustment for all levels of hierarchical nesting of sibs in the presence of repeated measures

North Dakota Economic-Demographic Assessment Model (NEDAM): Technical Description

This report describes the logic, structure, data bases, and operational procedures of the North Dakota model.Research Methods/ Statistical Methods,

Data and safety monitoring in social behavioral intervention trials: the REACH II experience

Background Psychosocial and behavioral interventions trials targeting a broad range of complex social and behavioral problems such as smoking, obesity and family caregiving have proliferated in the past 30 years. At the same time the use of Data and Safety Monitoring Boards (DSMBs) to monitor the progress and quality of intervention trials and the safety of study participants has increased substantially. Most of the existing literature and guidelines for safety monitoring and reporting of adverse events focuses on medical interventions. Consequently, there is little guidance for investigators conducting social and behavior trials. Purpose This paper summarizes how issues associated with safety monitoring and adverse event reporting were handled in the Resources for Enhancing Alzheimer\u27s Caregiver Health (REACH II) program, a multi-site randomized clinical trial, funded by the National Institutes on Aging (NIA) and the National Institutes of Nursing Research (NINR), that tested the efficacy of a multicomponent social/behavioral intervention for caregivers of persons with Alzheimer\u27s disease. Methods A task force was formed to define adverse events for the trial and protocols for reporting and resolving events that occurred. The task force conducted a review of existing polices and protocols for data and safety monitoring and adverse event reporting and identified potential risks particular to the study population. An informal survey regarding data and safety monitoring procedures with investigators on psychosocial intervention trials was also conducted. Results Two categories of events were defined for both caregivers and patients; adverse events and safety alerts. A distinction was also made between events detected at baseline assessment and those detected post-randomization. Standardized protocols were also developed for the reporting and resolution of events that occurred and training of study personnel. Results from the informal survey indicated wide variability in practices for data safety and monitoring across psychosocial intervention trials. Conclusions Overall, the REACH II experience demonstrates that existing guidelines regarding safety monitoring and adverse event reporting pose unique challenges for social/behavioral intervention trials. Challenges encountered in the REACH II program included defining and classifying adverse events, defining resolution of adverse events and attributing causes for events that occurred. These challenges are highlighted and recommendations for addressing them in future studies are discussed

Evolution of AANAT: expansion of the gene family in the cephalochordate amphioxus

<p>Abstract</p> <p>Background</p> <p>The arylalkylamine <it>N</it>-acetyltransferase (AANAT) family is divided into structurally distinct vertebrate and non-vertebrate groups. Expression of vertebrate AANATs is limited primarily to the pineal gland and retina, where it plays a role in controlling the circadian rhythm in melatonin synthesis. Based on the role melatonin plays in biological timing, AANAT has been given the moniker "the Timezyme". Non-vertebrate AANATs, which occur in fungi and protists, are thought to play a role in detoxification and are not known to be associated with a specific tissue.</p> <p>Results</p> <p>We have found that the amphioxus genome contains seven <it>AANAT</it>s, all having non-vertebrate type features. This and the absence of <it>AANATs </it>from the genomes of Hemichordates and Urochordates support the view that a major transition in the evolution of the <it>AANATs </it>may have occurred at the onset of vertebrate evolution. Analysis of the expression pattern of the two most structurally divergent <it>AANAT</it>s in <it>Branchiostoma lanceolatum </it>(<it>bl</it>) revealed that they are expressed early in development and also in the adult at low levels throughout the body, possibly associated with the neural tube. Expression is clearly not exclusively associated with the proposed analogs of the pineal gland and retina. blAANAT activity is influenced by environmental lighting, but light/dark differences do not persist under constant light or constant dark conditions, indicating they are not circadian in nature. bfAANATα and bfAANATδ' have unusually alkaline (> 9.0) optimal pH, more than two pH units higher than that of vertebrate AANATs.</p> <p>Conclusions</p> <p>The substrate selectivity profiles of bfAANATα and δ' are relatively broad, including alkylamines, arylalkylamines and diamines, in contrast to vertebrate forms, which selectively acetylate serotonin and other arylalkylamines. Based on these features, it appears that amphioxus AANATs could play several roles, including detoxification and biogenic amine inactivation. The presence of seven AANATs in amphioxus genome supports the view that arylalkylamine and polyamine acetylation is important to the biology of this organism and that these genes evolved in response to specific pressures related to requirements for amine acetylation.</p

Pharmacy Data for Tuberculosis Surveillance and Assessment of Patient Management

Pharmacy data help locate tuberculosis cases and assess their management