Beta cell dysfunction, oxidative stress and S6K1 activation in pancreas in the Zucker obese rat model [abstract]

Insulin resistance and beta cell dysfunction are leading components in the pathogenesis of type 2 diabetes mellitus. Over-nutrition leads to activation of the mTOR/S6K1. S6K1 activation leads to serine phosphorylation of IRS1, triggering its proteosomal degradation and interfering with insulin metabolic signaling. We investigated the role of over-nutrition on S6K1 pathway, oxidative stress and insulin signaling in the Zucker Obese (ZO) rat, which displays severe obesity, systemic insulin resistance, glucose intolerance, and hypertension

Assessment of email communication skills of rheumatology fellows: a pilot study

Physician–patient email communication is gaining popularity. However, a formal assessment of physicians' email communication skills has not been described. We hypothesized that the email communication skills of rheumatology fellows can be measured in an objective structured clinical examination (OSCE) setting using a novel email content analysis instrument which has 18 items. During an OSCE, we asked 50 rheumatology fellows to respond to a simulated patient email. The content of the responses was assessed using our instrument. The majority of rheumatology fellows wrote appropriate responses scoring a mean (±SD) of 10.6 (±2.6) points (maximum score 18), with high inter-rater reliability (0.86). Most fellows were concise (74%) and courteous (68%) but not formal (22%). Ninety-two percent of fellows acknowledged that the patient's condition required urgent medical attention, but only 30% took active measures to contact the patient. No one encrypted their messages. The objective assessment of email communication skills is possible using simulated emails in an OSCE setting. The variable email communication scores and incidental patient safety gaps identified, suggest a need for further training and defined proficiency standards for physicians' email communication skills