Diabetes and urbanization in the Omani population: an analysis of national survey data

Background

Automated procedures are increasingly used in cancer registration, and it is important that the data produced are systematically checked for consistency and accuracy. We evaluated an automated procedure for cancer registration adopted by the Lombardy Cancer Registry in 1997, comparing automatically-generated diagnostic codes with those produced manually over one year (1997).

Methods

The automatically generated cancer cases were produced by Open Registry algorithms. For manual registration, trained staff consulted clinical records, pathology reports and death certificates. The social security code, present and checked in both databases in all cases, was used to match the files in the automatic and manual databases. The cancer cases generated by the two methods were compared by manual revision.

Results

The automated procedure generated 5027 cases: 2959 (59%) were accepted automatically and 2068 (41%) were flagged for manual checking. Among the cases accepted automatically, discrepancies in data items (surname, first name, sex and date of birth) constituted 8.5% of cases, and discrepancies in the first three digits of the ICD-9 code constituted 1.6%. Among flagged cases, cancers of female genital tract, hematopoietic system, metastatic and ill-defined sites, and oropharynx predominated. The usual reasons were use of specific vs. generic codes, presence of multiple primaries, and use of extranodal vs. nodal codes for lymphomas. The percentage of automatically accepted cases ranged from 83% for breast and thyroid cancers to 13% for metastatic and ill-defined cancer sites.

Conclusion

Since 59% of cases were accepted automatically and contained relatively few, mostly trivial discrepancies, the automatic procedure is efficient for routine case generation effectively cutting the workload required for routine case checking by this amount. Among cases not accepted automatically, discrepancies were mainly due to variations in coding practice.     

The effect of saffron (Crocus sativus L.) on glycemia,lipid profile,and antioxidant status in patients with type-2 diabetes mellitus: A randomized placebo-controlled trial

In the current study, we aimed to investigate the effect of saffron supplementation on glycemic status, lipid profile, atherogenic indices, and oxidative status in patients with type-2 diabetes (T2DM). In a randomized, double-blind controlled trial, 70 patients were randomly allocated into two groups (n = 35, each) and received 100 mg/day of saffron or placebo for eight weeks. Dietary intake, weight, body mass index (BMI), waist and hip circumferences (WC and HC), waist to hip ratio (WHR), fasting blood sugar (FBS), hemoglobin A1c (HbA1c), insulin, and Homeostatic model assessment for insulin resistance (HOMA-IR), lipid profile, atherogenic indices, oxidative status, and liver enzymes were determined before and after the intervention. At the end of the eighth week, saffron intervention could significantly reduce FBS (7.57%), lipid profile (except high-density lipoprotein cholesterol [HDL-C]), atherogenic indices, and liver enzymes (p < .05). Moreover, saffron could improve oxidative status (nitric oxide [NO] and malondialdehyde [MDA] reduced by 26.29% and 16.35%, respectively). Catalase (CAT) concentration remained unchanged. Saffron supplementation may alleviate T2DM by improving glycemic status, lipid profile, liver enzymes, and oxidative status. Further investigation is necessary to assess possible side effects and confirm the positive effect of saffron as a complementary therapy in clinical recommendations for T2DM.     

Strain Rate and Stress Amplitude Effects on the Mechanical Behavior of Carbon Paste Used in the Hall–Héroult Process and Subjected to Cyclic Loadings

Carbon products such as anodes and ramming paste must have well-defined physical, mechanical, chemical, and electrical properties to perform their functions effectively in the aluminum electrolysis cell. The physical and mechanical properties of these products are assigned during the shaping procedure in which compaction stresses are applied to the green carbon paste. The optimization of the shaping process is crucial to improving the properties of the carbon products and consequently to increasing the energy efficiency and decreasing the greenhouse gas emissions of the Hall–Héroult process. The objective of this study is to experimentally investigate the effect(s) of the strain rate, of the stress maximum amplitude, and of the unloading level on the behavior of a green carbon paste subjected to cyclic loading. To this end, experiments consisting of (1) cyclic compaction tests at different maximum stress amplitudes and strain rates, and (2) cyclic compaction tests with different unloading levels were carried out. The study obtained the following findings about the behavior of carbon paste subjected to cyclic loads. The strain rate in the studied range had no effect either on the evolution of the permanent strain as a function of the cycle number, nor on the shape of the stress–strain hysteresis during the cyclic loading. Moreover, samples of the same density that had been subjected to different maximum stress amplitudes in their loading history did not have the same shape of the stress–strain curve. On the other hand, despite having different densities, samples subjected to the same number of cycles produce the same stress–strain curve during loading even though they were subjected to different maximum stress amplitudes in their loading histories. Finally, the level of unloading during each cycle of a cyclic test proved significant; when the sample was unloaded to a lower level of stress during each cycle, the permanent strain as a function of the cycle number was higher.     

Knowledge, attitude, practice and performance of family physicians concerning holistic management of hypertension

Holistic medicine emphasizes looking for any patient as a whole, putting in consideration the psychological, social, cultural and environmental factors. Family Practice is a good area for applying this approach. The aim of the present study was to assess Family Physicians' knowledge, attitude, practice and performance concerning holistic management of hypertensive patients. The study included all family physicians working in 5 family medicine facilities (n=27) in Alexandria Governorate. A KAP questionnaire was designed to assess their knowledge, attitude and practice. An observation checklist was designed to check their performance with hypertensive patients. The results revealed that male physicians had better knowledge than females. None of the physicians had negative attitude towards holistic care for hypertensive patients, while male physicians had better practice level than females (81.8%, 62.5% respectively). Moreover, the differences in performance level when distributed by health facility were statistically significant, where the majority of physicians with good performance level were in El-Seyouf family health centre (FHC) (65.7%), while the majority of physicians with poor performance level were in Mohsen family health unit (FHU) (82.4%). Continuing Medical Education (EMC) and training are recommended to increase family physicians' competency and help them to develop the necessary skills.     

Triggered doxorubicin release in solid tumors from thermosensitive liposome‐peptide hybrids: Critical parameters and therapeutic efficacy

Temperature‐sensitive vesicles designed by inclusion of leucine zipper peptides within a lipid bilayer (Lp‐Peptide hybrids) encapsulating Doxorubicin (DOX) have been reported. Intravenous administration of these constructs prolonged blood circulation kinetics and increased tumor accumulation in vivo with local mild hyperthermia. In this study, the biological activity of the DOX‐loaded Lp‐Peptide hybrid vesicles was further investigated at the cellular level and in vivo compared to lysolipid‐containing temperature‐sensitive liposomes (LTSL) and traditional temperature‐sensitive liposomes. Lp‐Peptide vesicles were not toxic to cell cultures at 37°C, while effective cancer cell toxicity was observed after 1 hr of heating at 42°C. The activity of Lp‐Peptide vesicles in vivo was studied using two different heating protocols to obtain tumor intravascular or interstitial drug release. Lp‐Peptide vesicle treatment allowing intravascular DOX release showed equally effective tumor growth retardation and survival to that of LTSL treatment. The Lp‐Peptide vesicles also offered therapeutic responses using the alternative heating protocol to maximise drug release within the tumor interstitium. Matching the drug release kinetics of temperature‐sensitive vesicles with the heating protocol applied is considered the most critical factor to determine therapeutic efficacy in the clinical translation of such modalities.     

Proline derived guanidine catalysts forge extensive H-bonded architectures: a solution and solid state study

The preparation of a range of amino acid derived guanidine organocatalysts is reported together with their application to the Michael addition of 2-hydroxy-1,4-napthoquinone to β-nitrostyrene, achieving a maximum ee of 56%. Some insight into the mechanism was sought by using X-ray crystallography and a detailed study of the intra- and intermolecular hydrogen bonding is reported.

Catalysts assemble! We present the design and synthesis of a large family of amino acid derived guanidine organic moieties as catalysts in the solution state and building blocks towards extended H-bonded architectures upon crystallisation.     

Determinants of discordance in patients' and physicians' rating of rheumatoid arthritis disease activity

Objective

To assess the determinants of patients' (PTGL) and physicians' (MDGL) global assessment of rheumatoid arthritis (RA) activity and factors associated with discordance among them.

Methods

A total of 7,028 patients in the Quantitative Standard Monitoring of Patients with RA study had PTGL and MDGL assessed at the same clinic visit on a 0–10‐cm visual analog scale (VAS). Three patient groups were defined: concordant rating group (PTGL and MDGL within ±2 cm), higher patient rating group (PTGL exceeding MDGL by >2 cm), and lower patient rating group (PTGL less than MDGL by >2 cm). Multivariable regression analysis was used to identify determinants of PTGL and MDGL and their discordance.

Results

The mean ± SD VAS scores for PTGL and MDGL were 4.01 ± 2.70 and 2.91 ± 2.37, respectively. Pain was overwhelmingly the single most important determinant of PTGL, followed by fatigue. In contrast, MDGL was most influenced by swollen joint count (SJC), followed by erythrocyte sedimentation rate (ESR) and tender joint count (TJC). A total of 4,454 (63.4%), 2,106 (30%), and 468 (6.6%) patients were in the concordant, higher, and lower patient rating groups, respectively. Odds of higher patient rating increased with higher pain, fatigue, psychological distress, age, and morning stiffness, and decreased with higher SJC, TJC, and ESR. Lower patient rating odds increased with higher SJC, TJC, and ESR, and decreased with lower fatigue levels.

Conclusion

Nearly 36% of patients had discordance in RA activity assessment from their physicians. Sensitivity to the “disease experience” of patients, particularly pain and fatigue, is warranted for effective care of RA.     

Primary aldosteronism: making sense of partial data sets from failed adrenal venous sampling-suppression of adrenal aldosterone production can be used in clinical decision making

Background

It has been suggested that accurate clinical decisions may be made in patients with primary aldosteronism (PA) in the setting of failed cannulation of an adrenal vein, thereby utilizing only data from either right or left adrenal venous sampling (AVS) alone.