SGLT1 in pancreatic α cells regulates glucagon secretion in mice, possibly explaining the distinct effects of SGLT2 inhibitors on plasma glucagon levels

学位記番号：医博甲173

Health-related quality of life in advanced non-small cell lung cancer : a methodological appraisal based on a systematic literature review

Background: The majority of lung cancer patients are diagnosed with advanced non-small cell lung cancer (NSCLC), the bulk of which receive palliative systemic treatment with the goal to provide effective symptom palliation and safeguard health-related quality of life (HRQoL). Advanced NSCLC trials with HRQoL endpoints face methodological constraints limiting interpretability. Objectives: We provide a comprehensive overview of recent clinical trials evaluating the impact of systemic therapies on HRQoL in advanced NSCLC, focusing on the methodological quality, with the ultimate goal to improve interpretation, comparison and reporting of HRQoL data. Methods: A systematic literature review was performed. Prospective studies published over the last decade evaluating the impact of systemic treatments on HRQoL in advanced NSCLC were included. Methodological quality of HRQoL reporting was assessed with the CONSORT-PRO extension. Results: Hundred-twelve manuscripts describing 85 trials met all criteria. No formal conclusion can be drawn regarding the impact on HRQoL of different treatments. We report an important variety in methodological quality in terms of definitions of HRQoL, missing data points, lack of standardization of analyzing and presenting HRQoL and no standard follow-up time. The quality of HRQoL data reporting varies substantially between studies but improves over time. Conclusion: This review shows that in the heterogeneous landscape of trials addressing HRQoL in advanced stage NSCLC. Methodology reporting remains generally poor. Adequate reporting of HRQoL outcome data is equally important to support clinical decision-making as to correctly inform health policy regarding direct approval and reimbursement of the new drugs and combinations that will come online

Acceptance model of electronic medical record

This paper discusses acceptance issues of Electronic Medical Record System (EMR), particularly in Malaysia. A detailed overview of EMR and its benefits are firstly discussed. A number of acceptance models are scrutinized. Then factors affecting EMR acceptance are put forward. Finally, before proposing an EMR acceptance model, an instrument formed by adapting and then finding its factors loading is presented

Molecular epidemiology of Mycobacterium bovis in Cameroon

We describe the largest molecular epidemiological study of Bovine Tuberculosis (bTB) in a sub-Saharan African country with higher spatial resolution providing new insights into bTB. Four hundred and ninety-nine samples were collected for culture from 201 and 179 cattle with and without bTB-like lesions respectively out of 2,346 cattle slaughtered at Bamenda, Ngaoundere, Garoua and Maroua abattoirs between 2012-2013. Two hundred and fifty-five M. bovis were isolated, identified and genotyped using deletion analysis, Hain® Genotype MTBC, spoligotyping and MIRU-VNTR. African 1 was the dominant M. bovis clonal complex, with 97 unique genotypes including 19 novel spoligotypes representing the highest M. bovis genetic diversity observed in Africa to date. SB0944 and SB0953 dominated (63%) the observed spoligotypes. A third of animals with multiple lesions had multiple strain infections. Higher diversity but little evidence of recent transmission of M. bovis was more common in Adamawa compared to the North-West Region. The Adamawa was characterised by a high frequency of singletons possibly due to constant additions from an active livestock movement network compared to the North-West Region where a local expansion was more evident. The latter combined with population-based inferences suggest an unstable and stable bTB-endemic status in the North-West and Adamawa Regions respectively

Lyophilisation of influenza, rabies and Marburg lentiviral pseudotype viruses for the development and distribution of a neutralisation-assay based diagnostic kit

Pseudotype viruses (PVs) are chimeric, replication-deficient virions that mimic wild-type virus entry mechanisms and can be safely employed in neutralisation assays, bypassing the need for high biosafety requirements and performing comparably to established serological assays. However, PV supernatant necessitates -80°C long-term storage and cold-chain maintenance during transport, which limits the scope of dissemination and application throughout resource-limited laboratories. We therefore investigated the effects of lyophilisation on influenza, rabies and Marburg PV stability, with a view to developing a pseudotype virus neutralisation assay (PVNA) based kit suitable for affordable global distribution. Infectivity of each PV was calculated after lyophilisation and immediate reconstitution, as well as subsequent to incubation of freeze-dried pellets at varying temperatures, humidities and timepoints. Integrity of glycoprotein structure following treatment was also assessed by employing lyophilised PVs in downstream PVNAs. In the presence of 0.5M sucrose-PBS cryoprotectant, each freeze-dried pseudotype was stably stored for 4 weeks at up to 37°C and could be neutralised to the same potency as unlyophilised PVs when employed in PVNAs. These results confirm the viability of a freeze-dried PVNA-based kit, which could significantly facilitate low-cost serology for a wide portfolio of emerging infectious viruses

Computational Models of Material Interfaces for the Study of Extracorporeal Shock Wave Therapy

Extracorporeal Shock Wave Therapy (ESWT) is a noninvasive treatment for a variety of musculoskeletal ailments. A shock wave is generated in water and then focused using an acoustic lens or reflector so the energy of the wave is concentrated in a small treatment region where mechanical stimulation enhances healing. In this work we have computationally investigated shock wave propagation in ESWT by solving a Lagrangian form of the isentropic Euler equations in the fluid and linear elasticity in the bone using high-resolution finite volume methods. We solve a full three-dimensional system of equations and use adaptive mesh refinement to concentrate grid cells near the propagating shock. We can model complex bone geometries, the reflection and mode conversion at interfaces, and the the propagation of the resulting shear stresses generated within the bone. We discuss the validity of our simplified model and present results validating this approach

Continuous Parenteral Nutrition to Reduce Pneumonia: Its Effects on Severe Head Injury Patients in Hasan Sadikin Hospital Bandung, Indonesia

The aim of this study was to compare the effects of enteral-, standard- and continousparenteral nutrition therapy to reduce incidence of pneumonia in severe head injury (SHI) patients. We used nutrition therapy as one of the treatments for reducing pneumonia in SHI patients. Twenty one brain-injured patients with peak 24-hour admission Glasgow Coma Scale (GCS) scores of 4-8 were prospectively and randomly assigned to receive continuous total parenteral nutrition (TPNC) for 24 hours nonstop, total parenteral nutrition standard (TPNS) and enteral nutrition (EN) in March-May 2011. Patients were observed up to 14 days post injury. Pneumonia was assessed by using clinical, radiology and laboratory tests with the incidence of pneumonia significantly different among groups (p<0.05). The GCS changes over time among groups were significantly different; nutritional assessment parameters such as anthropometry were not significantly different among groups; total lymphocyte count was significantly increased in TPNC group; albumin was significantly increased in 7th and 14th day post injury in TPNC group (p < 0.05). Absolute lymphosit count was significantly increased on 7th day and 14th day post injury in TPNC group (p < 0.05). Incidence of pneumonia was significantly decreased in TPNC group (p < 0.05). Calories and protein given by TPNC within 24 hours nonstop can be administered better in acute SHI patients than by EN via nasogastric routes. Neurological recovery from SHI occurs more rapidly in patients with better and earlier nutritional support, especially in TPNC group

Mental health services required after disasters: Learning from the lasting effects of disasters

Extent: 13p.Disasters test civil administrations’ and health services’ capacity to act in a flexible but well-coordinated manner because each disaster is unique and poses unusual challenges. The health services required differ markedly according to the nature of the disaster and the geographical spread of those affected. Epidemiology has shown that services need to be equipped to deal with major depressive disorder and grief, not just posttraumatic stress disorder, and not only for victims of the disaster itself but also the emergency service workers. The challenge is for specialist advisers to respect and understand the existing health care and support networks of those affected while also recognizing their limitations. In the initial aftermath of these events, a great deal of effort goes into the development of early support systems but the longer term needs of these populations are often underestimated. These services need to be structured, taking into account the pre-existing psychiatric morbidity within the community. Disasters are an opportunity for improving services for patients with posttraumatic psychopathology in general but can later be utilized for improving services for victims of more common traumas in modern society, such as accidents and interpersonal violence.A. C. McFarlane and Richard William

Effect of sourdough addition and storage time on in vitro starch digestibility and estimated glycemic index of tef bread

The effect of sourdough amount and storage time on starch digestibility and estimated glycemic index (eGI) of tef bread was investigated. The rapidly digestible starch (RDS), slowly digestible starch (SDS) and resistant starch (RS) of 0-30% sourdough fresh tef breads ranged from 49 to 58, 16 to 29 and 20 to 26 g/100 g starch, respectively. Storage of tef breads up to 5 days decreased the RDS by more than 2-fold while SDS and RS increased by 2 and 3 fold, respectively. The eGI for fresh and stored breads ranged from 39 to 89. Addition of sourdough increased the eGI of fresh breads while no uniform pattern was seen in the stored breads. As the storage time increased, all the breads showed a decrease in eGI. In vivo study is necessary to further investigate the effect of sourdough on GI of tef bread