Once-Weekly Exenatide as Adjunct Treatment of Type 1 Diabetes Mellitus in Patients Receiving Continuous Subcutaneous Insulin Infusion Therapy

Objective The use of once-weekly exenatide in type 2 diabetes mellitus is well supported, but little is known about its effectiveness in type 1 diabetes. The objective of this study was to determine the clinical efficacy of once-weekly exenatide on glycemic control in patients with type 1 diabetes when added to basal-bolus insulin therapy. Methods For this retrospective study, patients with type 1 diabetes, aged 18 years and older, receiving continuous subcutaneous insulin infusion, using a continuous glucose monitoring device or regularly measuring blood glucose levels and receiving 2 mg of exenatide once weekly for at least 3 months were included. Demographic information, glycated hemoglobin (A1C), body weight, body mass index, systolic and diastolic blood pressures, total daily insulin dose, basal and bolus insulin doses, 28-day continuous subcutaneous insulin infusion glucose average and incidence of hypoglycemia were collected at baseline and 3 months after beginning therapy with once-weekly exenatide. Results An electronic medical record search identified 11 patients with type 1 diabetes who met the inclusion criteria. Comparing baseline and 3 months after initiation of once-weekly exenatide revealed reductions of 0.6% in A1C (p=0.013), 3.7% in body weight (p=0.008), 1.7 kg/m2 in body mass index (p=0.003), 13% in total daily insulin dose (p=0.011) and 9.3 units in bolus insulin dose (p=0.015). Conclusions This study revealed that the addition of once-weekly exenatide to insulin therapy for type 1 diabetes patients leads to significant improvements in A1C, body weight, body mass index and insulin doses

Prevention of childhood poisoning in the home: overview of systematic reviews and a systematic review of primary studies

Unintentional poisoning is a significant child public health problem. This systematic overview of reviews, supplemented with a systematic review of recently published primary studies synthesizes evidence on non-legislative interventions to reduce childhood poisonings in the home with particular reference to interventions that could be implemented by Children's Centres in England or community health or social care services in other high income countries. Thirteen systematic reviews, two meta-analyses and 47 primary studies were identified. The interventions most commonly comprised education, provision of cupboard/drawer locks, and poison control centre (PCC) number stickers. Meta-analyses and primary studies provided evidence that interventions improved poison prevention practices. Twenty eight per cent of studies reporting safe medicine storage (OR from meta-analysis 1.57, 95% CI 1.22–2.02), 23% reporting safe storage of other products (OR from meta-analysis 1.63, 95% CI 1.22–2.17) and 46% reporting availability of PCC numbers (OR from meta-analysis 3.67, 95% CI 1.84–7.33) demonstrated significant effects favouring the intervention group. There was a lack of evidence that interventions reduced poisoning rates. Parents should be provided with poison prevention education, cupboard/drawer locks and emergency contact numbers to use in the event of a poisoning. Further research is required to determine whether improving poison prevention practices reduces poisoning rates

Polymorphism discovery and association analyses of the interferon genes in type 1 diabetes.

BACKGROUND: The aetiology of the autoimmune disease type 1 diabetes (T1D) involves many genetic and environmental factors. Evidence suggests that innate immune responses, including the action of interferons, may also play a role in the initiation and/or pathogenic process of autoimmunity. In the present report, we have adopted a linkage disequilibrium (LD) mapping approach to test for an association between T1D and three regions encompassing 13 interferon alpha (IFNA) genes, interferon omega-1 (IFNW1), interferon beta-1 (IFNB1), interferon gamma (IFNG) and the interferon consensus-sequence binding protein 1 (ICSBP1). RESULTS: We identified 238 variants, most, single nucleotide polymorphisms (SNPs), by sequencing IFNA, IFNB1, IFNW1 and ICSBP1, 98 of which where novel when compared to dbSNP build 124. We used polymorphisms identified in the SeattleSNP database for INFG. A set of tag SNPs was selected for each of the interferon and interferon-related genes to test for an association between T1D and this complex gene family. A total of 45 tag SNPs were selected and genotyped in a collection of 472 multiplex families. CONCLUSION: We have developed informative sets of SNPs for the interferon and interferon related genes. No statistical evidence of a major association between T1D and any of the interferon and interferon related genes tested was found.RIGHTS : This article is licensed under the BioMed Central licence at http://www.biomedcentral.com/about/license which is similar to the 'Creative Commons Attribution Licence'. In brief you may : copy, distribute, and display the work; make derivative works; or make commercial use of the work - under the following conditions: the original author must be given credit; for any reuse or distribution, it must be made clear to others what the license terms of this work are

A Bound Preserving Energy Stable Scheme for a Nonlocal Cahn-Hilliard Equation

We present a finite-volume based numerical scheme for a nonlocal Cahn-Hilliard equation which combines ideas from recent numerical schemes for gradient flow equations and nonlocal Cahn-Hilliard equations. The equation of interest is a special case of a previously derived and studied system of equations which describes phase separation in ternary mixtures. We prove the scheme is both energy stable and respects the analytical bounds of the solution. Furthermore, we present numerical demonstrations of the theoretical results using both the Flory-Huggins (FH) and Ginzburg-Landau (GL) free-energy potentials

Consanguinity and susceptibility to infectious diseases in humans.

Studies of animal populations suggest that low genetic heterozygosity is an important risk factor for infection by a diverse range of pathogens, but relatively little research has looked to see whether similar patterns exist in humans. We have used microsatellite genome screen data for tuberculosis (TB), hepatitis and leprosy to test the hypothesis that inbreeding depression increases risk of infection. Our results indicate that inbred individuals are more common among our infected cases for TB and hepatitis, but only in populations where consanguineous marriages are common. No effect was found either for leprosy, which is thought to be oligogenic, or for hepatitis in Italy where consanguineous marriages are rare. Our results suggest that consanguinity is an important risk factor in susceptibility to infectious diseases in humans

Numerical Study of a Strongly Coupled Two-scale System with Nonlinear Dispersion

Thinking of flows crossing through regular porous media, we numerically explore the behavior of weak solutions to a two-scale elliptic-parabolic system that is strongly coupled by means of a suitable nonlinear dispersion term. The two-scale system of interest originates from the fast-drift periodic homogenization of a nonlinear convective-diffusion-reaction problem, where the structure of the non-linearity in the drift fits to the hydrodynamic limit of a totally asymmetric simple exclusion process for a population of particles. In this article, we focus exclusively on numerical simulations that employ two decoupled approximation schemes, viz. 'scheme 1' - a Picard-type iteration - and 'scheme 2' - a time discretization decoupling. Additionally, we describe a computational strategy which helps to drastically improve computation times. Finally, we provide several numerical experiments to illustrate what dispersion effects are introduced by a specific choice of microstructure and model ingredients.Comment: 27 pages, 10 figures, 3 table

Strongly Coupled Two-scale System with Nonlinear Dispersion: Weak Solvability and Numerical Simulation

We investigate a two-scale system featuring an upscaled parabolic dispersion-reaction equation intimately linked to a family of elliptic cell problems. The system is strongly coupled through a dispersion tensor, which depends on the solutions to the cell problems, and via the cell problems themselves, where the solution of the parabolic problem interacts nonlinearly with the drift term. This particular mathematical structure is motivated by a rigorously derived upscaled reaction-diffusion-convection model that describes the evolution of a population of interacting particles pushed by a large drift through an array of periodically placed obstacles (i.e., through a regular porous medium). We prove the existence and uniqueness of weak solutions to our system by means of an iterative scheme, where particular care is needed to ensure the uniform positivity of the dispersion tensor. Additionally, we use finite element-based approximations for the same iteration scheme to perform multiple simulation studies. Finally, we highlight how the choice of micro-geometry (building the regular porous medium) and of the nonlinear drift coupling affects the macroscopic dispersion of particles

A Continuum Model for Morphology Formation from Interacting Ternary Mixtures: Simulation Study of the Formation and Growth of Patterns

Our interest lies in exploring the ability of a coupled nonlocal system of two quasilinear parabolic partial differential equations to produce phase separation patterns. The obtained patterns are referred here as morphologies. Our target system is derived in the literature as the rigorous hydrodynamic limit of a suitably scaled interacting particle system of Blume--Capel--type driven by Kawasaki dynamics. The system describes in a rather implicit way the interaction within a ternary mixture that is the macroscopic counterpart of a mix of two populations of interacting solutes in the presence of a background solvent. Our discussion is based on the qualitative behavior of numerical simulations of finite volume approximations of smooth solutions to our system and their quantitative postprocessing in terms of two indicators (correlation and structure factor calculations). Our results show many similar features compared to what one knows at the level of the stochastic Blume--Capel dynamics with three interacting species. The properties of the obtained morphologies (shape, connectivity, and so on) can play a key role in, e.g., the design of the active layer for efficient organic solar cells

Understanding the price of volatility risk in carry trades

This paper investigates the cross-sectional pricing ability of the short- and long-run components of global foreign exchange (FX) volatility for carry trade returns. We find a negative and statistically significant factor risk price for the long-run component, but no significant pricing effect due to the short-run volatility component. We also document that the dynamics of the long-run component of global FX volatility are related to US macroeconomic fundamentals. Our results are robust to various parametrizations of the volatility models used to obtain the volatility components and they are invariant to alternative asset pricing testing methodologies and sample periods

Associations of Lifestyle Factors, Disease History and Awareness with Health-Related Quality of Life in a Thai Population

10.1371/journal.pone.0049921PLoS ONE711