517 research outputs found
Informal Online Decision Making: Current Practices and Support System Design
Existing group decision support systems are too complex to support lightweight, informal decision making made popular by the amount of information available on the Web. From an examination of related work, an online survey and a formative study to examine how people currently use the Web for decision support, we present a set of design recommendations towards the development of an informal Web decision support tool
Addition of or switch to insulin therapy in people treated with glucagon-like peptide-1 receptor agonists : a real-world study in 66â583 patients
Background
Real world outcomes of addition or switch to insulin therapy in type 2 diabetes (T2DM) patients on glucagon-like paptide-1 receptor agonist (GLP-1RA) with inadequately controlled hyperglycaemia, are not known.
Materials and methods
Patients with T2DM (n = 66 583) with a minimum of 6 months of GLP-1RA treatment and without previous insulin treatment were selected. Those who added insulin (n = 39 599) or switched to insulin after GLP-1RA cessation (n = 4706) were identified. Adjusted changes in glycated haemoglobin (HbA1c), weight, systolic blood pressure (SBP), and LDL cholesterol were estimated over 24 months follow-up.
Results
Among those who continued with GLP-1RA treatment without adding or switching to insulin, the highest adjusted mean HbA1c change was achieved within 6 months, with no further glycaemic benefits observed during 24 months of follow-up. Addition of insulin within 6 months of GLP-1RA initiation was associated with 18% higher odds of achieving HbA1c <7% at 24 months, compared with adding insulin later. At 24 months, those who added insulin reduced HbA1c significantly by 0.55%, while no glycaemic benefit was observed in those who switched to insulin. Irrespective of intensification with insulin, weight, SBP and LDL cholesterol were significantly reduced by 3 kg, 3 mm Hg, and 0.2 mmol/L, respectively, over 24 months.
Conclusions
Significant delay in intensification of treatment by addition of insulin is observed in patients with T2DM inadequately controlled with GLP-1RA. Earlier addition of insulin is associated with better glycaemic control, while switching to insulin is not clinically beneficial during 2 years of treatment. Non-responding patients on GLP-1RA would benefit from adding insulin therapy, rather than switching to insulin
Transport and Use of a Centaur Second Stage in Space
As nations continue to explore space, the desire to reduce costs will continue to grow. As a method of cost reduction, transporting and/or use of launch system components as integral components of missions may become more commonplace in the future. There have been numerous scenarios written for using launch vehicle components (primarily space shuttle used external tanks) as part of flight missions or future habitats. Future studies for possible uses of launch vehicle upper stages might include asteroid diverter using gravity orbital perturbation, orbiting station component, raw material at an outpost, and kinetic impactor. The LCROSS (Lunar CRater Observation and Sensing Satellite) mission was conceived as a low-cost means of determining whether water exists at the polar regions of the moon. Manifested as a secondary payload with the LRO (Lunar Reconnaissance Orbiter) spacecraft aboard an Atlas V launch vehicle, LCROSS guided its spent Centaur Earth Departure Upper Stage (EDUS) into the lunar crater Cabeu's, as a kinetic impactor. This paper describes some of the challenges that the LCROSS project encountered in planning, designing, launching with and carrying the Centaur upper stage to the moon
Flight Operations for the LCROSS Lunar Impactor Mission
The LCROSS (Lunar CRater Observation and Sensing Satellite) mission was conceived as a low-cost means of determining the nature of hydrogen concentrated at the polar regions of the moon. Co-manifested for launch with LRO (Lunar Reconnaissance Orbiter), LCROSS guided its spent Centaur upper stage into the Cabeus crater as a kinetic impactor, and observed the impact flash and resulting debris plume for signs of water and other compounds from a Shepherding Spacecraft. Led by NASA Ames Research Center, LCROSS flight operations spanned 112 days, from June 18 through October 9, 2009. This paper summarizes the experiences from the LCROSS flight, highlights the challenges faced during the mission, and examines the reasons for its ultimate success
Media Appropriation and Explicitation
<p>This paper presents a novel characterization of new media art together with an exploration of some key aspects of its practice: I propose that new media artâs defining characteristics are media appropriation and explicitation. With media appropriation I refer to the dialectal inscription into the art practice of the knowledge that allows for some particular technological production. I also propose that new media artâs language is constructed in part via the explicitation of certain aspects of more âtraditionalâ art, and that this explicitation allows for a construction of a new vocabulary. Examples of this are the explicitation of randomness, interaction, programming, or of the role that tools and instruments play, among others.</p
Spin-polarized imaging of strongly interacting fermions in the ferrimagnetic state of Weyl candidate CeBi
CeBi has an intricate magnetic phase diagram whose fully-polarized state has
recently been suggested as a Weyl semimetal, though the role of states in
promoting strong interactions has remained elusive. Here we focus on the
less-studied, but also time-reversal symmetry-breaking ferrimagnetic phase of
CeBi, where our density functional theory (DFT) calculations predict additional
Weyl nodes near the Fermi level . We use spin-polarized scanning
tunneling microscopy and spectroscopy to image the surface ferrimagnetic order
on the itinerant Bi states, indicating their orbital hybridization with
localized Ce states. We observe suppression of this spin-polarized
signature at , coincident with a Fano line shape in the
conductance spectra, suggesting the Bi states partially Kondo screen the
magnetic moments, and this hybridization causes strong Fermi-level
band renormalization. The band flattening is supported by our quasiparticle
interference (QPI) measurements, which also show band splitting in agreement
with DFT, painting a consistent picture of a strongly interacting magnetic Weyl
semimetal
MicroRNA 101b Is Downregulated in the Prefrontal Cortex of a Genetic Model of Depression and Targets the Glutamate Transporter SLC1A1 (EAAT3) in Vitro
BACKGROUND: MicroRNAs (miRNAs) are small regulatory molecules that cause translational repression by base pairing with target mRNAs. Cumulative evidence suggests that changes in miRNA expression may in part underlie the pathophysiology and treatment of neuropsychiatric disorders, including major depressive disorder (MDD). METHODS: A miRNA expression assay that can simultaneously detect 423 rat miRNAs (miRBase v.17) was used to profile the prefrontal cortex (PFC) of a genetic rat model of MDD (the Flinders Sensitive Line [FSL]) and the controls, the Flinders Resistant Line (FRL). Gene expression data from the PFC of FSL/FRL animals (GEO accession no. GSE20388) were used to guide mRNA target selection. Luciferase reporter assays were used to verify miRNA targets in vitro. RESULTS: We identified 23 miRNAs that were downregulated in the PFC of the FSL model compared with controls. Interestingly, one of the identified miRNAs (miR-101b) is highly conserved between rat and human and was recently found to be downregulated in the PFC of depressed suicide subjects. Using a combination of in silico and in vitro analyses, we found that miR-101b targets the neuronal glutamate transporter SLC1A1 (also known as EAAC1 or EAAT3). Accordingly, both mRNA and protein levels of SLC1A1 were found to be upregulated in the PFC of the FSL model. CONCLUSIONS: Besides providing a list of novel miRNAs associated with depression-like states, this preclinical study replicated the human association of miR-101 with depression. In addition, since one of the targets of miR-101b appears to be a glutamate transporter, our preclinical data support the hypothesis of a glutamatergic dysregulation being implicated in the etiology of depression
Stakeholder Theory and Marketing: Moving from a Firm-Centric to a Societal Perspective
This essay is inspired by the ideas and research examined in the special section on âStakeholder Marketingâ of the Journal of Public Policy & Marketing in 2010. The authors argue that stakeholder marketing is slowly coalescing with the broader thinking that has occurred in the stakeholder management and ethics literature streams during the past quarter century. However, the predominant view of stakeholders that many marketers advocate is still primarily pragmatic and company centric. The position advanced herein is that stronger forms of stakeholder marketing that reflect more normative, macro/societal, and network-focused orientations are necessary. The authors briefly explain and justify these characteristics in the context of the growing âprosocietyâ and âproenvironmentâ perspectivesâorientations that are also in keeping with the public policy focus of this journal. Under the âhard formâ of stakeholder theory, which the authors endorse, marketing managers must realize that serving stakeholders sometimes requires sacrificing maximum profits to mitigate outcomes that would inflict major damage on other stakeholders, especially society
- âŠ