Metformin Dosis Rendah Jangka Pendek dan Risiko Timbulnya Aterosklerosis pada Prediabetes Non Obes

Low-dose short-term metformin and the risk of atherosclerosis in non obese prediabetic.Background: The establishment of macrovascular (cardiovascular) event is initiated in the period of prediabetic. Metformin plays role in the carbohydrate and lipid metabolism as well as vascular protection. The mechanism of the cardiovascular event risk increase in the prediabetic individual has not been clearly established. The study was to determine if insulin resistance control by low-dose short-term metformin administration in the non-obese prediabetic individual might decrease the atherosclerosis risk.Method: The present study was a prospective, experimental study with pretest-posttest control group design. It was conducted on the first degree relative of type-2 DM patient who met the criteria of non-obese prediabetic individual. Subjects were randomly classified into treatment group (designed for metformin administration), and the control group (designed for placebo administration). The prediction of atherosclerosis risk was based on the hsCRP, PAI-1, VCAM-1 and fibrinogen levels.Results: The margin between pre and post metformin administration term were 1.89 vs 0.06 mg/L (p=0.001), 1.42 vs 0.84 IU/mL (p=0.015), 180.85 vs 03.81 mg/L (p=0.061) and 80.15 vs 31.42 mg/dL (p=0.001) for hsCRP, PAI-1, VCAM-1 and Fibrinogen in the treatment and control group, respectively.Conclusion: Low-dose short-term metformin administration might decrease the atherosclerosis risk factor in the non-obese prediabetic individuals

Clinical and pathological outcomes of induction chemotherapy before neoadjuvant radiotherapy in locally‐advanced rectal cancer

Background and ObjectivesIn North America, preoperative combination chemoradiation is the most commonly recommended and utilized approach to locally advanced rectal cancer. There is increasing interest in the use of induction chemotherapy (IC) before radiation and surgery in locally advanced rectal cancer. How widely IC is being used and whether it improves pathologic and oncologic outcomes is unknown.MethodsWe evaluated clinical stage 2 or 3 rectal cancer patients in the National Cancer Database between 2006 and 2015. We identified predictors of use of IC with multivariable logistic regression and compared survival between groups using Cox proportional hazards regression.ResultsAmong 36 268 patients, IC use increased significantly over time from 5.5% in 2006 to 15.9% in 2015 (P < 0.001). Treatment at a hospital with a high IC rate was an independent predictor of receipt of IC. IC and traditional therapy yielded similar pathologic complete response rates (32.2% vs 30.5%, P = 0.2) and similar 5‐year survival (82.4% vs 81.4%, 0.71).ConclusionsUse of IC for locally advanced rectal cancer has increased significantly. The choice of IC seems to be driven more by institutional and regional practice patterns than clinical characteristics and is not associated with improved pathologic or oncologic outcomes.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/150518/1/jso25474.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/150518/2/jso25474_am.pd

Root canal instrumentation efficacy of non-fused and fused primary molar roots:a micro-computed tomography study

Purpose Pulpectomy may be indicated in restorable primary teeth exhibiting irreversible pulpitis or pulpal necrosis. The purpose of this study was to compare the cleaning and shaping efficacy of NiTi systems (Reciproc(R) Blue and MTwo(R)) with manual stainless-steel instrumentation in primary molars using micro-CT analysis. Methods Fifty-seven maxillary second primary molars were scanned using micro-CT. Teeth with three divergent roots were divided randomly (n = 15) according to instrument type (K file, MTwo (R), and Reciproc (R) Blue). Teeth with root fusion were instrumented manually as a separate group (n = 12). Pre- and post-instrumentation micro-CT images were superimposed, and the instrumentation area (IA) and procedural complications were recorded. Results No statistically significant differences in IA between file systems was observed in the non-fused teeth. The mean IA of fused roots was significantly lower than in the non-fused distobuccal (p = 0.003) and palatal (p 60%) occurred in both non-fused and fused primary teeth with fewer procedural complications observed after manual instrumentation

A revision of the British Chronostratigraphy within the Last Glacial-Interglacial Cycle based on new evidence from Arclid, Cheshire UK

Of the 24 Greenland interstadials (GI) in the Last Glacial-interglacial cycle (LGIC) only five are conventionally recognised in Britain. This paper aims to improve understanding of the LGIC in Britain from a site at Arclid, Cheshire. Sediments were characterised and luminescence used to establish a chronology. This found that the Chelford Sand Formation spans 77-47 ka with sand deposited initially by aeolian but later by fluvial transportation. Coleoptera and Diptera from the basal peat lens provided a reconstruction for a heather-rich heathland environment grazed by large herbivores, with summer temperatures between 13-18° C, and winter temperatures between -14 and 1°C. Flies included the earliest records of the blood-sucking horsefly Haematopota pluvialis, and the soldierfly Chloromyia formosa. The overlying Stockport Sand Formation was deposited fluvioglacially between 47-41 ka with the upper Stockport Till formed by the advance of the last British icesheet after ~33 ka. Stenothermic beetle analysis from Arclid indicate similarities with results from other British mid LGIC sites, some of which are at or beyond the limit of radiocarbon dating and may be of a similar age to Arclid. Basal organic sediments found at Arclid along with other reassigned sites are proposed as a new Arclid Interstadial. A revised British LGIC chronostratigraphy has the Wretton, Chelford and Brimpton Interstadials and the previously suggested but not widely recognised Cassington Interstadial. The Arclid Interstadial occurred after these, but prior to the Upton Warren Interstadial complex. This closes the previous gap in interstadials between the Brimpton Interstadial and the Upton Warren Interstadial complex within the British chronostratigraphy

Genetic screening in sporadic ALS and FTD.

The increasing complexity of the genetic landscape in amyotrophic lateral sclerosis (ALS) and frontotemporal dementia (FTD) presents a significant resource and physician training challenge. At least 10% of those diagnosed with ALS or FTD are known to carry an autosomal dominant genetic mutation. There is no consensus on what constitutes a positive family history, and ascertainment is unreliable for many reasons. However, symptomatic individuals often wish to understand as much as possible about the cause of their disease, and to share this knowledge with their family. While the right of an individual not to know is a key aspect of patient autonomy, and despite the absence of definitive therapy, many newly diagnosed individuals are likely to elect for genetic testing if offered. It is incumbent on the practitioner to ensure that they are adequately informed, counselled and supported in this decision

Sustained carbon uptake and storage following moderate disturbance in a Great Lakes forest

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/117030/1/eap20132351202.pd

Production of substituted styrene bioproducts from lignin and lignocellulose using engineered pseudomonas putida KT2440

Ferulic acid is a renewable chemical found in lignocellulose from grasses such as wheat straw and sugarcane. Pseudomonas putida is able to liberate and metabolize ferulic acid from plant biomass. Deletion of the hydroxycinnamoyl-CoA hydratase-lyase gene (ech) produced a strain of P. putida unable to utilize ferulic and p-coumaric acid, which is able to accumulate ferulic acid and p-coumaric acid from wheat straw or sugar cane bagasse. Further engineering of this strain saw the replacement of ech with the phenolic acid decarboxylase padC, which converts p-coumaric and ferulic acid into 4-vinylphenol and the flavor agent 4-vinylguaiacol, respectively. The engineered strain containing padC is able to generate 4-vinylguaiacol and 4-vinylphenol from media containing lignocellulose or Green Value Protobind lignin as feedstock, and does not require the addition of an exogenous inducer molecule. Biopolymerization of 4-vinylguaiacol and 4-vinylcatechol styrene products is also carried out, using Trametes versicolor laccase, to generate "biopolystyrene" materials on small scale. [Abstract copyright: © 2020 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.