Randomized study of two different target levels of glycemic control within the acceptable range in type 2 diabetes - Effects on well-being at 1 year

OBJECTIVE - A randomized trial with 1-year follow-up was conducted in 23 general practices to study the relationship between target values for glycemic control and well-being in type 2 diabetes. RESEARCH DESIGN AND METHODS - A total of 176 patients with type 2 diabetes, aged 40-75 years, were included. General practitioners were encouraged to make decisions according to a standardized step-up regimen until the target level of glycemic control was reached. The random allocation to a strict or a less strict target level of glycemic control (fasting capillary glucose <6.5 or <8.5 mmol/l), change in HbA(1c) and fasting glucose, and initiating insulin or treatment with oral hypoglycemic agents were studied as putative determinants of scores on a type 2 diabetes symptom checklist, a profile of mood states, an affect balance scale, and general well-being. Adjustments were made for baseline scores on the outcome at issue. RESULTS - Positive affect (an odds ratio [OR] [95% CI] of 0.39 [0.19-0.83]) and perceived treatment burden (OR 0.48 [0.23-0.98]) were unfavorably altered in the group randomly allocated to stricter target levels (fasting capillary glucose <6.5 mmol/l). Patients who had a decrease in HbA(1c) of 1% or more tended to have comparatively favorable mood (OR displeasure score 0.35 [0.13-0.94]) and general well-being scores at 1 year (ORs of having unfavorable scores ranged from 0.4 to 0.5, NS). CONCLUSIONS - Perceived treatment burden and positive effect are unfavorably affected by random allocation to a strict target level for glycemic control. Improved glycemic control is associated with favorable mood and possibly general well-being in type 2 diabetes

Longitudinal opioid use among HIV-infected patients, 2000 to 2014

Longitudinal opioid prescription use is unknown among HIV-infected patients. Group-based trajectory modeling followed by multinomial logistic regression was used to identify distinct trajectories and their association with baseline characteristics among 1239 HIV-infected UNC CFAR HIV Clinical Cohort participants, 2000-2014. Three trajectories were identified: (1) 72% never/sporadic opioid use (referent group), (2) 11% episodic use (associated with female sex, depression, drug-related diagnoses, antiretroviral therapy use, and undetectable HIV RNA), and (3) 16% chronic use (associated with older age, female sex, and mental health diagnoses). Overall, opioid prescription decreased substantially with longer time in HIV care among both episodic and chronic users

Magnetotransport Mechanisms in Strongly Underdoped YBa_2Cu_3O_x Single Crystals

We report magnetoresistivity measurements on strongly underdoped YBa_2Cu_3O_x (x=6.25, 6.36) single crystals in applied magnetic fields H || c-axis. We identify two different contributions to both in-plane and out-of-plane magnetoresistivities. The first contribution has the same sign as the temperature coefficient of the resistivity \partial ln(\rho_i)/\partial T (i={c,ab}). This contribution reflects the incoherent nature of the out-of-plane transport. The second contribution is positive, quadratic in field, with an onset temperature that correlates to the antiferromagnetic ordering.Comment: 4 pages, 3 figure

Atom lasers: production, properties and prospects for precision inertial measurement

We review experimental progress on atom lasers out-coupled from Bose-Einstein condensates, and consider the properties of such beams in the context of precision inertial sensing. The atom laser is the matter-wave analog of the optical laser. Both devices rely on Bose-enhanced scattering to produce a macroscopically populated trapped mode that is output-coupled to produce an intense beam. In both cases, the beams often display highly desirable properties such as low divergence, high spectral flux and a simple spatial mode that make them useful in practical applications, as well as the potential to perform measurements at or below the quantum projection noise limit. Both devices display similar second-order correlations that differ from thermal sources. Because of these properties, atom lasers are a promising source for application to precision inertial measurements.Comment: This is a review paper. It contains 40 pages, including references and figure

Emerging role of insulin with incretin therapies for management of type 2 diabetes

Type 2 diabetes mellitus (T2DM) is a progressive disease warranting intensification of treatment, as beta-cell function declines over time. Current treatment algorithms recommend metformin as the first-line agent, while advocating the addition of either basal-bolus or premixed insulin as the final level of intervention. Incretin therapy, including incretin mimetics or enhancers, are the latest group of drugs available for treatment of T2DM. These agents act through the incretin axis, are currently recommended as add-on agents either as second-or third-line treatment, without concurrent use of insulin. Given the novel role of incretin therapy in terms of reducing postprandial hyperglycemia, and favorable effects on weight with reduced incidence of hypoglycemia, we explore alternative options for incretin therapy in T2DM management. Furthermore, as some evidence alludes to incretins potentially increasing betacell mass and altering disease progression, we propose introducing these agents earlier in the treatment algorithm. In addition, we suggest the concurrent use of incretins with insulin, given the favorable effects especially in relation to weight gain

Measurement of the production cross section for a W boson and two b jets in pp collisions at root s=7 TeV

The production cross section for a W boson and two b jets is measured using proton&#8211;proton collisions at s=7 TeV in a data sample collected with the CMS experiment at the LHC corresponding to an integrated luminosity of 5.0 fb &#8722;1 . The W+bb¯ events are selected in the W&#8594;&#956;&#957; decay mode by requiring a muon with transverse momentum pT>25 GeV and pseudorapidity |&#951;|25 GeV and |&#951;|<2.4 . The measured W+bb¯ production cross section in the fiducial region, calculated at the level of final-state particles, is &#963;(pp&#8594;W+bb¯)×B(W&#8594;&#956;&#957;)=0.53±0.05(stat.)±0.09(syst.)±0.06(theo.)±0.01(lum.) pb , in agreement with the standard model prediction. In addition, kinematic distributions of the W+bb¯ system are in agreement with the predictions of a simulation using MadGraph and pythia