541 research outputs found
PDB20: SIMULATING THE LONG TERM COSTEFFECTIVENESS OF A COMBINATION REGIMEN OF REPAGLINIDE PLUS ROSIGLITAZONE VS. ROSIGLITAZONE MONOTHERAPY OVER A 30-YEAR PERIOD
PDB3 INTENSIVE LIFESTYLE CHANGES OR METFORMIN IN OVERWEIGHT, GLUCOSE INTOLERANT PATIENTS: MODELING THE LONG-TERM HEALTH ECONOMICS IMPLICATIONS OF THE DIABETES PREVENTION PROGRAM IN THE FRENCH, GERMAN, AND UK SETTINGS
Effect of Lignosilicon on the Content and Antioxidant Activity of the Polyphenols of Buckwheat Fagopyrum esculentum Moench
Lignin preparations, introduced into soil jointly with buckwheat Fagopyrum esculentum Moench, variety 'Aiva' (cultivated throughout Latvia) seeds during the sowing in quantities of 20 kg ha-1 and 40 kg ha-1, exerted a favourable effect on the ned in alcohol extracts from the biomass of different morphological parts of buckwheat, were represented mainly by rutin. The content of rutin in the ethanol extracts from the biomass of flowers with bract reached the maximum values in the phase of accomplishing blooming - beginning of fruit formation to be 2.74% in terms of dry mass (exceeding the rutin content development of plants and the synthesis of flavonoids in flowers with bract. Flavonoids, determin the control by 65%) in the variant with 40 kg ha-1 of Lignosilicon. Lignin preparations favoured the increase in the radical scavenging capacity of the alcohol extracts of the biomass of flowers with bract of buckwheat, as well as grain and hulls. The increment of the buckwheat grain crop, in comparison with the control on the background of 40 kg ha-1 of lignin, was 12%, and that on the background of 20 kg ha-1 and 40 kg/ha of Lignosilicon 10% and 15%, respectively
RACE-OC Project: Rotation and variability in the open cluster M11 (NGC6705)
Rotation and magnetic activity are intimately linked in main-sequence stars
of G or later spectral types. The presence and level of magnetic activity
depend on stellar rotation, and rotation itself is strongly influenced by
strength and topology of the magnetic fields. Open clusters represent
especially useful targets to investigate the rotation/activity/age connection.
The open cluster M11 has been studied as a part of the RACE-OC project
(Rotation and ACtivity Evolution in Open Clusters), which is aimed at exploring
the evolution of rotation and magnetic activity in the late-type members of
open clusters with different ages. Photometric observations of the open cluster
M11 were carried out in June 2004 using LOAO 1m telescope. The rotation periods
of the cluster members are determined by Fourier analysis of photometric data
time series. We further investigated the relations between the surface
activity, characterized by the light curve amplitude, and rotation. We have
discovered a total of 75 periodic variables in the M11 FoV, of which 38 are
candidate cluster members. Specifically, among cluster members we discovered 6
early-type, 2 eclipsing binaries and 30 bona-fide single periodic late-type
variables. Considering the rotation periods of 16 G-type members of the almost
coeval 200-Myr M34 cluster, we could determine the rotation period distribution
from a more numerous sample of 46 single G stars at an age of about 200-230 Myr
and determine a median rotation period P=4.8d. A comparison with the younger
M35 cluster (~150 Myr) and with the older M37 cluster (~550 Myr) shows that G
stars rotate slower than younger M35 stars and faster than older M37 stars. The
measured variation of the median rotation period is consistent with the
scenario of rotational braking of main-sequence spotted stars as they age.Comment: Accepted by Astronomy and Astrophysics on Dec 15, 200
Continuous subcutaneous insulin infusion therapy is associated with reduced retinopathy progression compared with multiple daily injections of insulin
AIMS/HYPOTHESIS: We aimed to compare diabetic retinopathy outcomes in people with type 1 diabetes following introduction of continuous subcutaneous insulin infusion (CSII) therapy with outcomes in people receiving continuing therapy with multiple daily insulin injections (MDI). METHODS: This is a retrospective cohort study using the Scottish Care Information – Diabetes database for retinal screening outcomes and HbA(1c) changes in 204 adults commenced on CSII therapy between 2013 and 2016, and 211 adults eligible for CSII during the same period but who continued on MDI therapy. Diabetic retinopathy progression (time to minimum one-grade worsening in diabetic retinopathy from baseline grading) was plotted for CSII and MDI cohorts using Kaplan–Meier curves, and outcomes were compared using multivariate Cox regression analysis adjusting for age, sex, baseline HbA(1c), blood pressure, cholesterol, smoking status and socioeconomic quintile. Impact of baseline HbA(1c) and change in HbA(1c) on diabetic retinopathy progression was assessed within CSII and MDI cohorts. RESULTS: CSII participants were significantly younger, were from less socially deprived areas, and had lower HbA(1c) and higher diastolic BP at baseline. There was a larger reduction in HbA(1c) at 1 year in those on CSII vs MDI (−6 mmol/mol [−0.6%] vs −2 mmol/mol [−0.2%], p < 0.01). Diabetic retinopathy progression occurred in a smaller proportion of adults following commencement of CSII vs continued MDI therapy over mean 2.3 year follow-up (26.5% vs 18.6%, p = 0.0097). High baseline HbA(1c) (75 mmol/mol [9%]) was associated with diabetic retinopathy progression in the MDI group (p = 0.0049) but not the CSII group (p = 0.93). Change in HbA(1c) at follow-up, irrespective of baseline glycaemic status, did not significantly affect diabetic retinopathy progression in either group. CONCLUSIONS/INTERPRETATION: CSII was associated with reduced diabetic retinopathy progression compared with continued MDI therapy, and may be protective against diabetic retinopathy progression for those with high baseline HbA(1c). Progression of diabetic retinopathy over 3 years was not associated with a change in HbA(1c). GRAPHICAL ABSTRACT: [Image: see text] SUPPLEMENTARY INFORMATION: The online version contains peer-reviewed but unedited supplementary material available at 10.1007/s00125-021-05456-w
An exploration of contextual dimensions impacting goals of care conversations in postgraduate medical education
BACKGROUND: Postgraduate medical trainees are not well prepared difficult conversations about goals of care with patients and families in the acute care clinical setting. While contextual nuances within the workplace can impact communication, research to date has largely focused on individual communication skills. Our objective was to explore contextual factors that influence conversations between trainees and patients/families about goals of care in the acute care setting. METHODS: We conducted an exploratory qualitative study involving five focus groups with Internal Medicine trainees (n = 20) and a series of interviews with clinical faculty (n = 11) within a single Canadian centre. Thematic framework analysis was applied to categorize the data and identify themes and subthemes. RESULTS: Challenges and factors enabling goals of care conversations emerged within individual, interpersonal and system dimensions. Challenges included inadequate preparation for these conversations, disconnection between trainees, faculty and patients, policies around documentation, the structure of postgraduate medical education, and resource limitations; these challenges led to missed opportunities, uncertainty and emotional distress. Enabling factors were awareness of the importance of goals of care conversations, support in these discussions, collaboration with colleagues, and educational initiatives enabling skill development; these factors have resulted in learning, appreciation, and an established foundation for future educational initiatives. CONCLUSIONS: Contextual factors impact how postgraduate medical trainees communicate with patients/families about goals of care. Attention to individual, interpersonal and system-related factors will be important in designing educational programs that help trainees develop the capacities needed for challenging conversations
Variations in patterns of care across neonatal units and their associations with outcomes in very preterm infants: the French EPIPAGE-2 cohort study
OBJECTIVES: To describe patterns of care for very preterm (VP) babies across neonatal intensive care units (NICUs) and associations with outcomes. DESIGN: Prospective cohort study, EPIPAGE-2. SETTING: France, 2011. PARTICIPANTS: 53 (NICUs); 2135 VP neonates born at 27 to 31 weeks. OUTCOME MEASURES: Clusters of units, defined by the association of practices in five neonatal care domains - respiratory, cardiovascular, nutrition, pain management and neurodevelopmental care. Mortality at 2 years corrected age (CA) or severe/moderate neuro-motor or sensory disabilities and proportion of children with scores below threshold on the neurodevelopmental Ages and Stages Questionnaire (ASQ). METHODS: Hierarchical cluster analysis to identify clusters of units. Comparison of outcomes between clusters, after adjustment for potential cofounders. RESULTS: Three clusters were identified: Cluster 1 with higher proportions of neonates free of mechanical ventilation at 24 hours of life, receiving early enteral feeding, and neurodevelopmental care practices (26 units; n=1118 babies); Cluster 2 with higher levels of patent ductus arteriosus and pain screening (11 units; n=398 babies); Cluster 3 with higher use of respiratory, cardiovascular and pain treatments (16 units; n=619 babies). No difference was observed between clusters for the baseline maternal and babies' characteristics. No differences in outcomes were observed between Clusters 1 and 3. Compared with Cluster 1, mortality at 2 years CA or severe/moderate neuro-motor or sensory disabilities was lower in Cluster 2 (adjusted OR 0.46, 95% CI 0.25 to 0.84) but with higher proportion of children with an ASQ below threshold (adjusted OR 1.49, 95% CI 1.07 to 2.08). CONCLUSION: In French NICUs, care practices for VP babies were non-randomly associated. Differences between clusters were poorly explained by unit or population differences, but were associated with mortality and development at 2 years. Better understanding these variations may help to improve outcomes for VPT babies, as it is likely that some of these discrepancies are unwarranted
Altruism can proliferate through group/kin selection despite high random gene flow
The ways in which natural selection can allow the proliferation of
cooperative behavior have long been seen as a central problem in evolutionary
biology. Most of the literature has focused on interactions between pairs of
individuals and on linear public goods games. This emphasis led to the
conclusion that even modest levels of migration would pose a serious problem to
the spread of altruism in group structured populations. Here we challenge this
conclusion, by analyzing evolution in a framework which allows for complex
group interactions and random migration among groups. We conclude that
contingent forms of strong altruism can spread when rare under realistic group
sizes and levels of migration. Our analysis combines group-centric and
gene-centric perspectives, allows for arbitrary strength of selection, and
leads to extensions of Hamilton's rule for the spread of altruistic alleles,
applicable under broad conditions.Comment: 5 pages, 2 figures. Supplementary material with 50 pages and 26
figure
The radial curvature of an end that makes eigenvalues vanish in the essential spectrum II
Under the quadratic-decay-conditions of the radial curvatures of an end, we
shall derive growth estimates of solutions to the eigenvalue equation and show
the absence of eigenvalues.Comment: "" in the conditions and should be replaced by
"". in the conclusion of Theorem 1.3
should be replaced by ; trivial miss-calculatio
- …