17,791 research outputs found

    Metformin use in pregnancy: promises and uncertainties

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    Metformin has been prescribed in pregnancy for over 40 years; for much of this time, use has been limited both in numbers and geographically, and the evidence base has been confined to observational studies. In early years, perceived safety concerns and lack of availability of the drug in many countries acted as a barrier to use. More recently, RCTs have begun to examine the role of metformin in pregnancy in much-needed detail. However, this evidence base has been interpreted differently in different countries, leading to very wide variation in its current application in pregnancy. In this short review, we will discuss the history of metformin in pregnancy and highlight some of the key clinical trials. We will then consider some of the remaining controversies associated with metformin use in pregnancy, most important of these being the potential for long-term ‘programming’ effects on the fetus as a result of metformin being able to cross the placenta. We will also consider clinical situations where metformin might be avoided. Finally, we will discuss some future directions for this drug as it reaches its sixtieth anniversary

    The origin of amorphous rims on lunar plagioclase grains: Solar wind damage or vapor condensates

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    A distinctive feature of micron sized plagioclase grains from mature lunar soils is a thin (20 to 100 nm) amorphous rim surrounding the grains. These rims were originally described from high voltage electron microscope observations of lunar plagioclase grains by Dran et al., who observed rims up to 100 nm thick on plagioclase grains from Apollo 11 and 12 soils. These rims are believed to be the product of solar wind damage. The amorphous rims were studied on micron sized plagioclase grains from a mature Apollo 16 soil using a JEOL 200FX transmission electron microscope equipped with an energy dispersive x ray spectrometer. It was found that the amorphous rims are compositionally distinct from the interior plagioclase and it is proposed that a major component of vapor condensates is present in the rims

    Gestational diabetes mellitus- right person, right treatment, right time?

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    Background: Personalised treatment that is uniquely tailored to an individual’s phenotype has become a key goal of clinical and pharmaceutical development across many, particularly chronic, diseases. For type 2 diabetes, the importance of the underlying clinical heterogeneity of the condition is emphasised and a range of treatments are now available, with personalised approaches being developed. While a close connection between risk factors for type 2 diabetes and gestational diabetes has long been acknowledged, stratification of screening, treatment and obstetric intervention remains in its infancy. Conclusions: Although there have been major advances in our understanding of glucose tolerance in pregnancy and of the benefits of treatment of gestational diabetes, we argue that far more vigorous approaches are needed to enable development of companion diagnostics, and to ensure the efficacious and safe use of novel therapeutic agents and strategies to improve outcomes in this common condition

    Genetic variation within and among asexual populations of Porphyra umbilicalis Kützing (Bangiales, Rhodophyta) in the Gulf of Maine, USA

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    The intertidal marine red alga Porphyra umbilicalis reproduces asexually in the Northwest Atlantic. We looked for population substructure among typical open-coastal and atypical estuarine habitats in seven asexual populations of P. umbilicalis from Maine to New Hampshire using eight expressed sequence tag-simple sequence repeats (EST-SSR) or microsatellite loci. Six genotypes were identified, four of which may represent recombinant genotypes from a recombination event that took place locally, or that took place prior to introduction to the Northwest Atlantic. Genotypic diversity was lowest in a population from Wiscasset, Maine, which inhabits an atypical habitat high in the intertidal zone of a bridge piling in an estuarine tidal rapid. Genotypic diversity was highest in the southernmost populations from New Hampshire; we identified two genotypes that were unique to the southernmost populations, and probably represent the most derived genotypes. We looked at genetic distances among populations in similar habitats, and found that populations were more closely related to their closest neighboring population than to a population in a similar habitat. We show that genotypic diversity within P. umbilicalis populations in the Gulf of Maine is relatively high and thus fits a model of high steady-state variation within asexual populations

    Developing analytical distributions for temperature indices for the purposes of pricing temperature-based weather derivatives

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    Temperature-based weather derivatives are written on an index which is normally defined to be a nonlinear function of average daily temperatures. Recent empirical work has demonstrated the usefulness of simple time-series models of temperature for estimating the payoffs to these instruments. This paper develops analytical distributions of temperature indices on which temperature derivatives are written. If deviations of daily temperature from its expected value is modelled as an Ornstein-Uhlenbeck process with time-varying variance, then the distributions of the temperature index on which the derivative is written is the sum of truncated, correlated Gaussian deviates. The key result of this paper is to provide an analytical approximation to the distribution of this sum, thus allowing the accurate computation of payoffs without the need for any simulation. A data set comprising average daily temperature spanning over a hundred years for four Australian cities is used to demonstrate the efficacy of this approach for estimating the payoffs to temperature derivatives. It is demonstrated that expected payoffs computed directly from historical records is a particulary poor approach to the problem when there are trends in underlying average daily temperature. It is shown that the proposed analytical approach is superior to historical pricing.Weather Derivatives, Temperature Models, Cooling Degree Days, Maximum Likelihood Estimation, Distribution for Correlated Variables
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