DPP-4 inhibitor dose selection according to manufacturer specifications:A Contemporary Experience From UK General Practice

Recently, 2 dipeptidyl peptidase-4 (DPP-4) inhibitors, sitagliptin and saxagliptin, adjusted dosing specification from creatinine clearance to glomerular filtration rate, more typically reported in routine laboratory tests. This cross-sectional study examines all DPP-4 inhibitor initiations that require dose adjustment and the dose selection using data from UK general practice. Results indicate that 34% of patients taking a nonlinagliptin DPP-4 inhibitor were given a higher dose and 11% a lower dose than specified in the Summary of Product Characteristics. This reinforces the deviation from Summary of Product Characteristics prescription of DPP-4 inhibitors identified in earlier studies despite improvement in compatibility with routine reporting. (C) 2019 The Authors. Published by Elsevier Inc

On de-Sitter geometry in crater statistics

The cumulative size-frequency distributions of impact craters on planetary bodies in the solar system appear to approximate a universal inverse square power-law for small crater radii. In this article, we show how this distribution can be understood easily in terms of geometrical statistics, using a de-Sitter geometry of the configuration space of circles on the Euclidean plane and on the unit sphere. The effect of crater overlap is also considered.Comment: 6 pages, 2 figures, accepted by MNRAS. Version 2: title modified, appendix added, some small change

Risk assessment in relation to the detection of small pulmonary nodules

The National Lung Cancer Screening trial (NLST) demonstrated that individuals assigned to the LDCT screening arm had a 20% lower mortality than those who were assigned to the conventional chest radiography. The NLST was thoroughly analyzed by the US Preventive Task Force on CT Screening and they recommended that lung cancer screening should be implemented. A number of other countries have also recommended implementation, whilst others are awaiting the outcome of the NELSON Trial. However, recommendations for the management of CT screen detected nodules have only recently had any clarity. The management of CT detected nodules in the NLST was based on the identification and reporting of 4 mm diameter nodules found on the CT screens but there was no NLST radiology protocol in place for the management of nodules. The use of volumetric analysis is not routinely used in the USA and there is still a reliance on utilising the CT nodule diameter as the management parameter. The first pulmonary risk model was developed by the Canadians, utilising data sets from the Pan-Canadian Early detection of Lung cancer (PanCan) and validated in the chemoprevention trial dataset at the British Columbian Agency. This Canadian model, known as the Brock Model, is currently available and has been integrated into the British Thoracic Society guidelines on the management of pulmonary nodules. The American College of Radiology setup a Lung Cancer Screening Committee subgroup on Lung-RADS, to standardize lung cancer screening CT reporting and provide management recommendations. However, it has been recommended that the Lung-RADS system should be revised as the system as it has never been studied in a prospective fashion. The NELSON trial introduced a third screening test, the "indeterminate" screening test result, this was done with the aim to reduce the false-positives CT screening results and also utilized by the UKLS trial successfully. On comparing the radiological CT screen volumetric and diameter based protocols in the NELSON trial, the sensitivity and negative predictive value appeared to be comparable, however a higher specificity and positive predictive value was found for the volume-based protocols, thus confirming the advantage of utilising the volumetric approach over diameter The British Thoracic Society (BTS) has undertaken an in-depth piece of work developing guidelines on the management of pulmonary nodules, utilising the wealth of data published by the NELSON team and support the use of volumetric analysis for the management of pulmonary nodules

Singlet levels of the NV−^{-} centre in diamond

The characteristic transition of the NV- centre at 637 nm is between ${}^3\mathrm{A}_2$ and ${}^3\mathrm{E}$ triplet states. There are also intermediate ${}^1\mathrm{A}_1$ and ${}^1\mathrm{E}$ singlet states, and the infrared transition at 1042 nm between these singlets is studied here using uniaxial stress. The stress shift and splitting parameters are determined, and the physical interaction giving rise to the parameters is considered within the accepted electronic model of the centre. It is established that this interaction for the infrared transition is due to a modification of electron-electron Coulomb repulsion interaction. This is in contrast to the visible 637 nm transition where shifts and splittings arise from modification to the one-electron Coulomb interaction. It is also established that a dynamic Jahn-Teller interaction is associated with the singlet ${}^1\mathrm{E}$ state, which gives rise to a vibronic level 115 $\mathrm{cm}^{-1}$ above the ${}^1\mathrm{E}$ electronic state. Arguments associated with this level are used to provide experimental confirmation that the ${}^1\mathrm{A}_1$ is the upper singlet level and ${}^1\mathrm{E}$ is the lower singlet level.Comment: 19 pages, 6 figure

Reduced order multirate schemes in industrial circuit simulation

AbstractIn this paper the industrial application of Reduced Order Multirate (ROMR) schemes is presented. This paper contains the mathematical foundations of the ROMR schemes and elaborates on the construction of these schemes using specific Model Order Reduction (MOR) techniques. Especially the Maximum Entropy Snapshot Sampling method for generating a reduced basis and reduction by Gauß–Newton with Approximated Tensors (GNAT). This basis generation method is also used for generating the basis for the gappy hyper-reduction method used for nonlinear function evaluation. For the multirate integration part, a Backward Differentation Formula approach to integration is used in conjunction with a coupled-slowest-first multirate approach. After introducing the numerical approach to industrial circuit simulation validation experiments are performed. First a simple academic model is used, and then an industrial test case is simulated as presented by STMicroelectronics. A significant speedup in simulation time is achieved whilst accuracy and convergence is kept

CPAs And Electronic Survey Media

Gathering and utilizing data about customers and other stakeholders has become vital to maintaining competitiveness in today’s business world. With the ongoing expansion of the Internet, new methods for data collection are available. The success of utilizing new methods depends on the technological capabilities of the audience from whom data are sought.  One group of business professionals perceived to possess above average technological skills is practicing Certified Public Accountants (CPAs). A study was designed to measure the response rates of CPAs to different survey administration methods. This study compares one traditional survey method (regular mail) with newer methods for collecting survey data (e-mail and WWW form)

Sorafenib prevents human retinal pigment epithelium cells from light-induced overexpression of VEGF, PDGF and PlGF

Background Cumulative light exposure is significantly associated with progression of age-related macular degeneration (AMD). Inhibition of vascular endothelial growth factor is the main target of current antiangiogenic treatment strategies in AMD. However, other growth factors, such as platelet-derived growth factor (PDGF) and placenta growth factor (PlGF), have a substantial impact on development of AMD. Previous reports indicate that sorafenib, an oral multikinase inhibitor, might have beneficial effects on exudative AMD. This study investigates the effects of sorafenib on light-induced overexpression of growth factors in human retinal pigment epithelial (RPE) cells. Methods Primary human RPE cells were exposed to white light and incubated with sorafenib. Viability, expression, and secretion of VEGF-A, PDGF-BB, and PlGF and their mRNA were determined by reverse transcription-polymerase chain reactions, immunohistochemistry and enzyme-linked immunosorbent assays. Results Light exposure decreased cell viability and increased expression and secretion of VEGF-A, PDGF-BB and PlGF. These light-induced effects were significantly reduced when cells were treated with sorafenib at a dose of 1 mu g/ml. Conclusion The results show that sorafenib has promising properties as a potential antiangiogenic treatment for AMD