Fixed-ratio combination of insulin degludec and liraglutide (IDegLira) improves cardiovascular risk markers in patients with type 2 diabetes uncontrolled on basal insulin

In this post hoc analysis we investigated the effects of insulin degludec/liraglutide fixed-ratio combination (IDegLira) versus comparators on cardiovascular (CV) risk markers in participants in the DUAL II (vs. insulin degludec), DUAL V (vs. insulin glargine 100 units/mL) and DUAL VII (vs. basal-bolus therapy) trials, grouped by sex, age (<65 years, ≥65 years) and diabetes duration (<10 years, ≥10 years). Treatment contrasts were in favour of IDegLira in many subgroups for changes from baseline in glycated haemoblogin (DUAL II, DUAL V), body weight (all three trials), systolic blood pressure (BP; all three trials), HDL cholesterol (DUAL VII) and LDL cholesterol (DUAL II, DUAL V). Higher heart rates were seen with IDegLira versus comparators (all three trials) plus significantly higher diastolic BP in men (DUAL V). Differences in treatment effect were seen between sexes in waist circumference (DUAL II), systolic BP (DUAL II, DUAL V) and triglycerides (DUAL VII), and between diabetes durations in LDL cholesterol (DUAL V). In conclusion, IDegLira is associated with a general improvement in CV risk markers compared with basal insulin or basal-bolus therapy after 26 weeks of treatment

Dissociation energy of the hydrogen molecule at 10−9^{-9} accuracy

The ionization energy of ortho-H$_2$ has been determined to be $E^\mathrm{o}_\mathrm{I}(\mathrm{H}_2)/(hc)=124\,357.238\,062(25)$ cm$^{-1}$ from measurements of the GK(1,1)--X(0,1) interval by Doppler-free two-photon spectroscopy using a narrow band 179-nm laser source and the ionization energy of the GK(1,1) state by continuous-wave near-infrared laser spectroscopy. $E^\mathrm{o}_\mathrm{I}$(H$_2$) was used to derive the dissociation energy of H$_2$, $D^{N=1}_{0}$(H$_2$), at $35\,999.582\,894(25)$ cm$^{-1}$ with a precision that is more than one order of magnitude better than all previous results. The new result challenges calculations of this quantity and represents a benchmark value for future relativistic and QED calculations of molecular energies.Comment: 6 pages, 5 figure

Relatório sobre experiências na implantação de unidades de referencia tecnológica em sistemas agroflorestais, no Projeto Iguatú II.

O público alvo preferencial desta publicação são os agricultores familiares e técnicos de campo, principalmente aqueles motivados pelo cultivo de espécies arbóreas nativas e interessados na adoção de práticas agroecológicas. Com conteúdo simples e de fácil leitura, as informações e discussões foram descritas com a intenção de subsidiar a introdução do componente florestal nos sistemas de produção agropecuários, visando principalmente à sustentabilidade e à qualidade ambiental. A diversificação dos eventos ocorridos nas diferentes experiências traduz importantes recomendações que, embora de caráter aparentemente simples, nem sempre são de fácil solução.bitstream/item/40275/1/Doc181.pd

Práticas de marketing educacional nas escolas públicas

O presente trabalho tem como objetivo identificar práticas de Marketing Educacional nas escolas públicas. Tendo por base razões pessoais, profissionais, teóricas e legais que justificam estudos sobre as práticas de Marketing Educacional nas escolas públicas, revê-se a literatura sobre a evolução do marketing (geral) até à emergência do marketing societal e do Marketing Educacional. Partindo dos normativos legais e da literatura, exploram-se as fontes de informação, a autonomia das escolas, a accountability, o planeamento estratégico e evidências dessas práticas associadas ao Marketing Educacional. Para o efeito, optou-se, metodologicamente, por realizar uma pesquisa quantitativa através de um inquérito por questionário realizado junto dos(as) diretores(as) dos agrupamentos de escolas e escolas não agrupadas de Portugal Continental. No que respeita aos principais resultados obtidos, é possível concluir que, apesar de haver evidências de predominar a orientação da gestão para a “produção” do serviço educativo, há práticas de Marketing Educacional nas escolas públicas. Contudo, as escolas têm ainda uma consciência míope do que é o Marketing Educacional, pois há défice na identificação e na implementação dessas práticas. Verifica-se que as escolas fazem estudos de suporte a decisões sobre oferta formativa, de avaliação institucional e de satisfação junto dos alunos e restante comunidade educativa. Definem e implementam estratégias não só para cumprir os normativos legais, mas também adequar os serviços aos alunos, tornando-os parte ativa da coprodução do serviço educativo. Com base nas conclusões e nas opções de concordância do(a)s diretores(as), foi delineado um plano de ação de intervenção de Marketing Educacional.This project aims to identify educational marketing practices in state schools. Based on personal, professional, theoretical and legal reasons that justify studies on Educational Marketing practices in state schools, we'll be reviewing the literature on the evolution of marketing, and of general marketing until the emergence of Educational Marketing. Starting from legal requirements and literature, we will explore information sources, school autonomy, accountability, strategic and practical evidence associated with Educational Marketing. For this purpose, it was decided, as far as methodology is concerned, to carry out a quantitative research through a survey with the School Directors/headmasters of the school groupings and schools in mainland Portugal. Concerning the main results obtained, it is possible to conclude that, although there is evidence of a predominant management orientation towards the “production” of the educational service, it is undeniable that there are Educational Marketing practices in state schools. However, schools still have a short-sighted awareness of what Educational Marketing is, as there is a deficit in identifying and implementing these practices. In fact, schools carry out surveys that support decisions on training courses, institutional assessment and satisfaction among students and the rest of the educational community. They define and implement strategies not only to comply with legal regulations, but also to adapt services to students, making them an active part of the co-production of the educational service. Based on the headmasters' conclusions and agreement options, an Educational Marketing action plan was outlined. KEYWORDS: Educational Marketing

Cost-effectiveness of oral alitretinoin in patients with severe chronic hand eczema - a long-term analysis from a Swiss perspective

BACKGROUND: The impact on patients suffering from chronic hand eczema (CHE) is enormous, as no licensed systemic treatment option with proven efficacy for CHE is available. Alitretinoin is a novel agent which showed high clinical efficacy in patients with severe, refractory CHE. We assessed the cost-effectiveness of alitretinoin for CHE patient treatment from a Swiss third party payer perspective. A further objective of this study was to determine the burden of disease in Switzerland. METHODS: A long-term Markov cohort simulation model was used to estimate direct medical costs (euro) and clinical effectiveness (quality adjusted life years, QALYs) of treating severe CHE patients with alitretinoin. Comparison was against the standard treatment of supportive care (optimised emollient therapy). Information on response rates were derived from a randomized controlled clinical trial. Costs were considered from the perspective of the Swiss health system. Swiss epidemiological data was derived from official Swiss Statistic institutions. RESULTS: Annual costs of alitretinoin treatment accounted for 2'212 euro. After a time horizon of 22.4 years, average remaining long-term costs accounted for 42'208 euro or 38'795 euro in the alitretinoin and the standard treatment arm, respectively. Compared with the standard therapy, the addition of alitretinoin yielded an average gain of 0.230 QALYs at the end of the simulation. Accordingly, the incremental cost-effectiveness ratio resulted in 14'816 euro/QALY gained. These results were robust to changes in key model assumptions. CONCLUSION: The therapy for CHE patients is currently insufficient. In our long-term model we identified the treatment with alitretinoin as a cost-effective alternative for the therapy of CHE patients in Switzerland

Cognition and resective surgery for diffuse infiltrative glioma: an overview

Compared to classical oncological outcome measures such as time to progression and survival, the importance of cognitive functioning in patients with diffuse infiltrative brain tumors has only recently been recognized. Apart from the relatively low incidence and the invariably fatal outcome of gliomas, the general assumption that cognitive assessment is time-consuming and burdensome contributes to this notion. Our understanding of the effects of brain surgery on cognition, for instance, is largely based on studies in surgical patients with refractory epilepsy, with only a limited number of studies in surgical patients with gliomas. The impact of other factors affecting cognition in glioma patients such as direct tumor effects, radiotherapy and chemotherapy, and medical treatment, including anti-epileptic drugs and steroids, have been studied more extensively. The purpose of this paper is to provide an overview of cognition in patients with diffuse infiltrative gliomas and the impact of resective surgery as well as other tumor and treatment-related factors