38 research outputs found

    Improving Glucose Control in Type II Diabetes with SGLT-2 Inhibitors and GLP-1 Agonists

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    Purpose: Preventing complications such as diseases related to renal and cardiovascular disease are an important part of managing patients with Type 2 diabetes (DM2). The initial gold standard monotherapy for DM2 is metformin. However, sodium glucose co-transporter 2 inhibitors (SGLT-2) and glucagon-like peptide 1 agonists (GLP-1) classes of medication have changed the direction in lowering glucose with added benefits. Research has much to say about the risks versus benefits of treating DM2 with SGLT-2 and GLP-1 antidiabetic medications versus metformin. Method: The purpose of this review of literature is to conduct a systematic review of the advantages and disadvantages of SGLT-2 inhibitors and GLP-1 receptor agonists, compared with metformin in patients with DM2. A search was conducted with search terms of “SGLT-2 inhibitors”, “GLP-1 agonists”, “Metformin”, and a secondary search including “cardiovascular protection in type 2 diabetes”, “kidney disease prevention in type 2 diabetes”. Thirty-two articles were selected to perform this review and twenty-two articles were excluded after the full-text review. Among excluded articles, two were found to be in a non-English language, eleven articles were reviews of studies already included in the literature review, and nine other articles did not fulfill the inclusion criteria of metformin versus SGLT-2 inhibitors and GLP-1 receptor agonists in the management of DM2 with other risk factors. Results: Research provides evidence that shows the effectiveness of metformin as a monotherapy versus SGLT-2 inhibitor and GLP-1 receptor agonists and the risks versus benefits associated with the most optimal outcomes available for DM2. There is reliable evidence to suggest that SGLT-2 inhibitors and GLP-1 receptor agonists offer superior benefits when compared to metformin alone. This review demonstrates the advantages of SGLT-2 inhibitors and GLP-1 receptor agonists compared with metformin. Conclusion: The findings of this systematic literature review suggest, that in the secondary prevention of cardiovascular and renal events in patients with DM2, dual treatment with SGLT-2 inhibitors or GLP-1 receptor agonists in conjunction with metformin demonstrate a significant advantage and enhanced safety profile over metformin as a monotherapy in reducing the risk of renal injury and adverse cardio vascular event

    Exploring Algebraic Thinking: In-Service Teacher Experiences, Outcomes, and Perceptions from an Algebra for All Capstone Unit Plan Project

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    Taking algebra is often noted as a key component for student preparation for college and career success. However, this course often serves as a barrier for secondary students to overcome due to their lack of preparation for such abstract contexts and due to a lack of meaningful professional experiences available to assist teachers develop those concepts. Initiatives such as Algebra for All were started to help educators at all grade levels develop methods to expose their students to algebraic thinking. In New York City, a five-course Algebra for All sequence was created for in-service public school educators at a local college in line with the Equity and Excellence initiative. Among those who completed the program, five were selected to participate in this study by being interviewed about their experiences, outcomes, and perceptions of completing a capstone project in which they designed, implemented, and reflected upon a unit plan. Results indicate that participants benefited from the collaborative nature of the project, and demonstrated positive outcomes for themselves, their students, and their colleagues. These results suggest that the unit plan template implemented and the relevant themes of the Algebra for All program have the ability to bring together elementary and secondary mathematics educators in ways that can lead to an overall strengthening of the community of educators in support of student engagement, enjoyment, and the learning of mathematics

    Macroscopic extreme wind regionalization

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    Galectin-3 and laminin expression in neoplastic and non-neoplastic thyroid tissue.

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    Galectin-3 is a 31 kD beta-galactoside-binding lectin which is expressed by several types of non-neoplastic and neoplastic cells and which may be involved in cell-extracellular matrix interactions. An immunohistochemical study has been made of the expression of galectin-3, as well as its ligand, laminin, in a spectrum of benign and malignant thyroid neoplasms and in some non-neoplastic conditions. Immunohistochemistry with anti-human recombinant galectin-3 antibody showed consistent, intense positivity in the neoplastic cells of 18 cases of papillary carcinoma and less intense staining in the five anaplastic carcinomas studied. In addition, two out of three poorly differentiated carcinomas, three out of six medullary carcinomas, and four out of eight follicular carcinomas had less intense or focal positivity. One case of Hurthle cell carcinoma showed scattered strongly positive cells. Eight follicular adenomas, three hyperplastic nodules, five nodular goitres, and normal thyroid tissue were negative. Galectin-3 mRNA expression was also evaluated in three of the papillary carcinomas, two follicular adenomas, and one hyperplastic nodule with matched normal tissue. Northern blot analysis demonstrated mRNA overexpression in the three cases of papillary carcinomas, whereas normal and benign tissues were negative. Laminin distribution in neoplastic and non-neoplastic tissue varied with architectural patterns but did not correlate with galectin-3 immunohistochemical expression. We conclude that expression of galectin-3 is limited to inflammatory foci in normal and benign thyroid tissue and is a phenotypic feature of malignant thyroid neoplasms, especially papillary carcinomas
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