Effect of sitagliptin on cardiovascular outcomes in type 2 diabetes

BACKGROUND: Data are lacking on the long-term effect on cardiovascular events of adding sitagliptin, a dipeptidyl peptidase 4 inhibitor, to usual care in patients with type 2 diabetes and cardiovascular disease. METHODS: In this randomized, double-blind study, we assigned 14,671 patients to add either sitagliptin or placebo to their existing therapy. Open-label use of antihyperglycemic therapy was encouraged as required, aimed at reaching individually appropriate glycemic targets in all patients. To determine whether sitagliptin was noninferior to placebo, we used a relative risk of 1.3 as the marginal upper boundary. The primary cardiovascular outcome was a composite of cardiovascular death, nonfatal myocardial infarction, nonfatal stroke, or hospitalization for unstable angina. RESULTS: During a median follow-up of 3.0 years, there was a small difference in glycated hemoglobin levels (least-squares mean difference for sitagliptin vs. placebo, -0.29 percentage points; 95% confidence interval [CI], -0.32 to -0.27). Overall, the primary outcome occurred in 839 patients in the sitagliptin group (11.4%; 4.06 per 100 person-years) and 851 patients in the placebo group (11.6%; 4.17 per 100 person-years). Sitagliptin was noninferior to placebo for the primary composite cardiovascular outcome (hazard ratio, 0.98; 95% CI, 0.88 to 1.09; P<0.001). Rates of hospitalization for heart failure did not differ between the two groups (hazard ratio, 1.00; 95% CI, 0.83 to 1.20; P = 0.98). There were no significant between-group differences in rates of acute pancreatitis (P = 0.07) or pancreatic cancer (P = 0.32). CONCLUSIONS: Among patients with type 2 diabetes and established cardiovascular disease, adding sitagliptin to usual care did not appear to increase the risk of major adverse cardiovascular events, hospitalization for heart failure, or other adverse events

Performance Indicators and Standards for Polish Research Libraries

Performance Indicators and Standards for Polish Research Libraries Abstract: The article discusses proposed standards for Polish research libraries evaluation. At the beginning, the authors present the situation of research libraries in Poland. They write about the effects of the social-political transformation in the 90s, present selected statistical data, and describe the progress in computerisation. The following part of the article relates to the currently applied in Poland standards of library evaluation. Discussed are e.g. the presently applied tools for data collection and analysis. The last part includes proposed methods for the preparation of standards and assessments for Polish research libraries

Kapitał marki bazujący na rodzinnym charakterze przedsiębiorstwa w sektorze usług noclegowych

The competitiveness of family-owned companies providing accommodation services is an important factor securing their operations. Among the characteristic features of the family-owned companies are: hospitality, the quality of the services provided and the relations between the guest and the owner which are based on mutual trust. Empirical research in the form of CAWI was carried out between 2017-2018 and covered 83 owners of family- -owned businesses. The authors analysed 23 elements characterising the brand of family- owned businesses, including a recognisable logo and name, the quality of the services, trust, openness to guests’ needs. The particular aim of the research was to answer the question of the perception of a brand’s importance among the owners of such companies. The results showed that in their opinion, the brand is responsible for identifying and distinguishing the company, helping to create the company’s image, retaining regular clients and gaining new guests. At the same time, it secures the company’s growth by improving its market power, providing its competitive advantage and generating additional income.Konkurencyjność przedsiębiorstw rodzinnych świadczących usługi noclegowe jest istotnym czynnikiem gwarantującym ich funkcjonowanie na rynku. Wśród wyróżników firm rodzinnych wymienić można: gościnność, jakość świadczonych usług oraz relacje między gościem a przedsiębiorcą bazujące na zaufaniu. Badania empiryczne w formie CAWI przeprowadzono w latach 2017-2018 wśród 83 przedstawicieli firm rodzinnych. Analizie poddano 23 elementy charakteryzujące markę firm rodzinnych, w tym m.in. rozpozna- walne logo i nazwę, jakość usługi, zaufanie, otwartość na potrzeby gości. Głównym celem badań była odpowiedź na pytanie o percepcje znaczenia marki przez właścicieli obiektów noclegowych. Wyniki dowiodły, że w opinii ankietowanych marka odpowiada za identyfi- kację i wyróżnienie przedsiębiorstwa, umożliwia kształtowanie wizerunku, utrzymanie stałych klientów i pozyskanie nowych gości. Jednocześnie zapewnia rozwój przez zwiększenie siły przetargowej, osiągnięcie przewagi konkurencyjnej i zagwarantowanie dodatkowych przychodów

Complete unilateral section of the pyramidal tract at the medullary level in Macaca mulatta

A short movie was shown to illustrate the motor deficits in hand usage which result in the adult monkey after complete unilateral section of the medullary pyramid at the level of the trapezoid body. The animal (68-70) was one of 8 in which unilateral or bilateral pyramidal section was undertaken for the primary purpose of studying the effects of pyramidal tract section on movements elicited by electrical stimulation of the rolandic region of the cerebral cortex. The results obtained in these 8 animals formed the subject of the J. Hughlings Jackson Memorial Lecture given at the Montreal Neurological Institute on May 11, 1971

Complete unilateral section of the pyramidal tract at the medullary level in Macaca mulatta

A short movie was shown to illustrate the motor deficits in hand usage which result in the adult monkey after complete unilateral section of the medullary pyramid at the level of the trapezoid body. The animal (68-70) was one of 8 in which unilateral or bilateral pyramidal section was undertaken for the primary purpose of studying the effects of pyramidal tract section on movements elicited by electrical stimulation of the rolandic region of the cerebral cortex. The results obtained in these 8 animals formed the subject of the J. Hughlings Jackson Memorial Lecture given at the Montreal Neurological Institute on May 11, 1971