The cost-effectiveness of diabetes prevention: results from the Diabetes Prevention Program and the Diabetes Prevention Program Outcomes Study

Background The Diabetes Prevention Program (DPP) was a randomized, controlled clinical trial. It demonstrated that among high-risk individuals with impaired glucose tolerance, diabetes incidence was reduced by 58 % with lifestyle intervention and 31 % with metformin compared to placebo. During the Diabetes Prevention Program Outcomes Study (DPPOS), all DPP participants were unmasked to their treatment assignments, the original lifestyle intervention group was offered additional lifestyle support, the metformin group continued metformin, and all three groups were offered a group-implemented lifestyle intervention. Over the 10 years of combined DPP/DPPOS follow-up, diabetes incidence was reduced by 34 % in the lifestyle group and 18 % in the metformin group compared to placebo. The purpose of this article is to review and synthesize analyses published by the DPP/DPPOS Research Group that have described the cost-effectiveness of diabetes prevention. Methods We describe the resource utilization and costs of the DPP and DPPOS interventions, the costs of non-intervention-related medical care, the impact of the interventions on diabetes progression and quality-of-life, and the cost-effectiveness of the interventions from health system and societal perspectives. Cost-effectiveness analyses were performed with a 3-year time horizon using DPP data, a lifetime time horizon that simulated 3-year DPP data, and a 10-year time horizon using combined DPP/DPPOS data. Results Although more expensive than the placebo intervention, the greater costs of the lifestyle and metformin interventions were offset by reductions in the costs of nonintervention-related medical care. Every year after randomization, quality-of-life was better for participants in the lifestyle intervention compared to those in the metformin or placebo intervention. In both the simulated lifetime analysis and the 10-year within trial economic analysis, lifestyle and metformin were extremely cost-effective (that is, improved outcomes at a low incremental cost) or even cost-saving (that is, improved outcomes and reduced total costs) compared to the placebo intervention. Conclusions The implementation of diabetes prevention programs in high-risk individuals will result in important health benefits and represents a good value for money. Trial registration NCT00004992 (DPP) and NCT00038727 (DPPOS)

The use of urea in limiting supplemental feed intake and efficiency of urea utilization by cattle on high roughage rations

Call number: LD2668 .T4 1965 W531Master of Scienc

The cost-effectiveness of diabetes prevention: results from the Diabetes Prevention Program and the Diabetes Prevention Program Outcomes Study

Background The Diabetes Prevention Program (DPP) was a randomized, controlled clinical trial. It demonstrated that among high-risk individuals with impaired glucose tolerance, diabetes incidence was reduced by 58 % with lifestyle intervention and 31 % with metformin compared to placebo. During the Diabetes Prevention Program Outcomes Study (DPPOS), all DPP participants were unmasked to their treatment assignments, the original lifestyle intervention group was offered additional lifestyle support, the metformin group continued metformin, and all three groups were offered a group-implemented lifestyle intervention. Over the 10 years of combined DPP/DPPOS follow-up, diabetes incidence was reduced by 34 % in the lifestyle group and 18 % in the metformin group compared to placebo. The purpose of this article is to review and synthesize analyses published by the DPP/DPPOS Research Group that have described the cost-effectiveness of diabetes prevention. Methods We describe the resource utilization and costs of the DPP and DPPOS interventions, the costs of non-intervention-related medical care, the impact of the interventions on diabetes progression and quality-of-life, and the cost-effectiveness of the interventions from health system and societal perspectives. Cost-effectiveness analyses were performed with a 3-year time horizon using DPP data, a lifetime time horizon that simulated 3-year DPP data, and a 10-year time horizon using combined DPP/DPPOS data. Results Although more expensive than the placebo intervention, the greater costs of the lifestyle and metformin interventions were offset by reductions in the costs of nonintervention-related medical care. Every year after randomization, quality-of-life was better for participants in the lifestyle intervention compared to those in the metformin or placebo intervention. In both the simulated lifetime analysis and the 10-year within trial economic analysis, lifestyle and metformin were extremely cost-effective (that is, improved outcomes at a low incremental cost) or even cost-saving (that is, improved outcomes and reduced total costs) compared to the placebo intervention. Conclusions The implementation of diabetes prevention programs in high-risk individuals will result in important health benefits and represents a good value for money. Trial registration NCT00004992 (DPP) and NCT00038727 (DPPOS)

The effect of the near earth micrometeoroid environment on a highly reflective mirror surface

A resurgence of interest in placing large solar concentrator solar dynamic systems in space for power generation has brought up again a concern for maintaining the integrity of the optical properties of highly specular reflecting surfaces in the near earth space environment. One of the environmental hazards needing evaluation is the micrometeoroid environment. It has been shown that highly reflective polished metals and thin film coatings degrade when exposed to simulated micrometeoroids in the lab. At NASA-Lewis, a shock tube was used to simulate the phenomenon of micrometeoroid impact by accelerating micron sized particles to hypervelocities. Any changes in the optical properties of surfaces exposed to this impact were then evaluated. The degradation of optical properties of polished metals and thin metallic films after exposure to simulated micrometeoroids was determined as a function of impacting kinetic energy area of the particles. A calibrated sensor was developed to not only detect the micrometeoroid environment, but also to evaluate the degradation of the optical properties of thin aluminum films in space. Results of the simulation are presented and discussed

A Wavelet Analysis of the Bitcoin- Hashrate Nexus Accounting for the Effects of Energy Commodities

This study investigates the relationship between the growth rates of Bitcoin and Bitcoin hashrate while controlling for the effect of energy commodities, specifically two-month futures on Brent crude oil, coal, and natural gas. Based on daily data from January 2013 until December 2022, we utilize the wavelet methodology to analyze dynamics both in time and frequency. Building on the previous work of Rehman and Kang (2021), this study extends the sample period and improves the replicability of their findings. Controlling for the effect of energy commodities, our analysis reveals several interesting results, highlighting the temporal and dynamic nature of these relationships. Our most significant observation that was discovered in both bi- and multivariate forms of the wavelet methodology is the low-frequency in-phase coherence between bitcoin's returns and hashrate growth rates, which persists from the beginning of 2020 until the end of our sample period in 2023, with hashrate growth rates leading bitcoin returns. These findings suggest that the link between the returns on bitcoin and hashrate growth rates while considering the impact of the energy commodities is complex and context-dependent, and further research is needed to fully understand the underlying mechanisms driving these relationships. Our study contributes to the existing literature on the Bitcoin-hashrate nexus by providing a more comprehensive analysis that accounts for the dynamic nature of these relationships, and by improving the replicability of previous research

A Wavelet Analysis of the Bitcoin-Hashrate Nexus Accounting for the Effects of Energy Commodities

This study investigates the relationship between the growth rates of Bitcoin and Bitcoin hashrate while controlling for the effect of energy commodities, specifically two-month futures on Brent crude oil, coal, and natural gas. Based on daily data from January 2013 until December 2022, we utilize the wavelet methodology to analyze dynamics both in time and frequency. Building on the previous work of Rehman and Kang (2021), this study extends the sample period and improves the replicability of their findings. Controlling for the effect of energy commodities, our analysis reveals several interesting results, highlighting the temporal and dynamic nature of these relationships. Our most significant observation that was discovered in both bi- and multivariate forms of the wavelet methodology is the low-frequency in-phase coherence between bitcoin's returns and hashrate growth rates, which persists from the beginning of 2020 until the end of our sample period in 2023, with hashrate growth rates leading bitcoin returns. These findings suggest that the link between the returns on bitcoin and hashrate growth rates while considering the impact of the energy commodities is complex and context-dependent, and further research is needed to fully understand the underlying mechanisms driving these relationships. Our study contributes to the existing literature on the Bitcoin-hashrate nexus by providing a more comprehensive analysis that accounts for the dynamic nature of these relationships, and by improving the replicability of previous research

Forebrain Origins of Glutamatergic Innervation to the Rat Paraventricular Nucleus of the Hypothalamus: Differential Inputs to the Anterior Versus Posterior Subregions

The hypothalamic paraventricular nucleus (PVN) regulates numerous homeostatic systems and functions largely under the influence of forebrain inputs. Glutamate is a major neurotransmitter in forebrain, and glutamate neurosignaling in the PVN is known to mediate many of its functions. Previous work showed that vesicular glutamate transporters (VGluTs; specific markers for glutamatergic neurons) are expressed in forebrain sites that project to the PVN; however, the extent of this presumed glutamatergic innervation to the PVN is not clear. In the present study retrograde FluoroGold (FG) labeling of PVN-projecting neurons was combined with in situ hybridization for VGluT1 and VGluT2 mRNAs to identify forebrain regions that provide glutamatergic innervation to the PVN and its immediate surround in rats, with special consideration for the sources to the anterior versus posterior PVN. VGluT1 mRNA colocalization with retrogradely labeled FG neurons was sparse. VGluT2 mRNA colocalization with FG neurons was most abundant in the ventromedial hypothalamus after anterior PVN FG injections, and in the lateral, posterior, dorsomedial, and ventromedial hypothalamic nuclei after posterior PVN injections. Anterograde tract tracing combined with VGluT2 immunolabeling showed that 1) ventromedial nucleus-derived glutamatergic inputs occur in both the anterior and posterior PVN; 2) posterior nucleus-derived glutamatergic inputs occur predominantly in the posterior PVN; and 3) medial preoptic nucleus-derived inputs to the PVN are not glutamatergic, thereby corroborating the innervation pattern seen with retrograde tracing. The results suggest that PVN subregions are influenced by varying amounts and sources of forebrain glutamatergic regulation, consistent with functional differentiation of glutamate projections. J. Comp. Neurol. 519:1301–1319, 2011. © 2010 Wiley-Liss, Inc

Electromagnetics from a quasistatic perspective

Quasistatics is introduced so that it fits smoothly into the standard textbook presentation of electrodynamics. The usual path from statics to general electrodynamics is rather short and surprisingly simple. A closer look reveals however that it is not without confusing issues as has been illustrated by many contributions to this Journal. Quasistatic theory is conceptually useful by providing an intermediate level in between statics and the full set of Maxwell's equations. Quasistatics is easier than general electrodynamics and in some ways more similar to statics. It is however, in terms of interesting physics and important applications, far richer than statics. Quasistatics is much used in electromagnetic modeling, an activity that today is possible on a PC and which also has great pedagogical potential. The use of electromagnetic simulations in teaching gives additional support for the importance of quasistatics. This activity may also motivate some change of focus in the presentation of basic electrodynamics