The decay constants fD{\mathbf{f_D}} and fDs{\mathbf{f_{D_{s}}}} in the continuum limit of Nf=2+1{\mathbf{N_f=2+1}} domain wall lattice QCD

We present results for the decay constants of the $D$ and $D_s$ mesons computed in lattice QCD with $N_f=2+1$ dynamical flavours. The simulations are based on RBC/UKQCD's domain wall ensembles with both physical and unphysical light-quark masses and lattice spacings in the range 0.11--0.07$\,$fm. We employ the domain wall discretisation for all valence quarks. The results in the continuum limit are $f_D=208.7(2.8)_\mathrm{stat}\left(^{+2.1}_{-1.8}\right)_\mathrm{sys}\,\mathrm{MeV}$ and $f_{D_{s}}=246.4(1.3)_\mathrm{stat}\left(^{+1.3}_{-1.9}\right)_\mathrm{sys}\,\mathrm{MeV}$ and $f_{D_s}/f_D=1.1667(77)_\mathrm{stat}\left(^{+57}_{-43}\right)_\mathrm{sys}$. Using these results in a Standard Model analysis we compute the predictions $|V_{cd}|=0.2185(50)_\mathrm{exp}\left(^{+35}_{-37}\right)_\mathrm{lat}$ and $|V_{cs}|=1.011(16)_\mathrm{exp}\left(^{+4}_{-9}\right)_\mathrm{lat}$ for the CKM matrix elements

A survey on alzheimer�s disease detection using gait analysis

Introduction: Early detection of Alzheimer's disease (AD), as a neurodegenerative disease and the most common cause of dementia in the elderly people, using gait analysis have been particularly noted by researcher in recent years. Because this novel method is non-invasive, less cost, and feasible in non-clinical and laboratory environments. Therefore, in this Meta-Analysis review article, detection of AD using gait analysis based on information technology tools surveyed in previous studies. Materials and Methods: The search for previous articles was done in databases such as Google Scholar, Pubmed, IEEE, Springer, and Elsevier. After finding articles in these databases, appropriate articles were selected to survey based on criteria such as focusing of the study on elderly patients with AD or mild cognitive impairment, the detection and assessment of AD, and the use of sensor technology to record gait. Results: AD can be detected, even in the early stages and also at a stage of mild cognitive impairment based on gait analysis using new technologies with sensors and information technologies. Also, it is possible to quantitatively evaluate and more accurately detect the disease based on the combination of different sensor technologies and the use of artificial intelligence techniques. Conclusion: Although gait analysis can be a novel tool for early detection of AD, but it is essential to be developed and improved based on sensors and artificial intelligence in order to be used as a reliable clinical tools. © 2020, Semnan University of Medical Sciences. All rights reserved

Challenging Issues in the Management of Cardiovascular Risk Factors in Diabetes During the COVID-19 Pandemic: A Review of Current Literature

The COVID-19 outbreak was declared a pandemic on March 2020. Many patients with SARS-CoV-2 infection have underlying chronic medical conditions such as diabetes, cardiovascular disease (CVD), and hypertension. Patient-related outcomes are worse if there are associated comorbidities. We do not have enough evidence regarding the most appropriate management of patients with diabetes during COVID-19 infection. Insulin resistance and CVD together increase the inflammatory state of the body, which can contribute to and perhaps mediate the increase of COVID-19 severity. Hence, in addition to management of dysglycemia, other CVD risk factors should be targeted. We explore the possible pathophysiologic links between diabetes and COVID-19 and discuss various options to treat dysglycemia, hypertension, and dyslipidemia in the era of COVID-19. © 2020, The Author(s)

A View Beyond HbA1c: Role of Continuous Glucose Monitoring

Hemoglobin A1C (HbA1c) is used as an index of average blood glucose measurement over a period of months and is a mainstay of blood glucose monitoring. This metric is easy to measure and relatively inexpensive to obtain, and it predicts diabetes-related microvascular complications. However, HbA1c provides only an approximate measure of glucose control; it does not address short-term glycemic variability (GV) or hypoglycemic events. Continuous glucose monitoring (CGM) is a tool which helps clinicians and people with diabetes to overcome the limitations of HbA1c in diabetes management. Time spent in the glycemic target range and time spent in hypoglycemia are the main CGM metrics that provide a more personalized approach to diabetes management. Moreover, the glucose management indicator (GMI), which calculates an approximate HbA1c level based on the average CGM-driven glucose level, facilitates individual decision-making when the laboratory-measured HbA1c and estimated HbA1c are discordant. GV, on the other hand, is a measure of swings in blood glucose levels over hours or days and may contribute to diabetes-related complications. In addition, addressing GV is a major challenge during the optimization of glycemia. The degree of GV is associated with the frequency, duration, and severity of the hypoglycemic events. Many factors affect GV in a patient, including lifestyle, diet, the presence of comorbidities, and diabetes therapy. Recent evidence supports the use of some glucose-lowering agents to improve GV, such as the new ultra-long acting insulin analogs, as these agents have a smoother pharmacodynamic profile and improve glycemic control with fewer fluctuations and fewer nocturnal hypoglycemic events. These newer glucose-lowering agents (such as incretin hormones or sodium�glucose cotransporter 2 inhibitors) can also reduce the degree of GV. However, randomized trials are needed to evaluate the effect of GV on important diabetes outcomes. In this review, we discuss the role of HbA1c as a measure of glycemic control and its limitations. We also explore additional glycemic metrics, with a focus on time (duration) in glucose target range, time (duration) in hypoglycemia, GV, GMI, and their correlation with clinical outcomes. © 2019, The Author(s)

Medicinal plants in the adjunctive treatment of patients with type-1 diabetes: a systematic review of randomized clinical trials

Propose: This study aims to systematically review the randomized controlled trials that address the effectiveness and safety of herbal medicine in patients with type 1 diabetes. Methods: The Cochrane Library (latest issue); MEDLINE (until recent); EMBASE (until recent); AMED (Allied and Complementary Medicine Database) (until recent); and CINHAL (until recent) were searched electronically for the identification of trials until October 2019. Articles were initially screened based on title and abstract and then by full text by two independent authors. References of retrieved studies were hand-searched for further studies. Risk of bias was assessed according to the Cochrane handbook of systematic reviews of interventions. The results were summarized into GRADE (grading of recommendations, assessment, development and evaluation) tables. No meta-analysis was applicable as only one study was found for each intervention. Results: Four RCTs were finally included in the systematic review with an overall moderate quality of conduct and low quality of reporting. The sample sizes were very small. The results of these RCTs show that cinnamon pills and Berberine/Silymarine compound capsules may decrease blood glucose indices from baseline, while fenugreek seeds and fig leaf decoction do not show any statistically significant effect. Conclusions: The evidence is scarce and no recommendations can be made based on current evidence. Further trials with more rigorous methodology and stronger quality of reporting are needed to make conclusions. © 2020, Springer Nature Switzerland AG

The optimal vitamin D cut-off value associated with hyperglycemia in an Iranian population

Background: Vitamin D deficiency may accelerate the risk of type 2 diabetes mellitus. The association of vitamin D with hyperglycemia may be influenced by lifestyle. Objective: To evaluate the relationship between vitamin D status and hyperglycemia among the workers� population. Methods: This was a medical records review of 7054 Iranian factory workers participating in an annual health check-up for employees. Of those, potential participants were included in this analysis if data for serum 25-hydroxyvitamin D 25(OH) D levels were also available. Results: Data of 429 male participants were used for this analysis. Of those, 61.07% had serum 25(OH)D concentrations lower than the sufficient level �20 ng/ml. Hyperglycemic participants had significantly lower 25(OH)D than those with normal fasting blood glucose (FBG). Regression analyses highlighted serum 25(OH)D as a significant determinant of hyperglycemia OR: 0.943(0.901, 988); p = 0.01. The association between 25(OH)D and FBG remained significant after adjustment for potential confounders (p = 0.008). Using the ROC analysis, the serum 25(OH)D value of 14.7 ng/ml was the optimal cut-off point to predict hyperglycemia in this population (sensitivity: 63.6%, specificity: 62.3%, p = 0.01). Conclusion: Our results revealed a considerable proportion of participants with serum 25(OH)D below the optimal level as well as a significant inverse association between vitamin D status and hyperglycemia among the factory workers. These findings highlight the importance of including the evaluation of vitamin D status as a part of annual health examinations for employees, and may help health policy- makers prevent or delay type 2 diabetes mellitus among the workers� population. © 2019, Springer Nature Switzerland AG

Diabetes management during the COVID-19 pandemic: An Iranian expert opinion statement

The coronavirus infection is an evolving pandemic with high morbidity and mortality, especially in people with comorbidities. The case fatality rate (CFR) is 9.2 in the presence of diabetes, while it is 1.4 in those without any comorbidity. Diabetes is a prevalent disease globally; hence, healthcare professionals are highly concerned about severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic progression. Current evidence does not support higher incidence of coronavirus disease 2019 (COVID-19) in people with diabetes (PWD). However, people with diabetes are considered high risk for developing complications. Optimal metabolic control is a challenging concept, especially in the presence of an acute and severe respiratory viral infection. In this consensus, we considered the challenging issues in management of patients with diabetes during the COVID-19 pandemic. The consensus covers various aspects of outpatient as well as inpatient care based on the current evidence. © 2020 The Author(s)

Quantification of rigidity in Parkinson's disease

In this paper, a new method for quantification of rigidity in elbow joint of Parkinsonian patients is introduced. One of the most known syndromes in Parkinson's disease (PD) is increased passive stiffness in muscles, which leads to rigidity in joints. Clinical evaluation of stiffness in wrist and/or elbow, commonly used by clinicians, is based on Unified Parkinson's Disease Rating System (UPDRS). Subjective nature of this method may influence the accuracy and precision of evaluations. Hence, introducing an objective standard method based on quantitative measurements may be helpful. A test rig was designed and fabricated to measure range of motion and viscous and elastic components of passive stiffness in elbow joint. Measurements were done for 41 patients and 11 controls. Measures were extracted using Matlab-R14 software and statistic analyses were done by Spss-13. Relation between each computed measure and the level of illness were analyzed. Results showed a better correlation between viscous component of stiffness and UPDRS score compared to the elastic component. Results of this research may help to introduce a standard objective method for evaluation of PD. © 2007 Biomedical Engineering Society

Serum levels of CTRP3 in diabetic nephropathy and its relationship with insulin resistance and kidney function

Background C1q TNF related protein 3 (CTRP3) is an adipokine secreted from adipose tissue. Previous studies have suggested that CTRP3 improves insulin sensitivity and reduces inflammation. Human studies have evaluated circulating levels of this adipokine in patients with diabetes mellitus (DM), diabetic retinopathy, metabolic syndrome, and coronary artery diseases. However, circulating levels of this adipokine in patients with diabetic nephropathy have not been evaluated. The present study aimed to assess serum levels of CTRP3 in patients with type 2 diabetes mellitus (T2DM) and diabetic nephropathy (T2DM-NP) and its relationship with metabolic and inflammatory markers. Methods This cross-sectional study was performed on 55 controls, 54 patients with T2DM, and 55 patients with T2DM-NP. Serum levels of CTRP3, adiponectin, TNF-α, and IL-6 were measured by ELISA technique. Results Serum levels of CTRP3 were significantly lower in patients with T2DM (257.61 ± 69.79 ng/mL, p < 0.001) and T2DM-NP (222.03 ± 51.99 ng/mL, p < 0.001) compared to controls (328.17 ± 80.73 ng/mL), and those with T2DM-NP compared to T2DM group. CTRP3 was independently associated with HOMA-IR (r = -0.327, p < 0.05) and adiponectin (r = 0.436, p < 0.01) in T2DM group. In T2DM-NP patients, CTRP3 independently was associated with eGFR (r = 0.428, p < 0.01) and HOMA-IR (r = -0.436, p < 0.01). Furthermore, CTRP3 revealed a ability to differentiate T2DM-NP patients from controls (area under curve (95 confidence interval): 0.881 (0.820�0.943) and p < 0.001). Conclusion Decreased serum levels of CTRP3 in patients with T2DM and diabetic nephropathy and its association with pathologic mechanism in these patients suggested a possible role for CTRP3 in pathogenesis of diabetic nephropathy; nevertheless, further studies are required in this regard. © 2019 Moradi et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited

Impaired fasting glucose and major adverse cardiovascular events by hypertension and dyslipidemia status: The Golestan cohort study

Background: Whether pre-diabetes in the absence of hypertension (HTN) or dyslipidemia (DLP) is a risk factor for occurrence of major adverse cardiovascular events (MACE) is not fully established. We investigated the effect of impaired fasting glucose (IFG) alone and in combination with HTN, DLP or both on subsequent occurrence of MACE as well as individual MACE components. Methods: This longitudinal population-based study included 11,374 inhabitants of Northeastern Iran. The participants were free of any cardiovascular disease at baseline and were followed yearly from 2010 to 2017. Cox proportional hazard models were fitted to measure the hazard of IFG alone or in combination with HTN and DLP on occurrence of MACE as the primary endpoint. Results: Four hundred thirty-seven MACE were recorded during 6.2 ± 0.1 years follow up. IFG alone compared to normal fasting glucose (NFG) was not associated with an increase in occurrence of MACE (HR, 0.87; 95 CI, 0.19-4.02; p, 0.854). However, combination of IFG and HTN (HR, 2.88; 95 CI, 2.04-4.07; p, 0.000) or HTN + DLP (HR, 2.98; 95 CI, 1.89-4.71; p, 0.000) significantly increased the risk for MACE. Moreover, IFG + DM with or without HTN, DLP, or both was also associated with an increase in the incidence of MACE. Conclusion: IFG, per se, does not appear to increase hazard of MACE. However, IFG with HTN or HTN + DLP conferred a significant hazard for MACE in an incremental manner. Moreover, IFG without HTN, adjusted for DLP, can be associated with an increase in the risk for CVD- death. © 2020 The Author(s)