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Nevin Manimala Statistics

Efficacy and safety of dulaglutide compared with glargine in patients with type 2 diabetes: A systematic review and meta-analysis

J Clin Pharm Ther. 2021 Mar 6. doi: 10.1111/jcpt.13398. Online ahead of print.

ABSTRACT

WHAT IS KNOWN AND OBJECTIVE: One of the effective and consistent ways to achieve glycaemic control for patients with type 2 diabetes mellitus (T2DM) is once-daily basal insulin. But it is also associated with adverse outcomes such as hypoglycaemia. Dulaglutide, a novel long-acting GLP-1 receptor agonist, may be a more suitable therapy. The present meta-analysis aims to assess the efficacy and safety of once-weekly glucagon-like peptide-1 receptor agonist dulaglutide compared with insulin glargine for the treatment of T2DM.

METHODS: We searched PubMed, Embase and Cochrane Library from inception to December 2020. Randomized clinical trials comparing dulaglutide with insulin glargine in adults with T2DM were included. Revman5.2 software was used for meta-analysis.

RESULTS AND DISCUSSION: We included 5 studies with 3383 randomized participants. Compared with insulin glargine, dulaglutide 1.5 mg led to greater mean HbA1c reduction (MD = -0.33%, 95% CI = -0.52, -0.15) whereas dulaglutide 0.75 mg did not (MD = -0.21%, 95% CI = -0.43, 0.01). Body weight loss was seen with dulaglutide whereas weight gain was seen with insulin glargine. The risk of hypoglycaemia was lower in dulaglutide 0.75 mg and 1.5 mg groups than in insulin glargine group,whereas dulaglutide had a statistically higher gastrointestinal adverse events incidence than insulin glargine.

WHAT IS NEW AND CONCLUSIONS: Compared with insulin glargine, dulaglutide may serve as an effective alternative to provide improvement in glycaemic control with weight loss and less hypoglycaemia in patients with T2DM. It may be a more suitable therapy instead of basal insulin.

PMID:33675117 | DOI:10.1111/jcpt.13398

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Nevin Manimala Statistics

Echocardiographic reference intervals for volumetric measurements of the left ventricle using the Simpson’s method of discs in 1331 dogs

J Vet Intern Med. 2021 Mar 6. doi: 10.1111/jvim.16089. Online ahead of print.

ABSTRACT

BACKGROUND: Echocardiographic measurements play an important role in detecting cardiac enlargement and assessing cardiac function. In human cardiology, M-mode measurements have been widely replaced by volumetric measurements of the left ventricle (LV) using Simpson’s method of disc (SMOD). In veterinary cardiology, more large-scale studies are necessary to generate reference intervals (RIs) for SMOD LV volume measurements.

OBJECTIVE: To generate body size independent RIs for LV volume measurements in dogs.

ANIMALS: Healthy adult dogs (n = 1331) of variable size and somatotype.

METHODS: Prospective study. The SMOD was measured from the right parasternal long axis and the left apical 4-chamber view in clinically healthy dogs. The SMOD measurements were normalized to various allometric scales (kg, kg2/3 , or kg1/3 ). RIs for LV end-diastolic volume (LVEDV) and LV end-systolic volume (LVESV) using SMOD were estimated as prediction intervals of both a linear and an additive regression model. Additionally, after normalization to body weight, 95% RIs were determined using nonparametric methods with 2.5 and 97.5 percentiles serving as the lower and upper limits. Separate analyses were performed for 120 sighthound breeds and 1211 other breeds.

RESULTS: Echocardiographic LV volumes correlated best with weight in kilograms. The additive model proved to be more flexible and accurate than the other 2 methods to generate RIs. Separate RIs for sighthound and all other breeds are provided.

CONCLUSIONS AND CLINICAL IMPORTANCE: Body size and breed-independent RIs for LV volume measurements using SMOD were generated prospectively from a large and diverse population of dogs and are available for clinical use.

PMID:33675121 | DOI:10.1111/jvim.16089

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National profile of the growing population of older adults who access community health centers

J Am Geriatr Soc. 2021 Mar 5. doi: 10.1111/jgs.17088. Online ahead of print.

ABSTRACT

BACKGROUND: Community health centers (CHCs) are federally funded safety-net clinics that provide care to low income and medically underserved persons. The proportion of CHC patients aged ≥65 doubled in the last ten years, yet little is known about this population. We aim to describe the demographic and clinical characteristics of the older adult CHC population.

DESIGN: Cross sectional analysis.

SETTING: The nationally representative 2014 Health Center Patient Survey.

PARTICIPANTS: CHC patients ≥55 years.

MEASURES: We used descriptive statistics to characterize older adults across demographic and clinical variables. To determine differences by age, we stratified into three groups (55-64, 65-74, 75+ years). We used t-tests and chi-squared to calculate p values and survey weights to make national estimates.

RESULTS: We included 1875 older adults ≥55 years, representing over 4.2 million people. Older adults were mostly aged 55-64 (60%), female (51%), and white (60%). The majority (73%) had Medicare or Medicaid and 47% reported fair or poor health. Regardless of age, older adults had an average of three chronic conditions and 0.6 impairments in activities of daily living (ADL). Healthcare utilization was not significantly different across age groups with most taking ≥5 prescription medications (54%) and one in five reporting ≥2 emergency department visits or ≥1 hospitalization in the last year.

CONCLUSIONS: Adults 55-64 who attend CHCs have similar disease burden as adults ≥65. As the population of older adults who access CHCs grow, our findings highlight the opportunity to enhance focus on key principles of geriatric medicine, such as measurement of functional impairment for those who are <65 while also addressing underlying health disparities.

PMID:33675077 | DOI:10.1111/jgs.17088

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Letter to the Editor. Restructuring the Gut Microbiota of Cirrhotic Patients after HCV Eradication: a Matter of Time?

Hepatology. 2021 Mar 5. doi: 10.1002/hep.31784. Online ahead of print.

ABSTRACT

we read with interest the paper by Wellhöner et al. (1) about the effect of eradication of hepatitis C virus (HCV) infection on the gut microbiota. The Authors report that sustained virological response (SVR) at 24/48 weeks after hepatitis C virus (HCV) treatment does not lead to statistically significant changes in the gut microbiota of cirrhotic patients, but only in those with chronic hepatitis. Unfortunately, the Authors do not state the number of these two subgroups.

PMID:33675101 | DOI:10.1002/hep.31784

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Nevin Manimala Statistics

Feasibility and acceptability of home-based strength training in endometrial cancer survivors

J Cancer Surviv. 2021 Mar 6. doi: 10.1007/s11764-021-00990-3. Online ahead of print.

ABSTRACT

PURPOSE: Physical activity is important for healthy cancer survivorship, yet many endometrial cancer survivors do not participate in recommended muscle-strengthening activity. The purpose of this study was to determine the feasibility of home-based muscle strengthening activity in endometrial cancer survivors.

METHODS: Forty post-treatment endometrial cancer survivors were enrolled in a randomized trial, of twice-weekly home-based strength exercise versus wait-list control. The intervention included educational materials, exercise equipment (dumbbells, resistance bands), and support/feedback via video coaching sessions. Participants completed the exercises twice per week for 10 weeks, with a 5-week follow-up period. Feasibility was measured by program adherence, as well as safety of and satisfaction with the study.

RESULTS: On average, participants were 60.9 years old (SD = 8.7), had a BMI of 39.9 kg/m2 (SD = 15.2), and were 2.9 years (SD = 1.2) since diagnosis. The majority (83%) had stage I disease at diagnosis. Seventy-five percent adhered to the exercise prescription of twice/week, with 85% of participants missing fewer than 3 of the workouts. Forty percent of participants continued workouts during the 5-week follow-up. Participants were highly satisfied with intervention. No injuries or adverse everts occurred.

CONCLUSION: This home-based program was feasible in endometrial cancer survivors. While adherence was measured, future research should focus on long-term maintenance of exercise and should explore progressions and modifications of exercises at a distance for various abilities.

IMPLICATIONS FOR CANCER SURVIVORS: Muscle strengthening activities are recommended for all cancer survivors. This study shows that a home-based muscle strengthening exercise is feasible in endometrial cancer survivors.

PMID:33675013 | DOI:10.1007/s11764-021-00990-3

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Nevin Manimala Statistics

Intensification, regulation and diversification: The changing face of inland aquaculture in China

Ambio. 2021 Mar 5. doi: 10.1007/s13280-021-01503-3. Online ahead of print.

ABSTRACT

Trends in aquatic food consumption were matched against farm production surveys within Hubei province and compared to official production data and statistics. Surveys showed that consumer tastes were changing to a much broader aquatic food menu as their spending power increased. Traditional aquaculture species were becoming less profitable due to reduced profit margins as input costs increased and consumption preferences changed. Consequently, many producers were diversifying their production to meet local demand. Some farmers were also de-intensifying by reducing commercial aquafeed inputs and reverting to more traditional methods of dyke-crop culture to optimise trade-offs between input costs and labour, and manage their risk more effectively. In addition, analysis of local data showed that wholesale changes were occurring to aquaculture production as environmental protection legislation took effect which reduced the growing area for carps considerably.

PMID:33675016 | DOI:10.1007/s13280-021-01503-3

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HLA-DRB1 molecules and the presentation of anchor peptides from RhD, RhCE, and KEL proteins

Transfusion. 2021 Mar 5. doi: 10.1111/trf.16313. Online ahead of print.

ABSTRACT

BACKGROUND: Antigens from the Rh and Kell systems are recognized as the most immunogenic in clinical practice. This study evaluated the possible molecular mechanisms involved in the interaction of antigenic peptides with the DRB1 molecules, which help to explain the high frequency of anti-K and association of D + C antibodies in transfusion and incompatible pregnancy.

STUDY DESIGN AND METHODS: We included 201 patients with antibodies against antigens from the Rh and Kell systems and compare them with 174,015 controls. HLA-DRB1 genotyping and in silico analysis were performed. The NetMHCIIpan software was used to identify RhD-, RhCE-, and KEL-derived anchor peptides that bind to DRB1 molecules.

RESULTS: HLA-DRB1*15 is associated with an increased risk of D, C, E, and K alloimmunization, while the HLA-DRB1*01 and *12 alleles are overrepresented in patients with anti-C and anti-D, respectively. In silico analysis showed that three polymorphic points (60I, 68S, and 103S) common to C and D antigens can be presented by several DRB1 molecules, including DRB1*15:01. The DRB1*09:01 molecule, although not showing statistical significance, was able to interact strongly with almost all five anchor peptides from the sequence containing the polymorphic determinants of E antigen, except 217-WMFWPSVNS-225.

CONCLUSION: The DRB1*15 molecule has specific physicochemical characteristics in residues 11P and 13R in the P4 pocket that can favor the response to various antigenic peptides. Anti-K alloimmunization is unrestricted for interaction with specific DRB1 molecules, which suggests that almost all individuals in our population have DRB1 molecules capable of binding to KEL-derived anchor peptides and produce anti-K when stimulated.

PMID:33675036 | DOI:10.1111/trf.16313

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Optimal path for overcoming barriers in developing China’s wind energy industry

Environ Sci Pollut Res Int. 2021 Mar 5. doi: 10.1007/s11356-021-12531-7. Online ahead of print.

ABSTRACT

Developing the wind energy industry (WEI) has been a long-term strategy in China for responding to the energy crisis and greenhouse gas emissions. However, China’s WEI faces various barriers despite its favorable prospects. This paper aims to propose a path analysis approach for exploring the best methods and timing for overcoming diverse barriers in developing WEI systematically, especially in terms of revealing in which phases these barriers should take priority. A multidimensional barrier set categorized by institutional, economic and financial, social, technical, and market factors is identified via the integration of a literature review and empirical interviews. A path analysis approach based on the grey group DEMATEL-NK model is constructed, where the causalities and intensities among barriers are extracted to design a path simulation algorithm with heuristics. The optimal path for overcoming barriers in developing the WEI is generated through a simulation of the search and optimization process used to climb to the fitness landscape peak. The results show that the different barriers to completing the legal and regulatory framework should be prioritized to reach adequate financial incentives and coordination among stakeholders, and that an efficient talent cultivation system should be developed and industry-academic cooperation should be strengthened to increase technical and R&D capabilities in the short term. The optimal path presents a strategic instrument for managers to use to better develop sustainable and clean wind energy systems from the novel insights of prioritizing to overcome barriers.

PMID:33674972 | DOI:10.1007/s11356-021-12531-7

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gPROMS-driven modeling and simulation of fixed bed adsorption of heavy metals on a biosorbent: benchmarking and case study

Environ Sci Pollut Res Int. 2021 Mar 5. doi: 10.1007/s11356-021-13207-y. Online ahead of print.

ABSTRACT

Adsorptive separation of heavy metals from wastewater is a viable approach to reuse it and avoid environmental pollution. The productive employment of adsorptive separation at a commercial scale, however, relies on the optimized conditions of an adsorber bed holding maximum and selective isolation of the heavy metals. The experimental route includes a significant trial and error approach, is time-consuming, involves operating cost, and remains economically unattractive. Contrarily, simulation of a mathematical model mimicking the adsorption system along with experimental validation can significantly minimize optimization efforts and suggests the best conditions of separation. In this work, a convective-dispersive model and adsorption model for fixed bed adsorption of copper (Cu), chromium (Cr), and cadmium (Cd) metals over wheat bran biosorbent are simulated using the gPROMS tool for benchmarking. The influence of feed flow rate, bed height, and metal concentration is studied, and breakthrough profiles of all heavy metals are predicted and matched with the literature. The error values (R2 and RMSE) and Chi-squared values determined from gPROMS simulations matched well with the previously available MATLAB-simulated data. After a successful benchmarking, we modeled pilot-scale adsorption of Cr on coconut coir (or Biosorbent) in a gPROMS simulation environment. A detailed method and algorithm of gPROMS simulation for Cr isolation is provided. The influence of feed flow rate, bed height, and initial metal concentration is studied on the breakthrough curves of the Cr. The optimum operating condition for the pilot-scale isolation of Cr from the water is suggested. The parameters, such as the axial dispersion coefficient and distribution coefficient, are determined.

PMID:33674977 | DOI:10.1007/s11356-021-13207-y

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Nevin Manimala Statistics

Effects of melatonin supplementation on disease activity, oxidative stress, inflammatory, and metabolic parameters in patients with rheumatoid arthritis: a randomized double-blind placebo-controlled trial

Clin Rheumatol. 2021 Mar 5. doi: 10.1007/s10067-021-05670-2. Online ahead of print.

ABSTRACT

OBJECTIVE: Considering the pathologic significance of inflammation and oxidative stress in rheumatoid arthritis (RA) as well as the antioxidant, anti-inflammatory and hypolipidemic effects of melatonin, the current research is designed to investigate the effect of melatonin supplementation on disease activity, oxidative stress, inflammatory, and metabolic parameters in RA patients.

METHODS: In this randomized double-blind, placebo-controlled trial, 64 RA cases were selected and randomly assigned into 2 groups to take 6 mg/day melatonin or placebo for 12 weeks. Before and after trial, serum malondialdehyde (MDA), total antioxidant capacity (TAC), erythrocyte sedimentation rate (ESR), lipid profile, fasting blood sugar (FBS), and insulin levels were measured and disease activity was determined by disease activity score-28 (DAS-28).

RESULTS: Compared to the baseline, melatonin significantly decreased DAS-28, ESR, MDA, and LDL-C by 50.5%, 59%, 97%, and 13%, respectively (P<0.001) and significantly increased TAC by 89% (P=0.013) and HDL-C by 22% (P<0.001). After treatment, considerable differences were only seen between the two groups in serum MDA (P<0.001) and LDL-C (P=0.007) concentrations, adjusted for baseline measures. Moreover, there were no significant changes in DAS-28, ESR, TAC, triglyceride, total cholesterol, HDL-C, FBS, and insulin levels compared to placebo group (P>0.05).

CONCLUSIONS: Although melatonin supplementation had no beneficial effects on DAS-28, it could lower serum MDA and LDL-C levels. It seems that melatonin supplementation should not be used as a replace for routine drugs prescribed in RA treatment. Further investigations should be conducted to fully understand the effects of melatonin in RA. Key Points • Compared to baseline, melatonin significantly decreased DAS-28, ESR, MDA, and LDL-C and significantly increased TAC and HDL-C. • After treatment, considerable differences were only seen between melatonin and placebo groups in serum MDA and LDL-C concentrations. • After treatment, there were no significant changes in DAS-28, ESR, TAC, triglyceride, total cholesterol, HDL-C, FBS, and insulin levels compared to the placebo group.

PMID:33674988 | DOI:10.1007/s10067-021-05670-2