scholarly journals Insulin therapy in the hospital setting: a time for a change?

2016 ◽  
Vol 10 (1) ◽  
pp. 23
Author(s):  
Ada Maffettone ◽  
Massimo Rinaldi ◽  
Luigi Ussano ◽  
Andrea Fontanella
Keyword(s):  
Hospital Setting ◽  
The Other ◽  
Hospital Inpatient ◽  
Insulin Administration ◽  
Diabetes Treatment ◽  
Successful Management ◽  
Pros And Cons ◽  
Insulin Pens

The number of people with diabetes mellitus worldwide is expected to be more than double from 171 million in 2000 to 366 million in 2030. Approximately 25% of all hospital inpatient days are affected by diabetes. In Italy there are more than 12,000 hospitalizations excesses for 100,000 people per year, with a huge economic impact. Ever since its discovery in the 1920s, insulin has been the milestone of type 1 diabetes treatment and its use is increasingly necessary for the successful management of type 2 diabetes. Often patients believe that injecting insulin can be painful, inconvenient and embarrassing; generally they are afraid of gaining weight and of hypoglycemia. On the other side, physician’s concerns regarding insulin administration include potential dosing errors and patient non-compliance. Ever since its discovery in the mid-1920s, insulin was administered subcutaneously using a vial and syringe. In 1985 the first pen device was launched. Currently disposable insulin pens are the most used and preferred by patients in the daily use, but are not routinely used for diabetic inpatients. In this paper we will focus on the pros and cons of insulin administration with pens in the hospital setting.

The pseudomalachite-ludjibaite-reichenbachite conundrum: OD description

2019 ◽  
Vol 57 (5) ◽  
pp. 571-581
Author(s):  
Emil Makovicky
Keyword(s):  
Crystal Structures ◽  
Current Knowledge ◽  
The Other ◽  
Crystal Chemical ◽  
Layer System ◽  
Coordination Polyhedra

Abstract Crystal structures of the three polymorphs of Cu5(PO4)2(OH)4, namely pseudomalachite, ludjibaite, and reichenbachite, can be described as being composed of rods perpendicular to their crystal-chemical layering. Two different sorts of rods can be defined. Type 1 rods share rows of Cu coordination polyhedra, forming a series of slabs. Slab boundaries and slab interiors represent alternating geometric OD layers of two kinds, with layer symmetries close to P21/m and , which make up two different stacking schemes of geometric OD layers in the structures of ludjibaite and pseudomalachite. Such OD layers, however, are not developed in reichenbachite. Type 2 rods are defined as having columns of PO4 tetrahedra in the corners of the rods. In the Type 2 slabs composed of these rods, geometric Pg OD layers of glide-arrayed tetrahedra alternate with more complex OD layers; in ludjibaite this system of layers is oriented diagonally with respect to the Type 1 OD layer system. Two different OD stackings of Type 2 OD layers form the ludjibaite and reichenbachite structures but not that of pseudomalachite. Thus, ludjibaite might form disordered intergrowths with either of the other two members of the triplet but reichenbachite and pseudomalachite should not form oriented intergrowths. Current knowledge concerning formation of the three polymorphs is considered.

Comparing the Arrangements of Governance and Sustainable Development in OECD Countries: Coupled or Decoupled?

2019 ◽  
Vol 34 (1) ◽  
pp. 99-117
Author(s):  
Huh Taewook
Keyword(s):  
Sustainable Development ◽  
Oecd Countries ◽  
The Other ◽  
Type Analysis ◽  
Ideal Types ◽  
Type 3 ◽  
Relationship Of ◽  
The Relationship

This study attempts to analyze to what extent governance and sustainable development (SD) empirically appear compatible in the thirtyfive OECD countries through the fuzzy-set ideal type analysis, and identify which ideal types appear coupled or decoupled, and then reveal which countries belong to the coupled types or to the decoupled types. In short, twenty-two countries (including Sweden (fuzzy score, 0.953), Denmark (0.920), Finland (0.914), Norway (0.911) in Type 1 (G*S, ‘strong G-S coupled countries’); and Turkey (0.906), Greece (0.833), Mexico (0.828) in Type 4 (g*s, ‘lite g-s coupled countries’) are in line with the accepted conventions regarding the compatible relationship between governance and SD. On the other hand, the rest of thirteen countries (including USA (fuzzy score, 0.815), Luxembourg (0.721), Australia (0.660) in Type 2 (G*s, ‘G-s decoupled countries’); and Slovenia (0.728), France (0.644), Czech Rep. (0.625) in Type 3 (g*S, ‘g-S decoupled countries’) may indicate that the relationship of governance and SD is in fact experiencing tensions in the national contexts. These findings are characterized by the substance (of SD) and procedure (of governance) divide. Considering the results, this study focuses on the idea of reflexivity or reflexive capacity.

Abstract 281: Cerebral Regional Oxygen Saturation (rSO 2 ) is Useful as a Physiological Monitoring Tool During CPR in the Pre-Hospital Settings. An Analysis of 87 Cases in Osaka, Japan

Circulation ◽  
2019 ◽  
Vol 140 (Suppl_2) ◽  
Author(s):  
Shinji Shigematsu ◽  
Tomohiko Sakai ◽  
Tadahiko Shiozaki ◽  
Mitsuo Ohnishi ◽  
Ryosuke Takegawa ◽  
...  
Keyword(s):  
Oxygen Saturation ◽  
Primary Outcome ◽  
Hospital Setting ◽  
Primary Outcome Measure ◽  
Monitoring Tool ◽  
Non Invasive ◽  
Invasive Method ◽  
Neurologically Intact

Introduction: The simplified monitoring of regional cerebral oxygen saturation (rSO 2 ) is a non-invasive method of measuring cerebral perfusion, but continuous changes in the cerebral rSO 2 values among OHCA patients in the pre-hospital settings have not been sufficiently investigated. Our objective is to investigate the association between the change in rSO 2 pattern and patient outcome. Methods: We recently developed a very small portable rSO 2 monitoring system that can be used in the pre-hospital setting. The system can monitor cerebral rSO 2 immediately after attachment; monitoring is performed continuously during CPR. The system was used from June 2013 to May 2019 in Osaka City, Japan.The primary outcome measure was neurologically intact survival at 1 month. Results: We collected the continuous changes in the cerebral rSO 2 values of 87 OHCA patients during CPR by EMS personnel. The analyses of the continuous changes in the rSO 2 values of the 79 cases in which the rSO 2 value was measured before ROSC revealed two patterns of changes in the cerebral rSO 2 values. In type 1 (increasing rSO 2 type; n=38), the measured rSO 2 gradually increased during CPR or after ROSC. There were 3 patients of neurologically intact survival in type 1. In type 2 (non-increasing rSO 2 type; n=41), the measured rSO 2 did not increase during CPR. There was no patient of neurologically intact survival in type 2. We found an instructive phenomenon in the changes of the cerebral rSO 2 values. Measured rSO 2 dropped after confirmation of ROSC, which suggests that re-arrest had occurred during monitoring. Conclusion: We measured the continuous changes in cerebral rSO 2 values among 87 patients with OHCA in the pre-hospital setting and found 2 patterns and an instructive phenomenon in the continuous changes in rSO 2 values. Increasing type rSO 2 during CPR appeared to be associated with neurologically intact survival at 1 month.

Relational problems are not fully solved by a temporal sequence of statistical learning episodes

1997 ◽  
Vol 20 (1) ◽  
pp. 82-82 ◽  
Author(s):  
A. Vinter ◽  
P. Perruchet
Keyword(s):  
Implicit Learning ◽  
Statistical Learning ◽  
Temporal Sequence ◽  
The Other ◽  
Learning Mechanisms ◽  
Learning Research ◽  
The One

Clark & Thornton's conception finds an echo in implicit learning research, which shows that subjects may perform adaptively in complex structured situations through the use of simple statistical learning mechanisms. However, the authors fail to draw a distinction between, on the one hand, subjects' representations which emerge from type-1 learning mechanisms, and, on the other, their knowledge of the genuine abstract “recoding function” which defines a type-2 problem.

scholarly journals HOMOTYPIC COMPLEMENT-FIXING ANTIBODY IN MONKEYS INFECTED WITH TYPE 2 POLIOMYELITIS VIRUS BY THE ORAL ROUTE

1952 ◽  
Vol 96 (1) ◽  
pp. 55-58 ◽  
Author(s):  
Jordi Casals ◽  
Peter K. Olitsky ◽  
Albert B. Sabin
Keyword(s):  
Neutralizing Antibody ◽  
Oral Route ◽  
The Other ◽  
Human Beings ◽  
Serum Dilution ◽  
Cynomolgus Monkeys ◽  
Inapparent Infection ◽  
Order Of Magnitude

CF tests with Type 2 poliomyelitis antigen (MEF1) were performed on the pre- and postinfection sera of 20 cynomolgus monkeys which developed paralytic, non-paralytic, or inapparent infection following oral administration of a Type 2 strain of virus (Y-SK). All the monkeys developed neutralizing antibody, and 17 developed CF antibody in an original serum dilution titer of 1:4 or greater. The 3 monkeys which did not develop this level of CF antibody were in a group of 7 which died within 8 days after onset of paralysis. The CF titers were as high at 2 to 6 days after onset of paralysis in the other 4 moribund or dead monkeys as in the surviving animals tested 4 weeks after the first dose of virus and the CF titers were of the same order of magnitude in the groups with paralytic, non-paralytic, or inapparent infection. The Type 2 poliomyelitis CF titers developed in monkeys as a result of infection with homotypic virus were not greater than those found in human beings infected with heterotypic Type 1 poliomyelitis strains.

scholarly journals A Decomposable Branching Process in a Markovian Environment

2012 ◽  
Vol 2012 ◽  
pp. 1-24 ◽  
Author(s):  
Vladimir Vatutin ◽  
Elena Dyakonova ◽  
Peter Jagers ◽  
Serik Sagitov
Keyword(s):  
Survival Probability ◽  
Branching Process ◽  
The Other ◽  
Variable Environment ◽  
Markovian Environment ◽  
Constant Environment ◽  
Environment Type

A population has two types of individuals, with each occupying an island. One of those, where individuals of type 1 live, offers a variable environment. Type 2 individuals dwell on the other island, in a constant environment. Only one-way migration () is possible. We study then asymptotics of the survival probability in critical and subcritical cases.

scholarly journals Modern basal insulins: an ongoing story or the start of a new era?

2015 ◽  
Vol 18 (4) ◽  
pp. 5-11
Author(s):  
Ivan Ivanovich Dedov
Keyword(s):  
Basal Insulin ◽  
Diabetes Management ◽  
Insulin Analogues ◽  
Diabetes Treatment ◽  
New Era ◽  
Patients With Diabetes ◽  
Neutral Protamine Hagedorn ◽  
Long Acting

Basal insulin represents an essential tool in the treatment of both type 1 and type 2 diabetes mellitus. The development of insulin analogues has improved the possibilities of diabetes treatment. Despite significant progress in understanding the physiology, chemistry, kinetics and action of insulin, currently available basal insulin products do not optimally mimic the endogenous profile of insulin. Although basal insulin analogues have some advantages over neutral protamine Hagedorn insulin in diabetes treatment, hypoglycaemia remains the main problem in the achievement of optimal glycaemic control in most patients with diabetes. These unmet clinical needs have stimulated the development of new basal insulin analogues with improved pharmacological profiles. This article reviews the specific characteristics of new long-acting insulin analogues to try and understand their benefits and limitations in the improvement of diabetes management and their possibilities in physiologic and safe insulin replacement.

scholarly journals The role of glucocorticoid in the regulation of prostaglandin biosynthesis in non-pregnant bovine endometrium

2007 ◽  
Vol 193 (1) ◽  
pp. 127-135 ◽  
Author(s):  
Hwa-Yong Lee ◽  
Tomas J Acosta ◽  
Michiyo Tanikawa ◽  
Ryosuke Sakumoto ◽  
Junichi Komiyama ◽  
...  
Keyword(s):  
Mrna Expression ◽  
Estrous Cycle ◽  
Stromal Cells ◽  
Endometrial Tissue ◽  
The Other ◽  
Pcr Analysis ◽  
Factor Α

To determine whether glucocorticoids (GCs) play a role in regulating uterine function in cow, the present study examined the expression of mRNA encoding GC receptor (GC-R) α, 11β-hydroxysteroid dehydrogenase (11-HSD) type 1 and type 2, and the activity of 11-HSD1 in bovine endometrial tissue throughout the estrous cycle. We also studied the effects of cortisol on basal, oxytocin (OT)- and tumor necrosis factor-α (TNFα)-stimulated prostaglandin (PG) production. A quantitative real-time PCR analysis revealed that GC-Rα mRNA was expressed more strongly in the mid-luteal stage (days 8–12) than in the other stages. In contrast to GC-Rα mRNA expression, 11-HSD1 mRNA expression was greater in the follicular stage than in the other stages, whereas 11-HSD2 mRNA expression was lowest in the follicular stage. The activity of 11-HSD1 was greater in the follicular stage and estrus than in the other stages and was lowest in the mid-luteal stage. Cortisone was dose-dependently converted to cortisol in the cultured endometrial tissue. Although cortisol did not affect either the basal or OT-stimulated production of PGs in the cultured epithelial cells, the production of PGs stimulated by TNFα in the stromal cells was suppressed by cortisol (P < 0.05). Cortisol suppressed basal prostaglandin (PG)F2α without affecting basal PGE2 production in the stromal cells. The overall results suggest that the level of cortisol is locally regulated in bovine endometrium throughout the estrous cycle by 11-HSD1, and that cortisol could act as a luteoprotective factor by selectively suppressing luteolytic PGF2α production in bovine endometrium.

Diabetes-related distress is reduced in people with type 1, but not type 2 diabetes after participating in a diabetes treatment and teaching programme

2019 ◽  
Vol 45 (3) ◽  
pp. 310-312 ◽  
Author(s):  
N. Kuniss ◽  
U.A. Müller ◽  
C. Kloos ◽  
V. Jörgens ◽  
G. Kramer
Keyword(s):  
Type 2 Diabetes ◽  
Diabetes Treatment ◽  
Teaching Programme
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