Prevalence and Risk Factors of Sensory Symptoms in Diabetes Patients in Taiwan

BackgroundDiabetic sensory neuropathy has rarely been studied in the Asian populations. This study investigated the prevalence and risk factors of sensory symptoms (SS) in the Taiwanese diabetes patients.MethodsA total of 1,400 diabetes patients received a health examination together with a structured questionnaire interview for three categories of abnormal sensation of numbness or tingling pain, electric shock, and skin thickness sensation on seven anatomical sites on upper limbs and six sites on lower limbs. Prevalence of SS was defined using nine different criteria, with the least stringent criterion of “any positive symptom on at least 1 site” and the most stringent criterion of “any positive symptom on at least bilateral and symmetrical 2 sites involving the lower limb.” Logistic regression was used to estimate the odds ratios and their 95% confidence interval for SS by the different definitions. Fasting plasma glucose and hemoglobin A1c were entered in separate models to avoid hypercollinearity.ResultsThe prevalence of SS was 14.4 and 54.0% when using the most stringent and least stringent criterion, respectively. Women consistently had a significantly higher prevalence than men did. Among the three categories of symptoms, numbness or tingling pain was the most common, and fingers and toes were the most commonly involved anatomical sites. For any symptoms, 37.1% of the patients had any symptoms on the upper limbs and 41.7% had any symptoms on the lower limbs. Female sex, diabetes duration, hemoglobin A1c, and hypertension were associated with SS in all models.ConclusionsTaiwanese diabetes patients may have a high prevalence of SS if a structured questionnaire is used for screening. Female sex, diabetes duration, hemoglobin A1c, and hypertension are associated with SS.

Post hoc analyses of response rates to pharmacological treatments in children and adolescents with attention-deficit/hyperactivity disorder

Introduction and objectives: Lack of consensus regarding how best to define treatment response hinders translation from trials to the clinic. These post hoc analyses examine three commonly used response criteria in six trials of lisdexamfetamine dimesylate (LDX) in children and adolescents with attention-deficit/hyperactivity disorder (ADHD). Methods: Data from four short-term randomised controlled trials (RCTs) and two long-term open-label studies were analysed. Children and adolescents with ADHD received either dose-optimised (30–70 mg/day) or fixed-dose (70 mg/day) LDX. The RCTs included osmotic-release oral system methylphenidate (OROS-MPH) or atomoxetine (ATX) as a head-to-head comparator or as a reference treatment. Three definitions of response were used in these analyses: reductions of ⩾30% or ⩾50% in ADHD Rating Scale IV (ADHD-RS-IV) total score plus a Clinical Global Impressions – Improvement (CGI-I) score of 1 or 2, or an ADHD-RS-IV total score of ⩽18. Results: At the end point, LDX response rates for the least stringent criterion of ⩾30% reduction in ADHD-RS-IV total score plus a CGI-I score of 1 or 2 ranged from 69.6% to 82.6%. The proportion achieving the more stringent criterion of a reduction in ADHD-RS-IV total score of ⩾50% plus a CGI-I score of 1 or 2 at the end point ranged from 59.8% to 74.8%. An ADHD-RS-IV total score of ⩽18 at the end point was achieved by 56.7–79.9% of participants. Response rates remained stable throughout the long-term open-label studies. Conclusions: Response rates were similar for the two more stringent response criteria. The less stringent criterion resulted in higher response rates and may include partial responders.

Who has been a successful public intellectual?

A stringent criterion for a public intellectual is proposed: persons who are simultaneously major creative intellectuals, and successful political leaders. Using data from the careers of 2700 philosophers throughout world history, and social scientists in recent centuries, the article concludes that three kinds of political failure by intellectuals are prominent: (1) failure to attain political office; (2) failure while in office; and (3) failure of political influence from adoption of one’s ideas. On the whole, major intellectuals are not good at politics; and politicians do not make outstanding intellectuals. The skills and pressures of the two spheres are too different.

Multi-use and constraints from original use

Anderson's theory is plausible and largely consistent with the data. However, it remains underspecified on several fronts, and we highlight areas for potential improvement. Reuse is described as duplicating a functional component, preserving one function and tinkering to add another function. This is a promising model, but Anderson neglects other reasonable alternatives and we highlight several. Evidence cited in support of reuse fails to uniquely support it among a broader set of multi-use theories. We suggest that a more stringent criterion for direct support of reuse may be satisfied by focusing on previous adaptive functions (original use).

On Reading and Arguing: A Reply to Ahiakpor

To declare my case “not proven” is irrelevant. I agree my case is not proven, but all other cases on this topic, including Ahiakpor's, are equally unproven. Arguing about proof here is a waste of time. We simply do not have enough data for deductive certainty or even for the less stringent criterion of “proof beyond reasonable doubt.” The written record is not conclusive and the protagonists are dead. What is not a waste of time, however, is discussing probabilistic inferences from incomplete evidence.

Adequacy of Advance Tree-Seedling Regeneration in Pennsylvania's Forests

Measurement of tree seedlings and herbaceous vegetation from 499 sample locations across Pennsylvania revealed that advance tree-seedling regeneration is inadequate for new stand establishment across most of the State. The samples were located in stands from 40% to 75% stocked to focus on stands with ample light and growing space for establishment of abundant advance regeneration. A range of regeneration adequacy criteria was applied to the measurements. Using the least stringent criterion, a low density of stems of any tree species, resulted in 40% of the sample locations being adequately stocked. Applying the most stringent criterion, a high density of stems of desirable species, resulted in only 4% of the sample locations being adequately stocked. With the exception of forest-type group, no significant relationship was found between the adequacy of regeneration and other variables tested at the broad level of geographic scale of this study. Levels of fern and grass sufficient to hamper tree-seedling development were found at 54% of the sample locations. Fern species that propagate primarily by spreading rhizomes accounted for 70% of the total fern sample. North. J. Appl. For. 12(4):187-191.

Judgments of Sentence Grammaticality and Field-Dependence of Subjects

11 field-dependent and 14 field-independent students rated the relative grammaticality of sentences three times, with sentences presented repeatedly during the first and second judgments. All the subjects received negative reinforcement after the second judgments. Analyses showed that field-independent subjects tended to adopt a more stringent criterion on judgments after than before repetition, whereas no change in criterion was found for field-dependent subjects. Negative reinforcement showed only a tendency to lead field-dependent subjects toward greater change to a more lenient criterion than field-independent subjects. Change in judgments of grammaticality are reliably associated with the cognitive style of subjects, field dependence or field independence.

Judgments of Sentence Grammatically with Differentiation and Enrichment Strategies

30 students rated the relative grammaticality of isolated sentences twice, with sentences presented repeatedly between the two judgments. Subjects were asked to adopt either a differentiation or an enrichment strategy during a repetition phase. The former strategy involved differentiation by structurally analyzing the sentences, while the latter involved enrichment by supplying situational contexts for the sentences. Analysis showed an interaction between a strategy adopted and the time of judgments such that the subjects instructed to adopt a differentiation strategy tended to use a more stringent criterion on judgments after than before repetition, whereas the subjects asked to adopt an enrichment strategy showed a slight tendency to use a more lenient criterion. These findings indicated that these two types of mental processes are involved in part in the change in criterion for judgments of grammaticality as shown in previous studies.

Differential diagnosis of CT-hypodense cranial lesions with indium-111-oxine-labeled leukocytes

✓ Scintigraphy using indium-111-oxine-labeled white blood cells was used as a complementary diagnostic study in the differential diagnosis of 20 intracerebral cystic lesions for which computerized tomography scanning did not exclude cerebral abscess. To lower the rate of false-positive findings with scintiscanning, three criteria of positivity were tested in the 20 lesions. The most stringent criterion yielded 100% sensitivity, 94% specificity, and 96% diagnostic accuracy. The clinical and surgical implications of these results are discussed.

Adequacy of interlaboratory precision criteria in measuring intralaboratory performance.

We compared the predictive value of the various criteria used for grading pH and blood-gas measurements in interlaboratory proficiency testing programs with performance as determined from actual intralaboratory quality-assurance data. The evaluation criteria were the two-standard-deviation interval (2 SDI) proposed by the College of American Pathologists (CAP); CAP's proposed fixed criteria; and the fixed criteria of the American Thoracic Society (ATS). These were compared with 95% confidence limits derived from the individual laboratories' actual intralaboratory data. We found that the CAP's most-stringent criterion (2 SDI) overestimated the number of outliers (unacceptable results) for PCO2 and PO2, whereas the proposed fixed limits underestimated them. For pH and PCO2 the ATS's limits, which are more stringent, more closely match the individual laboratory's actual performance as measured by conventional (mean +/- 2 SD) intralaboratory quality-assurance practices.