Effects of regular insulin or insulin LISPRO on glucose metabolism after an oral glucose load in patients with type 2 diabetes mellitus.

Seven obese Type 2 diabetic patients were studied for two 4-h periods after ingestion of a glucose load to determine the effects of preprandial subcutaneous injection of Insulin Lispro (5 min before the meal) or regular insulin (20 min before the meal) on glucose metabolism. Glucose production and utilisation were measured using a dual isotope method. After Lispro, the mean postprandial increase in plasma glucose was 29% lower and the increase in insulin concentration 25% higher than after regular insulin (p < 0.05). Suppression of endogenous glucose production was similar with both types of insulin. Thus, preprandial injection of Lispro reduced postprandial glucose increments in Type 2 diabetic patients as compared to regular insulin. This effect is best explained by the increased postprandial bioavailability of Lispro.

Sensitivity to Change of the Ultrasound synovitis SONAR Score in RA Patients: Results of the Scqm Cohort

Background/Purpose: Since the end of 2009, an ultrasound scoring call SONAR has been implemented for RA patients as a routine tool in the SCQM registry (Swiss Clinical Quality Management registry for rheumatic diseases). A cross-sectional evaluation of patients with active disease and clinical remission according to the DAS28ESR and the novel ACR/EULAR remission criteria from 2010 clearly indicated a good correlational external validity of synovial pathologies with clinical disease activity in RA (2012 EULAR meeting. Objective: of this study was to evaluate the sensitivity to change of B-mode and Power-Doppler scores in a longitudinal perspective along with the changes in DAS28ESR in two consecutive visits among the patients included in the SCQM registry Methods: All patients who had at least two SONAR scores and simultaneous DAS28ESR evaluations between December 2009 and June 2012 were included in this study. The data came from 20 different operators working mostly in hospitals but also in private practices, who had received a previous teaching over 3 days in a reference center. The SONAR score includes a semi-quantitative B mode and Power-Doppler evaluation of 22 joints from 0 to 3, maximum 66 points for each score. The selection of these 22 joints was done in analogy to a 28 joint count and further restricted to joint regions with published standard ultrasound images. Both elbows and wrist joints were dynamically scanned from the dorsal and the knee joints from a longitudinal suprapatellar view in flexion and in joint extension. The bilateral evaluation of the second to fifth metacarpophalangeal and proximal interphalangeal joints was done from a palmar view in full extension, and the Power-Doppler scoring from a dorsal view with hand and finger position in best relaxation. Results: From the 657 RA patients with at least one score performed, 128 RA patients with 2 or more consultations of DAS28ESR, and a complete SONAR data set could be included. The mean (SD) time between the two evaluations was 9.6 months (54). The mean (SD) DAS28ESR was: 3.5 (1.3) at the first visit and was significantly lower (mean 3.0, SD.2.0, p:_0.0001) at the second visit. The mean (SD) of the total B mode was 12 (9.5) at baseline and 9.6 (7.6) at follow-up (p_0.0004). The Power-Doppler score at entry was 2.9 (5.7) and 1.9 (3.6), at the second visit, p _0.0001. The Pearson r correlation between change in DAS28ESR and the B mode was 0.44 (95% CI: 0.29, 0.57, p_ 0.0001),and 0.35 (95% CI: 0.16, 0.50, p _ 0.0002) for the Power-Doppler score,. Clinical relevant change in DAS (_1.1) was associated with a change of total B mode score _3 in 23/32 patients and a change a Doppler score _0.5 in 19/26. Conclusion: This study confirms that the SONAR score is sensitive to change and provides a complementary method of assessing RA disease activity to the DAS that could be very useful in daily practice.

Decision-making with distance measures and inducedaggregation operators

[spa] Se presenta un nuevo modelo para la toma de decisiones basado en el uso de medidas de distancia y de operadores de agregación inducidos. Se introduce la distancia media ponderada ordenada inducida (IOWAD). Es un nuevo operador de agregación que extiende el operador OWA a través del uso de distancias y un proceso de reordenación de los argumentos basado en variables de ordenación inducidas. La principal ventaja el operador IOWAD es la posibilidad de utilizar una familia parametrizada de operadores de agregación entre la distancia individual máxima y la mínima. Se estudian algunas de sus principales propiedades y algunos casos particulares. Se desarrolla un ejemplo numérico en un problema de toma de decisiones sobre selección de inversiones. Se observa que la principal ventaja de este modelo en la toma de decisiones es la posibilidad de mostrar una visión más completa del proceso, de forma que el decisor está capacitado para seleccionar la alternativa que está más cerca de sus intereses.

Decision-making with distance measures and inducedaggregation operators

[spa] Se presenta un nuevo modelo para la toma de decisiones basado en el uso de medidas de distancia y de operadores de agregación inducidos. Se introduce la distancia media ponderada ordenada inducida (IOWAD). Es un nuevo operador de agregación que extiende el operador OWA a través del uso de distancias y un proceso de reordenación de los argumentos basado en variables de ordenación inducidas. La principal ventaja el operador IOWAD es la posibilidad de utilizar una familia parametrizada de operadores de agregación entre la distancia individual máxima y la mínima. Se estudian algunas de sus principales propiedades y algunos casos particulares. Se desarrolla un ejemplo numérico en un problema de toma de decisiones sobre selección de inversiones. Se observa que la principal ventaja de este modelo en la toma de decisiones es la posibilidad de mostrar una visión más completa del proceso, de forma que el decisor está capacitado para seleccionar la alternativa que está más cerca de sus intereses.

Decision making techniques with similarity measures and OWA operators

We analyse the use of the ordered weighted average (OWA) in decision-making giving special attention to business and economic decision-making problems. We present several aggregation techniques that are very useful for decision-making such as the Hamming distance, the adequacy coefficient and the index of maximum and minimum level. We suggest a new approach by using immediate weights, that is, by using the weighted average and the OWA operator in the same formulation. We further generalize them by using generalized and quasi-arithmetic means. We also analyse the applicability of the OWA operator in business and economics and we see that we can use it instead of the weighted average. We end the paper with an application in a business multi-person decision-making problem regarding production management

Can 3T multiparametric magnetic resonance imaging accurately detect prostate cancer extracapsular extension?

BACKGROUND: Accurate staging is essential to determine the correct management of patients diagnosed with prostate cancer. We assess the accuracy of 3T multiparametric magnetic resonance imaging (MRI) with endorectal coil (3TemMRI) in detecting prostate cancer local extension. METHODS: We retrospectively reviewed charts from January 2008 to July 2012 from all patients undergoing radical prostatectomy. Patients were only included if 3TemMRI and radical prostatectomy were performed at our institution. Based on the presence of extracapsular extension (ECE) at 3TemMRI, prostate cancer was dichotomized into locally advanced or organ-confined disease. The accuracy of 3TemMRI local staging was then evaluated using definitive pathology as a reference. RESULTS: Overall, 177 radical prostatectomies were performed within the timeframe. After applying exclusion criteria, 60 patients were included in the final analysis. The mean patient age was 67 ± 7 (standard deviation) years. Mean prostate-specific antigen value was 12.7 ± 12.7 ng/L. Based on preoperative characteristics, we considered 38 of the 60 patients (63%) patients high risk. 3TemMRI identified an organ-confined tumour in 46 patients and locally advanced disease in 14 patients. When correlated to final pathology, 3TemMRI specificity, sensitivity, negative and positive predictive values, and accuracy in detecting locally advanced prostate cancer were 90%, 35%, 57%, 79% and 62%, respectively. INTERPRETATION: This study shows that the use of preoperative 3TemMRI can be used to identify organ-confined prostate cancer when locally advanced disease is suspected.

Central configurations of nested rotated regular tetrahedra

In this paper we prove that there are only two different classes of central configura- tions with convenient masses located at the vertices of two nested regular tetrahedra: either when one of the tetrahedra is a homothecy of the other one, or when one of the tetrahedra is a homothecy followed by a rotation of Euler angles = = 0 and = of the other one. We also analyze the central configurations with convenient masses located at the vertices of three nested regular tetrahedra when one them is a homothecy of the other one, and the third one is a homothecy followed by a rotation of Euler angles = = 0 and = of the other two. In all these cases we have assumed that the masses on each tetrahedron are equal but masses on different tetrahedra could be different.

Central configurations of nested regular polyhedra for the spatial 2n–body problem

We consider 2n masses located at the vertices of two nested regular polyhedra with the same number of vertices. Assuming that the masses in each polyhedron are equal, we prove that for each ratio of the masses of the inner and the outer polyhedron there exists a unique ratio of the length of the edges of the inner and the outer polyhedron such that the configuration is central.

Central configurations of three nested regular polyhedra for the spatial 3n–body problem

Three regular polyhedra are called nested if they have the same number of vertices n, the same center and the positions of the vertices of the inner polyhedron ri, the ones of the medium polyhedron Ri and the ones of the outer polyhedron Ri satisfy the relation Ri = ri and Ri = Rri for some scale factors R > > 1 and for all i = 1, . . . , n. We consider 3n masses located at the vertices of three nested regular polyhedra. We assume that the masses of the inner polyhedron are equal to m1, the masses of the medium one are equal to m2, and the masses of the outer one are equal to m3. We prove that if the ratios of the masses m2/m1 and m3/m1 and the scale factors and R satisfy two convenient relations, then this configuration is central for the 3n–body problem. Moreover there is some numerical evidence that, first, fixed two values of the ratios m2/m1 and m3/m1, the 3n–body problem has a unique central configuration of this type; and second that the number of nested regular polyhedra with the same number of vertices forming a central configuration for convenient masses and sizes is arbitrary.

Five years of denosumab exposure in women with postmenopausal osteoporosis: results from the first two years of the FREEDOM extension.

The 3-year FREEDOM trial assessed the efficacy and safety of 60 mg denosumab every 6 months for the treatment of postmenopausal women with osteoporosis. Participants who completed the FREEDOM trial were eligible to enter an extension to continue the evaluation of denosumab efficacy and safety for up to 10 years. For the extension results presented here, women from the FREEDOM denosumab group had 2 more years of denosumab treatment (long-term group) and those from the FREEDOM placebo group had 2 years of denosumab exposure (cross-over group). We report results for bone turnover markers (BTMs), bone mineral density (BMD), fracture rates, and safety. A total of 4550 women enrolled in the extension (2343 long-term; 2207 cross-over). Reductions in BTMs were maintained (long-term group) or occurred rapidly (cross-over group) following denosumab administration. In the long-term group, lumbar spine and total hip BMD increased further, resulting in 5-year gains of 13.7% and 7.0%, respectively. In the cross-over group, BMD increased at the lumbar spine (7.7%) and total hip (4.0%) during the 2-year denosumab treatment. Yearly fracture incidences for both groups were below rates observed in the FREEDOM placebo group and below rates projected for a "virtual untreated twin" cohort. Adverse events did not increase with long-term denosumab administration. Two adverse events in the cross-over group were adjudicated as consistent with osteonecrosis of the jaw. Five-year denosumab treatment of women with postmenopausal osteoporosis maintained BTM reduction and increased BMD, and was associated with low fracture rates and a favorable risk/benefit profile.

Iowa's People: a resource for extension educators, June 1989

Statistics about people and their families interest community planners, social scientists, Extension educators, and others because the family is the fundamental social institution in our society. The purpose of this publication is to bring together in one reference many statistics about people in Iowa counties that have been published separately elsewhere. Most of the data presented are limited to only one year. This cross-sectional view is similar to a photograph that shows only one point in time. At an earlier or later time it might appear differently. Although the statistics reported in the various tables and figures represent different years, the data presented were the most recent available at the time this publication was prepared.

A method for decision making with the OWA operator

A new method for decision making that uses the ordered weighted averaging (OWA) operator in the aggregation of the information is presented. It is used a concept that it is known in the literature as the index of maximum and minimum level (IMAM). This index is based on distance measures and other techniques that are useful for decision making. By using the OWA operator in the IMAM, we form a new aggregation operator that we call the ordered weighted averaging index of maximum and minimum level (OWAIMAM) operator. The main advantage is that it provides a parameterized family of aggregation operators between the minimum and the maximum and a wide range of special cases. Then, the decision maker may take decisions according to his degree of optimism and considering ideals in the decision process. A further extension of this approach is presented by using hybrid averages and Choquet integrals. We also develop an application of the new approach in a multi-person decision-making problem regarding the selection of strategies.