Patients' and physicians' preferences for type 2 diabetes mellitus treatments in Spain and Portugal: a discrete choice experiment.

OBJECTIVE To assess Spanish and Portuguese patients' and physicians' preferences regarding type 2 diabetes mellitus (T2DM) treatments and the monthly willingness to pay (WTP) to gain benefits or avoid side effects. METHODS An observational, multicenter, exploratory study focused on routine clinical practice in Spain and Portugal. Physicians were recruited from multiple hospitals and outpatient clinics, while patients were recruited from eleven centers operating in the public health care system in different autonomous communities in Spain and Portugal. Preferences were measured via a discrete choice experiment by rating multiple T2DM medication attributes. Data were analyzed using the conditional logit model. RESULTS Three-hundred and thirty (n=330) patients (49.7% female; mean age 62.4 [SD: 10.3] years, mean T2DM duration 13.9 [8.2] years, mean body mass index 32.5 [6.8] kg/m(2), 41.8% received oral + injected medication, 40.3% received oral, and 17.6% injected treatments) and 221 physicians from Spain and Portugal (62% female; mean age 41.9 [SD: 10.5] years, 33.5% endocrinologists, 66.5% primary-care doctors) participated. Patients valued avoiding a gain in bodyweight of 3 kg/6 months (WTP: €68.14 [95% confidence interval: 54.55-85.08]) the most, followed by avoiding one hypoglycemic event/month (WTP: €54.80 [23.29-82.26]). Physicians valued avoiding one hypoglycemia/week (WTP: €287.18 [95% confidence interval: 160.31-1,387.21]) the most, followed by avoiding a 3 kg/6 months gain in bodyweight and decreasing cardiovascular risk (WTP: €166.87 [88.63-843.09] and €154.30 [98.13-434.19], respectively). Physicians and patients were willing to pay €125.92 (73.30-622.75) and €24.28 (18.41-30.31), respectively, to avoid a 1% increase in glycated hemoglobin, and €143.30 (73.39-543.62) and €42.74 (23.89-61.77) to avoid nausea. CONCLUSION Both patients and physicians in Spain and Portugal are willing to pay for the health benefits associated with improved diabetes treatment, the most important being to avoid hypoglycemia and gaining weight. Decreased cardiovascular risk and weight reduction became the third most valued attributes for physicians and patients, respectively.

Implantació d’una xarxa de banda molt ampla a Rubrera

En el present projecte es tracta de la creació d’una Operadora de Xarxa de Telecomunicacions pel desplegament i explotació d’una xarxa de fibra òptica a la població de Rubrera per tal d’oferir a tots els seus habitants connexió a serveis que necessitaran el suport de banda moltampla. D’aquesta manera s’intenta apropar a tots el Rubrerencs la possibilitat d’accés a aquest tipus de serveis al mateix temps que els habitants de les poblacions més importants del país, integrant-los immediatament a la Societat de la Informació. Així doncs, es dur a terme elpresent projecte que es defineix amb els següents objectius:- És un fet que la Societat de la informació cada dia és més important en la vida diària de les persones. Per això, l’Ajuntament de Rubrera és conscient de que el seu objectiuprincipal és fer arribar la connexió a banda molt ampla a tots els seus habitants, sinó hofan les empreses privades que tenen les autoritzacions corresponents. Com que capoperador s’ha compromès a construir aquest tipus de xarxa a Rubrera a mig termini ,és per això que es proposa establir una xarxa per transportar serveis d’alta capacitat, de tal manera que Rubrera no es quedi desfasada respecte poblacions i territoris de l’entorn.- Proporcionar als Rubrerencs un ventall d‘Operadores de Serveis, d’altre manerainaccessible, on poder escollir. Afavorir i promoure la lliure competència entre lesOperadores a la localitat de Rubrera, que ajudarà a reduir els futurs costos entelecomunicacions.- Constitució d’una empresa de caràcter públic, lligada directament a l’Ajuntament deRubrera, per planificar, dissenyar, desplegar, operar i mantenir la xarxa de caràcter obert a tots els operadors de serveis i en cobertura de tot el territori municipal.- Promoure la inserció del màxim número possible d’operadors de serveis, sobre aquesta xarxa pública oberta, per que se’ls hi garantirà el mateix cost que aquestes han assumit en les poblacions més importants. S’intenta d’aquesta manera oferir a diversesoperadores, la possibilitat de prestar serveis a una població on, en principi no els és rentable el desplegament d’una xarxa pròpia.- Finalment s’intenta des d’aquest projecte oferir un model a seguir per altres poblacions que es trobin en la mateixa situació. La necessitat de banda molt ampla a tot el territori català i espanyol és imminent.

Reporte de datos de madurez sexual de la anchoveta peruana (engraulis ringens) durante el periodo 1961 - 1987

Se presentan datos de madurez sexual promedio mensual de la anchoveta peruana, Engraulis ringens por longitudes y sexos, para las Regiones Norte (06°-10°S), Centro (10°-14° S) y Sur (14°-18°20 ' S) para el período 1961-87. Estos se obtuvieron usando los datos de madurez sexual colectados macroscópicamente de ejemplares procedentes de los desembarques a lo largo del litoral peruano.

Audit report on the Butler County Solid Waste Commission for the year ended June 30, 2008

Audit report on the Butler County Solid Waste Commission for the year ended June 30, 2008

Genomewide association study using a high-density single nucleotide polymorphism array and case-control design identifies a novel essential hypertension susceptibility locus in the promoter region of endothelial NO synthase.

Essential hypertension is a multifactorial disorder and is the main risk factor for renal and cardiovascular complications. The research on the genetics of hypertension has been frustrated by the small predictive value of the discovered genetic variants. The HYPERGENES Project investigated associations between genetic variants and essential hypertension pursuing a 2-stage study by recruiting cases and controls from extensively characterized cohorts recruited over many years in different European regions. The discovery phase consisted of 1865 cases and 1750 controls genotyped with 1M Illumina array. Best hits were followed up in a validation panel of 1385 cases and 1246 controls that were genotyped with a custom array of 14 055 markers. We identified a new hypertension susceptibility locus (rs3918226) in the promoter region of the endothelial NO synthase gene (odds ratio: 1.54 [95% CI: 1.37-1.73]; combined P=2.58 · 10(-13)). A meta-analysis, using other in silico/de novo genotyping data for a total of 21 714 subjects, resulted in an overall odds ratio of 1.34 (95% CI: 1.25-1.44; P=1.032 · 10(-14)). The quantitative analysis on a population-based sample revealed an effect size of 1.91 (95% CI: 0.16-3.66) for systolic and 1.40 (95% CI: 0.25-2.55) for diastolic blood pressure. We identified in silico a potential binding site for ETS transcription factors directly next to rs3918226, suggesting a potential modulation of endothelial NO synthase expression. Biological evidence links endothelial NO synthase with hypertension, because it is a critical mediator of cardiovascular homeostasis and blood pressure control via vascular tone regulation. This finding supports the hypothesis that there may be a causal genetic variation at this locus.

Acústica pesquera y del plancton: pasado, presente y futuro

Describe la importancia de la acustica pesquera y del plancton que fue presentado en el Simposio sobre Acústica Pesquera desarrollado en Aberdeen en junio de 1995.

Bionomy of two flies of sanitary and forensic importance: Peckia (Sarcodexia) lambens (Wiedemann) and Oxysarcodexia amorosa (Schiner) (Diptera, Sarcophagidae)

ABSTRACTThis study aims to elucidate the bionomy of Peckia(Sarcodexia) lambens and Oxysarcodexia amorosa to provide data for medical, veterinary and forensic entomology analyses. We analyzed larval stage duration (L1–L3), weight of the mature larvae (L3), pupal stage duration, L1–adult duration, adult emergence and viability of larvae and adults of both species. Larval viability of P. (S.) lambens was 82% and the mean duration of the larval stage was 3.51 ± 0.99 days. The mature larvae had a mean weight of 33.67 ± 7.13 mg. The mean duration of the pupal stage was 8.26 ± 0.93 days and the mean duration of the L1–adult was 11.53 ± 1.22 days. Mean lifespan for females and males was 39.33 ± 1.52 and 57.33 ± 4.72 days, respectively. Larval viability of O. amorosa was 76% and mean duration of larval stage was 3.51 ± 0.64 days. Mature larvae had a mean weight of 28.28 ± 3.38 mg. Mean duration of the pupal stage was 10.14 ± 0.63 days and mean duration of the L1–adult was 13.60 ± 0.69 days. Mean lifespan for females and males was 83.66 ± 15.94 and 84.00 ± 19.97 days, respectively. Oxysarcodexia amorosa showed a L1–adult stage longer than P. (S.) lambens; however both species showed low viability. O. amorosa laid more larvae than P. (S.) lambens, this fact may occur because O. amorosa had longer life duration.

No use for waist-for-height ratio in addition to body mass index to identify children with elevated blood pressure.

Abstract Background. In children, waist-for-height ratio (WHtR) has been proposed to identify subjects at higher risk of cardiovascular diseases. The utility of WHtR to identify children with elevated blood pressure (BP) is unclear. Design. Cross-sectional population-based study of schoolchildren. Methods. Weight, height, waist circumference and BP were measured in all sixth-grade schoolchildren of the canton de Vaud (Switzerland) in 2005/06. WHtR was computed as waist [cm]/height [cm]. Elevated BP was defined according to sex-, age- and height-specific US reference data. The area under the receiver operating characteristic curve (AUC) statistic was computed to compare the ability of body mass index (BMI) z-score and WHtR, alone or in combination, to identify children with elevated BP. Results. 5207 children participated (76% response) [2621 boys, 2586 girls; mean (± SD) age, 12.3 ± 0.5 years; range: 10.1-14.9]. The prevalence of elevated BP was 11%. Mean WHtR was 0.44 ± 0.05 (range: 0.29- 0.77) and 11% had high WHtR (> 0.5). BMI z-score and WHtR were strongly correlated (Spearman correlation coefficient r = 0.76). Both indices were positively associated with elevated BP. AUCs for elevated BP was relatively low for BMI z-score (0.62) or for WHtR (0.62), and was not substantially improved when both indices were considered together (0.63). Conclusions. The ability of BMI z-score or WHtR to identify children aged 10-14 with elevated BP was weak. Adding WHtR did not confer additional discriminative power to BMI alone. These findings do not support the measurement of WHtR in addition to BMI to identify children with elevated BP.

Termination of Atrial Fibrillation by Catheter Ablation can be Successfully Predicted from Baseline ECG

Purpose Multiple organization indices (OIs) have been used to predict the outcome of stepwise catheter ablation (step-CA) in long-standing persistent AF (pers-AF), however with limited success. Our study aims at developing innovative OIs from baseline (BL, before ablation) ECG in order to predict the outcome of step-CA. Methods Fourteen consecutive patients (pts) (60±5 y, AF duration 21±9 m) underwent a step-CA consisting in pulmonary veins isolation, left atrial (LA) defragmentation and linear ablations, and right atrial (RA) ablations if non terminated. Chest lead V6 was placed in the back (V6b). After QRST cancellation from chest leads V1 to V6b, two OIs were computed to quantify the harmonic components of ECG atrial activity: 1) phase difference variance (PD) between the AF harmonic components as a measure of AF regularity, and 2) adaptive OI (AOI) evaluating the time evolution of the AF harmonic components. Both indices were compared to classical ones: a spectrum-based OI (SOI) and ECG AF cycle length (AFCL). Results Pers-AF was terminated into sinus rhythm or atrial tachycardia in 10/14 pts during step-CA, 8 during LA (LT), 2 during RA (RT) ablation, and 4 were non terminated (NT). The figure shows that LT was best separated from RT/NT before ablation by AOI computed on lead V1 (A) and PD from lead V6b (B) as compared to SOI and AFCL respectively. Conclusion Our results suggest that adaptive OIs computed before ablation perform better than classical OIs for separating LT from RT/NT pts. These findings are indicative of a higher baseline organization in LT pts that could be used to select candidates for the restoration of sinus rhythm by step-CA.

Intense green-yellow electroluminescence from Tb+-implanted silicon-rich silicon nitride/oxide light emitting devices

High optical power density of 0.5 mW/cm2, external quantum efficiency of 0.1%, and population inversion of 7% are reported from Tb+-implanted silicon-rich silicon nitride/oxide light emitting devices. Electrical and electroluminescence mechanisms in these devices were investigated. The excitation cross section for the 543 nm Tb3+ emission was estimated under electrical pumping, resulting in a value of 8.2 × 10−14 cm2, which is one order of magnitude larger than one reported for Tb3+:SiO2 light emitting devices. These results demonstrate the potentiality of Tb+-implanted silicon nitride material for the development of integrated light sources compatible with Si technology.