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Lack of evidence for interventions offered in UK fertility centres




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Preserving fertility in girls and young women with cancer




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Royal College of Surgeons launches postgraduate surgical certificate




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Covid-19: UK advisory panel members are revealed after experts set up new group




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Covid-19: UK death toll overtakes Italy’s to become worst in Europe




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Screening for Glucose Perturbations and Risk Factor Management in Dysglycemic Patients With Coronary Artery Disease--A Persistent Challenge in Need of Substantial Improvement: A Report From ESC EORP EUROASPIRE V

OBJECTIVE

Dysglycemia, in this survey defined as impaired glucose tolerance (IGT) or type 2 diabetes, is common in patients with coronary artery disease (CAD) and associated with an unfavorable prognosis. This European survey investigated dysglycemia screening and risk factor management of patients with CAD in relation to standards of European guidelines for cardiovascular subjects.

RESEARCH DESIGN AND METHODS

The European Society of Cardiology’s European Observational Research Programme (ESC EORP) European Action on Secondary and Primary Prevention by Intervention to Reduce Events (EUROASPIRE) V (2016–2017) included 8,261 CAD patients, aged 18–80 years, from 27 countries. If the glycemic state was unknown, patients underwent an oral glucose tolerance test (OGTT) and measurement of glycated hemoglobin A1c. Lifestyle, risk factors, and pharmacological management were investigated.

RESULTS

A total of 2,452 patients (29.7%) had known diabetes. OGTT was performed in 4,440 patients with unknown glycemic state, of whom 41.1% were dysglycemic. Without the OGTT, 30% of patients with type 2 diabetes and 70% of those with IGT would not have been detected. The presence of dysglycemia almost doubled from that self-reported to the true proportion after screening. Only approximately one-third of all coronary patients had completely normal glucose metabolism. Of patients with known diabetes, 31% had been advised to attend a diabetes clinic, and only 24% attended. Only 58% of dysglycemic patients were prescribed all cardioprotective drugs, and use of sodium–glucose cotransporter 2 inhibitors (3%) or glucagon-like peptide 1 receptor agonists (1%) was small.

CONCLUSIONS

Urgent action is required for both screening and management of patients with CAD and dysglycemia, in the expectation of a substantial reduction in risk of further cardiovascular events and in complications of diabetes, as well as longer life expectancy.




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A 52-Year-Old Woman With Hypertension and Diabetes Who Presents With Chest Pain

George D. Harris
Jul 1, 2007; 25:115-118
Case Studies




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Case Study: Treating Hypertension in Patients With Diabetes

Evan M. Benjamin
Jul 1, 2004; 22:137-138
Case Studies




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Personalized Management of Hyperglycemia in Type 2 Diabetes: Reflections from a Diabetes Care Editors' Expert Forum

Itamar Raz
Jun 1, 2013; 36:1779-1788
Diabetes Care Expert Forum




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Rapid Rise in Hypertension and Nephropathy in Youth With Type 2 Diabetes: The TODAY clinical trial

TODAY Study Group
Jun 1, 2013; 36:1735-1741
TODAY Study




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Prevalence of Diabetes in Mexican Americans, Cubans, and Puerto Ricans From the Hispanic Health and Nutrition Examination Survey, 1982-1984

Katherine M Flegal
Jul 1, 1991; 14:628-638
Supplement 3: Diabetes in Hispanic Americans




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Metformin Improves Glucose, Lipid Metabolism, and Reduces Blood Pressure in Hypertensive, Obese Women

Dario Giugliano
Oct 1, 1993; 16:1387-1390
Short Report




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Cardiovascular Outcomes Trials in Type 2 Diabetes: Where Do We Go From Here? Reflections From a Diabetes Care Editors Expert Forum

William T. Cefalu
Jan 1, 2018; 41:14-31
Diabetes Care Expert Forum




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Digitizing financial services key to Africa's post-pandemic growth, experts say

As the COVID-19 pandemic begins to take root in Africa, experts say that digitizing financial services could help keep the continent safe




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Coast Guard names Rear Adm. Melissa Bert as first female judge advocate general

The U.S. Coast Guard named Rear Adm. Melissa Bert as its first female judge advocate and chief counsel, its top legal position.




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Diuretic Treatment of Hypertension

Ehud Grossman
May 1, 2011; 34:S313-S319
Hypertension




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Cardiovascular Outcomes Trials in Type 2 Diabetes: Where Do We Go From Here? Reflections From a Diabetes Care Editors Expert Forum

William T. Cefalu
Jan 1, 2018; 41:14-31
Diabetes Care Expert Forum




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Invertir en el Vecindario: Cambios en los Patrones de Migración Entre México y Estados Unidos y Oportunidades para una Cooperación Sostenible

Presentación del reporte que refleja el contenido de encuentros del grupo de estudio sobre la migración México-Estados Unidos convocado por El Colegio de México y el Migration Policy Institute (MPI).




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Nonprofit recruiting dentists to volunteer in Puerto Rico

The U.S.-based International Medical Relief is sponsoring outreach trips to Puerto Rico in response to the earthquakes that have devastated the region.




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Alliance of the ADA offers education, entertainment at Conference 2020

From courses on burnout, vaping and more to golf and a low-country boil, the Alliance of the American Dental Association's upcoming Conference 2020 in Charleston, South Carolina, will offer a variety of educational and entertainment opportunities.




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Former ADA President Robert M. Anderton dies at 82

Dr. Robert M. Anderton, ADA president from 2000-01 and ADA trustee from 1995-99, died Feb. 14.




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American Dental Board of Anesthesiology recognized as national certifying board for dental specialty

The National Commission on Recognition of Dental Specialties and Certifying Boards announced March 4 it recognizes the American Dental Board of Anesthesiology as the national certifying board for dental anesthesiology.




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FDA alerts health care providers of EpiPen auto-injector errors

The U.S. Food and Drug Administration announced March 24 that it is alerting health care professionals, patients and caregivers of EpiPen autoinjector errors related to device malfunctions and user administration.




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Homeland Security issues alert on cybercriminals increasingly exploiting COVID-19 pandemic

The U.S. Department of Homeland Security issued an alert April 8 warning that cybercriminals are increasingly exploiting the COVID-19 pandemic to target individuals, small and medium businesses and large organizations.




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Poverty, lack of insurance can make heart failure prognosis worse, AHA says

Poverty and poor or non-existent health insurance coverage might worsen the effects of heart failure, the American Heart Association said Thursday.




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Poverty, poorer health make some in the Bronx more vulnerable to COVID-19

New York City has been the epicenter of the COVID-19 outbreak in the United States, with immigrant populations in areas such as the Bronx "disproportionately" affected, a commentary in JAMA Internal Medicine says.




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Combination Therapy With Canagliflozin Plus Liraglutide Exerts Additive Effect on Weight Loss, but Not on HbA1c, in Patients With Type 2 Diabetes

OBJECTIVE

To examine the effect of combination therapy with canagliflozin plus liraglutide on HbA1c, endogenous glucose production (EGP), and body weight versus each therapy alone.

RESEARCH DESIGN AND METHODS

Forty-five patients with poorly controlled (HbA1c 7–11%) type 2 diabetes mellitus (T2DM) on metformin with or without sulfonylurea received a 9-h measurement of EGP with [3-3H]glucose infusion, after which they were randomized to receive 1) liraglutide 1.2 mg/day (LIRA); 2) canagliflozin 100 mg/day (CANA); or 3) liraglutide 1.2 mg plus canagliflozin 100 mg (CANA/LIRA) for 16 weeks. At 16 weeks, the EGP measurement was repeated.

RESULTS

The mean decrease from baseline to 16 weeks in HbA1c was –1.67 ± 0.29% (P = 0.0001), –0.89 ± 0.24% (P = 0.002), and –1.44 ± 0.39% (P = 0.004) in patients receiving CANA/LIRA, CANA, and LIRA, respectively. The decrease in body weight was –6.0 ± 0.8 kg (P < 0.0001), –3.5 ± 0.5 kg (P < 0.0001), and –1.9 ± 0.8 kg (P = 0.03), respectively. CANA monotherapy caused a 9% increase in basal rate of EGP (P < 0.05), which was accompanied by a 50% increase (P < 0.05) in plasma glucagon-to-insulin ratio. LIRA monotherapy reduced plasma glucagon concentration and inhibited EGP. In CANA/LIRA-treated patients, EGP increased by 15% (P < 0.05), even though the plasma insulin response was maintained at baseline and the CANA-induced rise in plasma glucagon concentration was blocked.

CONCLUSIONS

These results demonstrate that liraglutide failed to block the increase in EGP caused by canagliflozin despite blocking the rise in plasma glucagon and preventing the decrease in plasma insulin concentration caused by canagliflozin. The failure of liraglutide to prevent the increase in EGP caused by canagliflozin explains the lack of additive effect of these two agents on HbA1c.




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2017 American Academy of Pediatrics Clinical Practice Guideline: Impact on Prevalence of Arterial Hypertension in Children and Adolescents With Type 1 Diabetes

OBJECTIVE

In 2017, the American Academy of Pediatrics introduced a new guideline (2017 Clinical Practice Guideline of the American Academy of Pediatrics [AAP 2017]) to diagnose arterial hypertension (HTN) in children that included revised, lower normative blood pressure (BP) values and cut points for diagnosing high BP in adolescents. We studied the impact of the new AAP 2017 guideline on prevalence of HTN in children with type 1 diabetes mellitus (T1DM).

RESEARCH DESIGN AND METHODS

Up to September 2018, 1.4 million office BP measurements in 79,849 children and adolescents (aged 5–20 years) with T1DM have been documented in the DPV (Diabetes Prospective Follow-up) registry. BP values of the most recent year were aggregated, and BP values of 74,677 patients without antihypertensive medication were analyzed (median age 16 years and diabetes duration 5.3 years and 52.8% boys). BP values were classified according to AAP 2017 and the references of the German Health Interview and Examination Survey for Children and Adolescents (KiGGS) (2011) and the Fourth Report on the Diagnosis, Evaluation, and Treatment of High Blood Pressure in Children and Adolescents (fourth report) (2004).

RESULTS

Of the patients, 44.1%, 29.5%, and 26.5% were hypertensive according to AAP 2017, KiGGS, and fourth report, respectively. Differences in prevalence of HTN were strongly age dependent: <10 years, AAP 2017 31.4%, KiGGS 30.7%, fourth report 19.6%; 10 to <15 years, AAP 2017 30.9%, KiGGS 31.2%, fourth report 22.4%; and ≥15 years, AAP 2017 53.2%, KiGGS 28.4%, fourth report 30.0%. Among teenagers ≥15 years, 59.1% of boys but only 46.3% of girls were classified as hypertensive by AAP 2017 but only 21.1%/26% of boys and 36.7%/34.4% of girls by KiGGS/fourth report, respectively.

CONCLUSIONS

Classification of BP as hypertension depends strongly on the normative data used. Use of AAP 2017 results in a significant increase in HTN in teenagers ≥15 years with T1DM, particularly in boys. AAP 2017 enhances the awareness of elevated BP in children, particularly in patients with increased risk for cardiovascular disease.




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Neanderthals preferred bovine bones for leather-making tools

When it came to selecting bones for leather-making tools, Neanderthals were surprisingly choosy. New archaeological analysis shows Neanderthals preferentially selected bovine rib bones to make a tool called a lissoir.




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Record cold, snow overtakes northeastern U.S.

Americans across a large portion of the Northeast are in the midst of an unusually late-season blast of Arctic air courtesy of the polar vortex.




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Rupert Grint, Georgia Groome confirm daughter's birth

Rupert Grint, who played Ron Weasley in the "Harry Potter" films, welcomed his first child, a daughter, with his girlfriend, Georgia Groome.




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Taylor Swift's Paris concert to air on ABC May 17

Taylor Swift announced her City of Lover concert, which took place in Paris, will air on ABC on May 17 at 10 p.m.




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Entertainer Roy Horn of Siegfried & Roy dies of COVID-19 complications at 75

German-born entertainer Roy Uwe Ludwig Horn, one half of the stage duo Siegfried & Roy, has died of complications from the coronavirus. He was 75.




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How to Stay Sane While Staying Home: Advice from an Introvert

For loners, recluses, and other solitary types such as myself, sheltering-in-place feels natural and normal. However scary other aspects of this pandemic might be, for us, this aspect isn’t. Working...





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[ Law & Ethics ] Open Question : If a relict population of Neandertals were found to be living in a certain cave, on a certain remote island, or in a certain house on?

Pennsylvania Avenue, would placing some of them in zoos be unethical? Would they be considered human enough to receive human rights?




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[ Politics ] Open Question : IF Cons rewrote the Constitution of the United States would it have less laws, more liberty, & move power from DC to the State Capitals?

Oh would that 'less laws/more liberty/more state capital power' look anything like Mike Pence's Religious Freedom Restoration Act or in other words the 'we Conservative Republican Christians are such oppressed persecuted victims WAAAAA WAAAA' Bill. https://www.youtube.com/watch?v=KIikqPmbgvI 




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Dependent on Remittances, Tajikistan’s Long-Term Prospects for Economic Growth and Poverty Reduction Remain Dim

More than 1 million Tajiks migrate to Russia every year—a sizeable outflow for a country of about 9 million people. These high levels of emigration have had major effects for Tajikistan, especially in the generation of remittances that help lift everyday Tajiks out of poverty but have also made the country increasingly dependent on Russia. This article explores challenges faced by Tajik migrants in Russia and the effects of emigration on Tajikistan’s economy and society.




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Tapping the Talents of Highly Skilled Immigrants in the United States: Takeaways from Experts Summit

Economists project a shortage of 5 million U.S. workers with postsecondary education and training by 2020. Yet 2 million immigrant college graduates in the United States are either unemployed or work in jobs that require no more than a high school degree. How can this skill underutilization, known as "brain waste," be remedied? MPI asked the experts, and this report summarizes their discussion and recommendations.




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A Dose of Libertarian Paternalism

About 25 years ago, Cass Sunstein opened a retirement account that had two portfolios. One was mostly bonds, the other mostly stocks. Like many academics who use the TIAA-CREF investment program, Sunstein divided his money equally between stocks and bonds.




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Cracked Foundation, Uncertain Future: Structural Weaknesses in the Common European Asylum System

During the 2015–16 migration crisis, European asylum systems were stretched to a breaking point. Yet many of the structural issues that contributed to failures to register newcomers, insufficient reception capacity, and growing backlogs of asylum cases existed before—and many remain unresolved. This report critically evaluates Common European Asylum System legal and operational shortcomings at a time when reform is on the table.




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Invertir en el vecindario: Cambios en los patrones de migración entre México y Estados Unidos y oportunidades para una cooperación sostenible

La migración entre México y Estados Unidos ha cambiado dramáticamente en los últimos años, pero las políticas y la retórica política en ambos países no se han actualizado a este contexto a la misma velocidad. Este reporte explora esta nueva realidad migratoria y cómo los dos gobiernos podrían trabajar juntos para abordar los desafíos de políticas públicas que tienen en común.




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Introduction to The Old Ways: A Journey on Foot by Robert Macfarlane

My first exposure to Robert Macfarlane happened a year ago when I picked up a battered copy of The Wild Places in order to shelve it. Instead, I checked it out from my branch and stayed up past midnight to read it. Thanks to Macfarlane, I was exposed to Roger Deakin's Wild Wood and Notes from Walnut Tree Farm. I found photos of Walnut Tree Farm, the late Deakin's house, much visited by Macfarlane, while searching for more information about both of them online.

I am from probably the last generation of American children to be raised on English children's books. I know that there is a generation of Quidditch-playing adults that were weaned on the Harry Potter books of British-born J. K. Rowling. While the Harry Potter books are gripping, they lack an essential British characteristic shared by many successful authors of British children's books:

  • Rudyard Kipling - the two Puck of Pook's Hill books
  • Rosemary Sucliff - all of her books
  • Elizabeth Goudge - Rowling helped get Linnets & Valerians and The Little White Horse republished
  • L. M. Boston - the Greene Knowe series
  • William Mayne
  • Robert Westall
  • Diana Wynne Jones - the British landscape of an alternative Britain
  • J. R. R. Tolkein -The Hobbit
  • Kenneth Graham - The Wind in the Willows
  • T. H. White - The Once and Future King
  • Susan Cooper - The Dark is Rising series
I'm sure that there are many more. What these authors and books have in common is a palpable sense of landscape; the English and Welsh earth itself is as present and influential as any of the characters. In any Harry Potter book I had the sense that the only character connected to the land was Hagrid; the rest of the wizards were interested in nature only insofar as they could exploit it for magical potions or familiars.

Both Macfarlane and his late mentor Deakin possessed the same sense of awareness of the land as these children's authors. Deakin kept his hedgerows alive to shelter birds and let animals wander at will through his house. Macfarlane travels, mostly on foot, as he did while he hiked and climbed in both The Wild Places and The Old Ways.




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When Good People Write Bad Sentences, by Robert Harris

All great writing starts with a sentence. But what is it that makes a sentence great?  Could it be grammar, syntax, style, word choice, information, meaning, common sense, passion etc? According to one author, there is only one rule for writing a great sentence. And this is the rule:  "whether you're Christian, Jew, Muslim, or a disciple of the church of Penn Jillette, when you sit down to write, the Reader is thy god." The rule is certainly thought-provoking but one has to wonder if one rule would be enough for writing a great sentence.

Robert Harris, in his book, "When Good People Write Bad Sentences," offers "12 Steps to Verbal Enlightenment" that can cure any eager to learn "bad writing addict." Besides, the 12 steps don’t just provide solutions to well-known problems in the categories of punctuation, syntax, diction, and style but also help bad writers understand the emotional foundations and psychological forces behind those problems. Harris argues, not without humor, that only with this deep understanding can permanent changes take place. He identifies nine types of ineffective sentences that arise from unexamined emotions and self-destructive needs, and offers an integrated approach which could help writers learn to take a broader and healthier perspective on sentence construction.

When it comes to the malady of writing badly, which he calls "malescribism,"--an uncontrollable urge to write carelessly and unpersuasively--Harris warns that this malady "is no respecter of status, nor does it take into account social, ethnic, or religious orientation." He also notes that malescribes could be black and white, male and female, believer and nonbeliever, liberal and conservative.

Since we all would like to write better sentences consistently, let's look at the advice offered by Robert Harris, and also share some of the great sentences that we have come across in our reading.


 




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Las puertas abiertas para los migrantes venezolanos y nicaragüenses en América Latina y el Caribe se cierran un poco a medida que aumenta la escala de los flujos y la presión en los servicios públicos

WASHINGTON – A pesar de que los gobiernos de América Latina y el Caribe han tomado medidas generosas e innovadoras para lidiar con el desplazamiento forzado desde Venezuela y más recientemente desde Nicaragua, la cálida bienvenida se ha enfriado en algunos lugares a medida que el número de entradas, la presión sobre los servicios públicos y la preocupación del público aumenta.




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¿Se Están Cerrando las Puertas? Respuestas a la Migración Venezolana en América Latina y el Caribe

MPI llevó a cabo un seminario en línea para marcar el lanzamiento de: Un portal sobre Migración en América Latina y el Caribe; y un informe que examina los efectos de las políticas migratorias y de integración en 11 países en América Latina y el Caribe ante el aumento de la migración venezolana y nicaragüense.




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Get Free Local COVID-19 Alerts with Inoreader

Everyone is concerned as the novel Coronavirus spreads at rapid rates across all countries of the world. We believe every…




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How we made our Free COVID-19 Alerting System and how you can build your own for any topic

Ever since we launched our Free COVID-19 Alerting System, we’ve been continuously asked how we made it. In this blog…




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Convert Almost Any Webpage Into RSS Feed With Inoreader’s Web Feeds

So, you wanted to follow this nice website for new content, but it doesn’t have an RSS feed yet? Don’t…




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¿Se Están Cerrando las Puertas? Respuestas a la Migración Venezolana en América Latina y el Caribe

MPI llevó a cabo un seminario en línea para marcar el lanzamiento de: Un portal sobre Migración en América Latina y el Caribe; y un informe que examina los efectos de las políticas migratorias y de integración en 11 países en América Latina y el Caribe ante el aumento de la migración venezolana y nicaragüense.