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Diabetes Core Update: Covid-19 – Inpatient Management of Persons with Diabetes April 2019

This special issue focuses on Diabetes, Covid-19 and Inpatient Management.

Recorded April 3, 2020.

This podcast will cover:

  1. Risk with Diabetes of Covid-19 and Complications of Covid-19
  2. Management of Hyperglycemia during Covid-19 Infection
  3. Sub-cutaneous Insulin for DKA
  4. CGM in the Hospital Setting
  5. Diabetes Education in the Hospital During Covid-19

Intended for practicing physicians and health care professionals, Diabetes Core Update discusses how the latest research and information published in journals of the American Diabetes Association are relevant to clinical practice and can be applied in a treatment setting.

Presented by:

Irl Hirsch, MD, Professor of Medicine, University of Washington, Seattle

Guillermo E. Umpierrez, MD, CDE, Professor of Medicine, Emory University, Atlanta Georgia




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Diabetes Core Update: Covid-19 – Deep Dive into Medication Management April 2019

This special issue focuses on Diabetes, Covid-19 and Inpatient Management.

Recorded April 14, 2020.

This podcast will cover:

  1. Inpatient Medication Management for Persons Admitted with Diabetes
  2. Outpatient Medication Management for Persons with Diabetes
    1. Hypoglycemic Medication Management
    2. ACE and ARBs
    3. NSAIDs

Intended for practicing physicians and health care professionals, Diabetes Core Update discusses how the latest research and information published in journals of the American Diabetes Association are relevant to clinical practice and can be applied in a treatment setting.

Presented by:

Neil Skolnik, M.D., Professor of Family and Community Medicine, Sidney Kimmel Medical College, Thomas Jefferson University, Associate Director, Family Medicine Residency Program, Abington Jefferson Health

Dr. Joshua Neumiller, Vice Chair & Allen I. White Distinguished Associate Professor of Pharmacotherapy at Washington State University




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Diabetes Core Update: Covid-19 and Diabetes – Considerations for Health Care Professionals - April 2019

Diabetes Core Update: Covid-19 and Diabetes – Considerations for Health Care Professionals - April 2019

This special issue is an audio version of the American Diabetes Associations Covid-19 leadership team discussing a range of issues on Covid-19 and Diabetes.

Recorded March 31, 2020.

Topics include:

  1. Access to medications
  2. Effect on Diabetes Self-management
  3. Can Patients take their own Supplies if they are an inpatient in the hospital – particularly insulin pumps and CGM
  4. Considerations for Specific Hypoglycemic Medications during Inpatient Hospitalization
  5. Differences in Management for Persons with Type 1 and Type 2 Diabetes
  6. SGLT-2 inhibitors and GLP-1 Receptor Agonists use During Covid-19 Infection
  7. Diabetes and Cardiovascular Disease during Covid-19
  8. ACEs and ARBs
  9. Stress among Healthcare Professionals

Intended for practicing physicians and health care professionals, Diabetes Core Update discusses how the latest research and information published in journals of the American Diabetes Association are relevant to clinical practice and can be applied in a treatment setting.

Presented by:

Robert Eckel, MD
ADA President, Medicine & Science
University of Colorado

Mary de Groot, PhD
ADA President, Health Care & Education
Indiana University

Irl Hirsch, MD
University of Washington

Anne Peters, MD
University of Southern California    

Louis Philipson, MD, PhD
ADA Past President, Medicine & Science
University of Chicago

Neil Skolnik, MD
Abington Jefferson Health




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Diabetes Core Update: COVID-19 – Inpatient Management # 2 April 2019

This special issue focuses on Answering Questions about Inpatient Care During Covid 19, a follow-up discussion to the Townhall meeting discussing inpatient care. 

Recorded April 15, 2020.

This podcast will cover:

  1. Subcutaneous Insulin Infusions
  2. CGM use in the inpatient setting
  3. Insulin Infusion pumps in the inpatient setting
  4. Inpatient Glycemic Control - what are the recommendations?
  5. Oral Medications
  6. Hydroxychloroquine adverse effects in persons with diabetes

Intended for practicing physicians and health care professionals, Diabetes Core Update discusses how the latest research and information published in journals of the American Diabetes Association are relevant to clinical practice and can be applied in a treatment setting.

Presented by:

Robert Eckel, MD
ADA President, Medicine & Science

Irl Hirsch, MD
University of Washington

Mary Korytkowski, MD
University of Pittsburgh




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Diabetes Core Update: COVID-19 – Inpatient Townhall April 2019

This special issue focuses on Answering Questions about Inpatient Care During Covid 19, a follow-up discussion to the Townhall meeting discussing inpatient care. 

Recorded April 7, 2020.

This is a part of the American Diabetes Associations ongoing project providing resources for practicing clinicians on the care of Diabetes during the Covid-19 pandemic.  Todays discussion is an audio version of a webinar recorded on April 17th, 2020 where the panel answered questions submitted during and after the last webinar/townhall a week prior on inpatient management of patients with diabetes with Covid-19.

Presented by:

Shivani Agarwal, MD, MPH
Albert Einstein College of Medicine

Jennifer Clements, PharmD, FCCP, BCPS, CDE, BCACP
American Pharmacists Association

Robert Eckel, MD
ADA President, Medicine & Science

Irl Hirsch, MD
University of Washington

Melanie Mabrey, DNP 
Co-Chair - American Association of Nurse Practitioners - Endocrine Specialty Practice Group

Jane Jeffrie-Seley, DNP, BC-ADM, CDCES
Association of Diabetes Care and Education Specialists 




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Diabetes Core Update: COVID-19 – Telehealth and COVID-19 , April 2019

This special issue focuses on Telehealth and COVID-19.

Recorded March 31, 2020.

Intended for practicing physicians and health care professionals, Diabetes Core Update discusses how the latest research and information published in journals of the American Diabetes Association are relevant to clinical practice and can be applied in a treatment setting.

Presented by:

Neil Skolnik, MD
Sidney Kimmel Medical College, Thomas Jefferson University

Eric Johnson, MD
University of North Dakota School of Medicine and Health Sciences




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Diabetes Core Update: COVID-19 – Caring for Ourselves while Caring for Others, April 2019

This special issue focuses on caring for ourselves while caring for others. 

Recorded April 1, 2020.

This is a part of the American Diabetes Associations ongoing project providing resources for practicing clinicians on the care of Diabetes during the Covid-19 pandemic.  Todays discussion is an audio version of a webinar recorded on April 1, 2020.

Presented by:

Neil Skolnik, M.D.

Abington Jefferson Health

 

Aaron Sutton

Behavioral Health Consultant

Abington Jefferson Health

 




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Diabetes Core Update: COVID-19 - Empowering Patients with Diabetes During Covid-19 April 2019

This special issue focuses on Empowering Patients with Diabetes During Covid-19

Recorded April 9, 2020.

This podcast will cover:

  1. Defining terms and talking with patients about the epidemiology of COVID-19
  2. How should providers talk with patients about the risk of COVID-19 – The impact of testing
  3. COVID-19 infection and its impact on self-care
  4. Barriers to Problem Solving
  5. Diabetes Self Care Helping to Create a Sense of Normalcy
  6. Self-Care – “Its OK not to be OK” – Acknowledging our feelings
  7. Coping with Stress

Intended for practicing physicians and health care professionals, Diabetes Core Update discusses how the latest research and information published in journals of the American Diabetes Association are relevant to clinical practice and can be applied in a treatment setting.

Presented by:

Mary de Groot, PhD
President, Health Care & Education, ADA

Jane Jeffrie-Seley, DNP, MPH
New York Presbyterian/Weill Cornell Medicine

Jean M. Lawrence, ScD, MPH, MSSA, FACE
Southern California Permanente Medical Group
Kaiser Permanente Research




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Diabetes Core Update: COVID-19 – Cardiovascular Concerns, April 2019

This special issue focuses on Cardiovascular Concerns with Diabetes an COVID-19. 

Recorded April 19, 2020.

This is a part of the American Diabetes Associations ongoing project providing resources for practicing clinicians on the care of Diabetes during the Covid-19 pandemic.  Todays discussion is an audio version of a webinar recorded on April 19, 2020.

Presented by:

Neil Skolnik, M.D., Professor of Family and Community Medicine, Sidney Kimmel Medical College, Thomas Jefferson University; Associate Director, Family Medicine Residency Program, Abington Jefferson Health

John J. Russell, M.D., Professor of Family and Community Medicine, Sidney Kimmel Medical College, Thomas Jefferson University; Director, Family Medicine Residency Program, Chair-Department of Family Medicine, Abington Jefferson Health




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Diabetes Core Update: COVID-19 – Older Adults with Diabetes and Covid-19 April 2019

This special issue focuses on Older Adults with Diabetes and Covid-19.

Recorded April 20, 2020.

This podcast will cover:

  1. Risk of COVID-19 in Older Adults
  2. What are the recommendations for glucose control during the pandemic
  3. Telemedicine
  4. Challenges to home care
  5. Long-term care settings

Intended for practicing physicians and health care professionals, Diabetes Core Update discusses how the latest research and information published in journals of the American Diabetes Association are relevant to clinical practice and can be applied in a treatment setting.

Presented by:

Irl Hirsch, MD
University of Washington
 
Elbert Huang, MD, MPH, FACP
University of Chicago
 
Stacie Levine, MD
University of Chicago

 




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Diabetes Core Update: COVID-19 – Impact on Youth and their Families, May 2019

This special issue focuses on the impact COVID-19 is having on youth with diabetes and their families. 

Recorded April 30, 2020.

This is a part of the American Diabetes Associations ongoing project providing resources for practicing clinicians on the care of Diabetes during the Covid-19 pandemic.  Today’s discussion is an audio version of a webinar recorded on April 30, 2020.

Presented by:

Barry Conrad, MPH, RD, CDE
Stanford Children's Health

Tamara S. Hannon, MD, MS
Indiana University

Marisa Hilliard, PhD
Baylor College of Medicine and Texas Children's Hospital

Cynthia Munoz, PhD, MPH
President-Elect, Helath Care & Education, American Diabetes Association

Jennifer Raymond, MD, MCR
Children's Hospital Los Angelas

 




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Diabetes Core Update – May 2019

Diabetes Core Update is a monthly podcast that presents and discusses the latest clinically relevant articles from the American Diabetes Association’s four science and medical journals – Diabetes, Diabetes Care, Clinical Diabetes, and Diabetes Spectrum. Each episode is approximately 20 minutes long and presents 5-6 recently published articles from ADA journals.

Intended for practicing physicians and health care professionals, Diabetes Core Update discusses how the latest research and information published in journals of the American Diabetes Association are relevant to clinical practice and can be applied in a treatment setting.

This issue will review:

  1. Incidence and Risk Factors for Chronic Kidney Disease in the Community
  2. Efficacy and Safety of Liraglutide 3.0 mg in Individuals With Overweight or Obesity and Type 2 Diabetes Treated With Basal Insulin
  3. Initial Glycemic Control and Care Among Adults Diagnosed With Type 2 Diabetes at a Younger Age
  4. Treatment and prevention of severe hypoglycaemia: Current and new formulations of glucagon – Diabetes Obesity and Metabolism
  5. Long-term Effects of Metformin on Patients With Type 2 Diabetic Kidney Disease
  6. Breakfast skipping is associated with persistently increased arterial stiffness in patients with type 2 diabetes – BMJ Open Diabetes Research and Care

For more information about each of ADA’s science and medical journals, please visit www.diabetesjournals.org.

Presented by:

Neil Skolnik, M.D., Professor of Family and Community Medicine, Sidney Kimmel Medical College, Thomas Jefferson University; Associate Director, Family Medicine Residency Program, Abington Jefferson Health

John J. Russell, M.D., Professor of Family and Community Medicine, Sidney Kimmel Medical College, Thomas Jefferson University; Director, Family Medicine Residency Program, Chair-Department of Family Medicine, Abington Jefferson Health




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HMC remains resolute in bid to keep out coronavirus

WESTERN BUREAU: THE HANOVER Municipal Corporation (HMC) has written to business operators in the parish, urging them to ensure that persons coming into their business places follow the health and safety protocols designed by the Ministry of Health...




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Corporate Raiding in Russia, Ukraine and Kazakhstan

Invitation Only Research Event

5 November 2019 - 9:00am to 1:00pm

Chatham House | 10 St James's Square | London | SW1Y 4LE

Event participants

John Patton, Argentem Creek
Rachel Cook, Peters & Peters
Tom Mayne, University of Exeter
Olga Bischof, Brown Rudnick LLP
Isobel Koshiw, Global Witness
Anton Moiseienko, RUSI

The widespread practice of illicit acquisition of a business or part of a business in the former Soviet states, known as ‘reiderstvo’ or asset-grabbing, is a major risk that disincentivises investment in the region.

It is distinct from the way corporate raiding occurs in the West and enabled by factors such as corruption and weak protection of property rights.

This roundtable will assess the practice of corporate raiding in Russia, Ukraine and Kazakhstan: its evolution over time, knock-on effects and potential solutions. The speakers will also address the implications for the UK legal system and possible policy responses.

Event attributes

Chatham House Rule

Department/project

Anna Morgan

Administrator, Ukraine Forum
+44 (0)20 7389 3274




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Nuclear Tensions Must Not Be Sidelined During Coronavirus

1 May 2020

Ana Alecsandru

Research Assistant, International Security Programme
Although the pandemic means the Nuclear Non-Proliferation Treaty (NPT) Review Conference (RevCon) is postponed, the delay could be an opportunity to better the health of the NPT regime.

2020-05-01-Iran-Peace-Nuclear

Painted stairs in Tehran, Iran symbolizing hope. Photo by Fatemeh Bahrami/Anadolu Agency/Getty Images.

Despite face-to-face diplomatic meetings being increasingly rare during the current disruption, COVID-19 will ultimately force a redefinition of national security and defence spending priorities, and this could provide the possibility of an improved political climate at RevCon when it happens in 2021.

With US presidential elections due in November and a gradual engagement growing between the EU and Iran, there could be a new context for more cooperation between states by 2021. Two key areas of focus over the coming months will be the arms control talks between the United States and Russia, and Iran’s compliance with the 2015 Joint Comprehensive Plan of Action (JCPOA), also known as the Iran Nuclear Deal.

It is too early to discern the medium- and longer-term consequences of COVID-19 for defence ministries, but a greater focus on societal resilience and reinvigorating economic productivity will likely undercut the rationale for expensive nuclear modernization.

Therefore, extending the current New START (Strategic Arms Reduction Treaty) would be the best, most practical option to give both Russia and the United States time to explore more ambitious multilateral arms control measures, while allowing their current focus to remain on the pandemic and economic relief.

Continuing distrust

But with the current treaty — which limits nuclear warheads, missiles, bombers, and launchers — due to expire in February 2021, the continuing distrust between the United States and Russia makes this extension hard to achieve, and a follow-on treaty even less likely.

Prospects for future bilateral negotiations are hindered by President Donald Trump’s vision for a trilateral arms control initiative involving both China and Russia. But China opposes this on the grounds that its nuclear arsenal is far smaller than that of the two others.

While there appears to be agreement that the nuclear arsenals of China, France, and the UK (the NPT nuclear-weapons states) and those of the states outside the treaty (India, Pakistan, North Korea, and Israel) will all have to be taken into account going forward, a practical mechanism for doing so proves elusive.

If Joe Biden wins the US presidency he seems likely to pursue an extension of the New START treaty and could also prevent a withdrawal from the Open Skies treaty, the latest arms control agreement targeted by the Trump administration.

Under a Biden administration, the United States would also probably re-join the JCPOA, provided Tehran returned to strict compliance with the deal. Biden could even use the team that negotiated the Iran deal to advance the goal of denuclearization of the Korean peninsula.

For an NPT regime already confronted by a series of longstanding divergences, it is essential that Iran remains a signatory especially as tensions between Iran and the United States have escalated recently — due to the Qassim Suleimani assassination and the recent claim by Iran’s Revolutionary Guard Corps to have successfully placed the country’s first military satellite into orbit.

This announcement raised red flags among experts about whether Iran is developing intercontinental ballistic missiles due to the dual-use nature of space technology. The satellite launch — deeply troubling for Iran’s neighbours and the EU countries — may strengthen the US argument that it is a cover for the development of ballistic missiles capable of delivering nuclear weapons.

However, as with many other countries, Iran is struggling with a severe coronavirus crisis and will be pouring its scientific expertise and funds into that rather than other efforts — including the nuclear programme.

Those European countries supporting the trading mechanism INSTEX (Instrument in Support of Trade Exchanges) for sending humanitarian goods into Iran could use this crisis to encourage Iran to remain in compliance with the JCPOA and its NPT obligations.

France, Germany and the UK (the E3) have already successfully concluded the first transaction, which was to facilitate the export of medical goods from Europe to Iran. But the recent Iranian escalatory steps will most certainly place a strain on the preservation of this arrangement.

COVID-19 might have delayed Iran’s next breach of the 2015 nuclear agreement but Tehran will inevitably seek to strengthen its hand before any potential negotiations with the United States after the presidential elections.

As frosty US-Iranian relations — exacerbated by the coronavirus pandemic — prevent diplomatic negotiations, this constructive engagement between the E3 and Iran might prove instrumental in reviving the JCPOA and ensuring Iran stays committed to both nuclear non-proliferation and disarmament.

While countries focus their efforts on tackling the coronavirus pandemic, it is understandable resources may be limited for other global challenges, such as the increasing risk of nuclear weapons use across several regions.

But the potential ramifications of the COVID-19 crisis for the NPT regime are profound. Ongoing tensions between the nuclear-armed states must not be ignored while the world’s focus is elsewhere, and the nuclear community should continue to work together to progress nuclear non-proliferation and disarmament, building bridges of cooperation and trust that can long outlast the pandemic.




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Norris McDonald | Coronavirus, faith-based medicine and quackery

Four companies involved in one of America’s “largest price-fixing cases” are now behind the anti-malaria drug touted by Donald ‘The Great Impeached’ Trump as a snake-oil, cure-all treatment for COVID-19, caused by the novel coronavirus. Several...




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Acuna set to smash records this season

Those hoping to watch Ronald Acuna Jr. extend last season's incredible post-All-Star break production should remember that his pace would have equated to 45 homers and 33 stolen bases over 162 games.




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Healthy Correa looks to put 2018 behind him

You can't help but learn a few things when you had the kind of year Astros star shortstop Carlos Correa experienced last season, when a nagging back injury derailed him in the second half and forced him to deal with the biggest adversity of his career.




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Putin-Trump call focuses on coronavirus, arms control, oil

MOSCOW (AP): United States (US) President Donald Trump and Russian President Vladimir Putin discussed progress in combating the coronavirus pandemic, along with arms-control issues and oil prices, in a phone call Thursday, the White House and the...




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Should all American doctors be using electronic medical records?

Evidence shows using electronic health records can increase efficiency, and reduce preventable medical errors - but only if they are used properly. However, in the US, the president of the American Medical Association calls them almost unusable. In this debate, Richard Hurley is joined by George Gellert, Regional Medical Informatics Officer at...




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Fighting inequality, corruption, and conflict - how to improve South Asia's health

The BMJ has published a series of articles, taking an in-depth look at health in South Asia. In this collection, authors from India, Pakistan, Nepal, Bangladesh, Sri Lanka, and Afghanistan collaborate to identify evidence-based solutions to shape health policy and interventions, and drive innovations and research in the region. In this podcast,...




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Did international accord on tobacco reduce smoking?

WHO Director-General Dr. Tedros recently said “Since it came into force 13 years ago, the Framework Convention on Tobacco Control remains one of the world’s most powerful tools for promoting public health,”. But is it? That’s what a to studies just published on bmj.com try and investigate - one of which pulls together all the data we have on...




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Front line stories - How corona is changing acute care

As we cover the covid-19 outbreak, we want to hear some of the stories from the frontline - And who better to heart of what this pandemic is doing to the profession in the UK, than some of the people who write regularly for The BMJ? In this first one, we wanted to look specifically at acute care - those at the sharp end of the response, so we're...




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C-Reactive Protein Is an Independent Predictor of Risk for the Development of Diabetes in the West of Scotland Coronary Prevention Study

Dilys J. Freeman
May 1, 2002; 51:1596-1600
Complications




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NCEP-Defined Metabolic Syndrome, Diabetes, and Prevalence of Coronary Heart Disease Among NHANES III Participants Age 50 Years and Older

Charles M. Alexander
May 1, 2003; 52:1210-1214
Complications




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Intrauterine exposure to diabetes conveys risks for type 2 diabetes and obesity: a study of discordant sibships

D Dabelea
Dec 1, 2000; 49:2208-2211
Articles




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PPARA Polymorphism Influences the Cardiovascular Benefit of Fenofibrate in Type 2 Diabetes: Findings From ACCORD-Lipid

The cardiovascular benefits of fibrates have been shown to be heterogeneous and to depend on the presence of atherogenic dyslipidemia. We investigated whether genetic variability in the PPARA gene, coding for the pharmacological target of fibrates (PPAR-α), could be used to improve the selection of patients with type 2 diabetes who may derive cardiovascular benefit from addition of this treatment to statins. We identified a common variant at the PPARA locus (rs6008845, C/T) displaying a study-wide significant influence on the effect of fenofibrate on major cardiovascular events (MACE) among 3,065 self-reported white subjects treated with simvastatin and randomized to fenofibrate or placebo in the ACCORD-Lipid trial. T/T homozygotes (36% of participants) experienced a 51% MACE reduction in response to fenofibrate (hazard ratio 0.49; 95% CI 0.34–0.72), whereas no benefit was observed for other genotypes (Pinteraction = 3.7 x 10–4). The rs6008845-by-fenofibrate interaction on MACE was replicated in African Americans from ACCORD (N = 585, P = 0.02) and in external cohorts (ACCORD-BP, ORIGIN, and TRIUMPH, total N = 3059, P = 0.005). Remarkably, rs6008845 T/T homozygotes experienced a cardiovascular benefit from fibrate even in the absence of atherogenic dyslipidemia. Among these individuals, but not among carriers of other genotypes, fenofibrate treatment was associated with lower circulating levels of CCL11—a proinflammatory and atherogenic chemokine also known as eotaxin (P for rs6008845-by-fenofibrate interaction = 0.003). The GTEx data set revealed regulatory functions of rs6008845 on PPARA expression in many tissues. In summary, we have found a common PPARA regulatory variant that influences the cardiovascular effects of fenofibrate and that could be used to identify patients with type 2 diabetes who would derive benefit from fenofibrate treatment, in addition to those with atherogenic dyslipidemia.




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Haiti records seventh death from COVID-19

PORT AU PRINCE, Haiti, CMC – The Ministry of Public Health has confirmed that a 20-year-old man has become the seventh person in Haiti to die of the coronavirus (COVID-19). It is urging the population to follow restriction measures, including...




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Bermuda records seventh COVID-19 death

HAMILTON, Bermuda, CMC –  Bermuda recorded its seventh COVID-19 death on Saturday as Finance Minister Curtis Dickinson announced that he would need to rewrite this year’s budget because of the battering from the global...




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United against coronavirus through art - Government of India calls artists to participate in a unique art competition

The COVID-19 pandemic around the world has taken the world by storm, touching the lives of every human being on Earth. The global nature of the crisis has united us as human beings and tragedy and deaths in any country by COVID-19 worry us all....




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D-backs announce record turnout to Fan Fest

As he walked around D-backs Fan Fest on Saturday afternoon at Salt River Fields, general manager Mike Hazen was pleasantly surprised to see the fan reaction as a record crowd of over 40,000 poured into the event.




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Preoperative Localization of Adenomas in Primary Hyperparathyroidism: The Value of 11C-Choline PET/CT in Patients with Negative or Discordant Findings on Ultrasonography and 99mTc-Sestamibi SPECT/CT

We aimed to assess the value of 11C-choline PET in patients with primary hyperparathyroidism and negative or discordant results on 99mTc-sestamibi imaging and neck ultrasound. Methods: Eighty-seven such patients were assessed and subsequently underwent parathyroidectomy. PET/CT image data were analyzed semiquantitatively using SUVmax and SUV ratios (target to contralateral thyroid gland and carotid artery). A positive PET/CT result was defined as focal uptake significantly higher than regular thyroid tissue. Ectopic foci were also considered positive. Inconclusive PET/CT cases were defined as a lesion with uptake equal to normal thyroid tissue. If no prominent or ectopic uptake was detectable, the PET/CT result was considered negative. Results: When dichotomizing the 11C-choline PET/CT imaging results by defining lesions with both positive and inconclusive uptake as positive, we found 84 of 92 lesions (91.3%) to have true-positive uptake whereas 8 lesions (8.7%) had false-positive uptake. One lesion showed false-negative uptake; the sensitivity was 98.8%. The corresponding positive predictive value for lesions was 91.3%. The mean SUVmax was 6.15 ± 4.92 in 72 lesions with positive uptake (70 patients) and 2.96 ± 2.32 in 20 lesions with inconclusive uptake (18 patients). Conclusion: These results in a large group of patients indicate that 11C-choline PET/CT is a promising tool for parathyroid adenoma localization when ultrasound and 99mTc-sestamibi imaging yield negative or discordant results.




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Clinical characteristics of 113 deceased patients with coronavirus disease 2019: retrospective study




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Use of electronic medical records in development and validation of risk prediction models of hospital readmission: systematic review




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Prevalence of diabetes recorded in mainland China using 2018 diagnostic criteria from the American Diabetes Association: national cross sectional study




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Conrad George and André Sheckleford | Incorrect layoff procedures can lead to future liability

OP-CONTRIBUTION: EMPLOYMENT CONTRACTS The COVID-19 pandemic is hitting businesses and the economy in a manner perhaps not seen since the Second World War. This, of course, has affected the ability of employers to pay their employees. The COVID-19...




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US Treasury says April-June borrowing will be a record US$2.99t

THE ECONOMIC paralysis triggered by the coronavirus pandemic is forcing the United States Treasury to borrow far more than it ever has before – US$2.99 trillion in the current quarter alone. The amount is more than five times the government’s...




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Sagicor raises doubt about Scotia Life T&T deal

Sagicor Finance Company has raised doubt about whether the deal to acquire the assets of Scotia Life Trinidad...




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Challenges and Opportunities in the Fight Against Corruption

Members Event

9 December 2019 - 6:30pm to 7:30pm

Chatham House | 10 St James's Square | London | SW1Y 4LE

Event participants

Rory Stewart, Member of Parliament for Penrith and The Border (2010-19); Secretary of State for International Development (2019)

Chair: Daniel Bruce, Chief Executive, Transparency International UK

Drawing on his experience in government, Rory Stewart shares his observations into the impact corruption can have on society.

This event is organized in association with Transparency International UK as part of Transparency International UK’s Annual Lecture series.

Members Events Team




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Coronavirus: Why The EU Needs to Unleash The ECB

18 March 2020

Pepijn Bergsen

Research Fellow, Europe Programme
COVID-19 presents the eurozone with an unprecedented economic challenge. So far, the response has been necessary, but not enough.

2020-03-18.jpg

EU President of Council Charles Michel chairs the coronavirus meeting with the leaders of EU member countries via teleconference on March 17, 2020. Photo by EU Council / Pool/Anadolu Agency via Getty Images.

The measures taken to limit the spread of the coronavirus - in particular social distancing -  come with significant economic costs, as the drop both in demand for goods and services and in supply due to workers being at home sick will create a short-term economic shock not seen in modern times.

Sectors that are usually less affected by regular economic swings such as transport and tourism are being confronted with an almost total collapse in demand. In the airline sector, companies are warning they might only be able to hold out for a few months more.

Building on the calls to provide income support to all citizens and shore up businesses, European leaders should now be giving explicit permission to the European Central Bank (ECB) to provide whatever financial support is needed.

Although political leaders have responded to the economic threat, the measures announced across the continent have mainly been to support businesses. The crisis is broader and deeper than the current response.

Support for weaker governments

The ECB already reacted to COVID-19 by announcing measures to support the banking system, which is important to guarantee the continuity of the European financial system and to ensure financially weaker European governments do not have to confront a failing banking system as well.

Although government-subsidised reduced working hours and sick pay are a solution for many businesses and workers, crucially they are not for those working on temporary contracts or the self-employed. They need direct income support.

This might come down to instituting something that looks like a universal basic income (UBI), and ensuring money keeps flowing through the economy as much as possible to help avoid a cascade of defaults and significant long-term damage.

But while this is likely to be the most effective remedy to limit the medium-term impact on the economy, it is particularly costly. Just as an indication, total compensation of employees was on average around €470bn per month in the eurozone last year.

Attempting to target payments using existing welfare payment channels would reduce costs, but is difficult to implement and runs the risk of many households and businesses in need missing out.

The increase in spending and lost revenue associated with these support measures dwarf the fiscal response to the 2008-09 financial crisis. The eurozone economy could contract by close to 10% this year and budget deficits are likely be in double digits throughout the bloc.

The European Commission has already stated member states are free to spend whatever is necessary to combat the crisis, which is not surprising given the Stability and Growth Pact - which includes the fiscal rules - allows for such eventualities.

Several eurozone countries do probably have the fiscal space to deal with this. Countries such as Germany and the Netherlands have run several years of balanced budgets recently and significantly decreased their debt levels. For countries such as Italy, and even France, it is a different story and the combination of much higher spending and a collapse in tax revenue is more likely to lead to questions in the market over the sustainability of their debt levels. In order to avoid this, the Covid-19 response must be financed collectively.

The Eurogroup could decide to use the European Stability Mechanism (ESM) to provide states with the funds, while suitably ditching the political conditionality that came with previous bailout. But the ESM currently has €410bn in remaining lending capacity, which is unlikely to be enough and difficult to rapidly increase.

So this leaves the ECB to pick up the tab of national governments’ increase in spending, as the only institution with effectively unlimited monetary firepower. But a collective EU response is complicated by the common currency, and particularly by the role of the ECB.

The ECB can’t just do whatever it likes and is limited more than other major central banks in its room for manoeuvre. It does have a programme to buy government bonds but this relies on countries agreeing to a rescue programme within the context of the ESM, with all the resulting political difficulties.

There are two main ways that the ECB could finance the response to the crisis. First, it could buy up more or all bonds issued by the member states. A first step in this direction would be to scrap the limits on the bonds it can buy. Through self-imposed rules, the ECB can only buy up to a third of every country’s outstanding public debt. There are good reasons for this in normal times, but these are not normal times. With the political blessing of the European Council, the Eurosystem of central banks could then start buying bonds issued by governments to finance whatever expenditure they deem necessary to combat the crisis.

Secondly, essentially give governments an overdraft with the ECB or the national central banks. Although a central bank lending directly to governments is outlawed by the European treaties, the COVID-19 crisis means these rules should be temporarily suspended by the European Council.

Back in 2012, the then president of the ECB, Mario Draghi, proclaimed the ECB would do whatever it takes, within its mandate, to save the euro, which was widely seen as a crucial step towards solving the eurozone crisis. The time is now right for eurozone political leaders to explicitly tell the ECB that together they can do whatever it takes to save the eurozone economy through direct support for businesses and households.




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Coronavirus and the Future of Democracy in Europe

31 March 2020

Hans Kundnani

Senior Research Fellow, Europe Programme
The pandemic raises difficult questions about whether liberal democracies can adequately protect their citizens.

2020-03-31-Police-Poland

Police officers wearing protective face masks patrol during coronavirus lockdown enforcement in Wroclaw, Poland. Photo by Bartek Sadowski/Bloomberg via Getty Images.

It is less than a month since we published our research paper on the future of democracy in Europe. But it feels like we now live in a different world. The coronavirus has already killed thousands of people in Europe, led to an unprecedented economic crisis and transformed daily life – and in the process raised difficult new questions about democracy.

The essence of our argument in the paper was that democracy in Europe should be deepened. But now there is a much more basic question about whether democracies can protect their citizens from the pandemic.

There has already been much discussion about whether authoritarian states will emerge stronger from this crisis than democracies. In particular, although the virus originated in China and the government initially seemed to struggle to deal with it, it was able to largely contain the outbreak in Hubei and deploy vast resources from the rest of the country to deal with it.

Come through the worst

China may have come through the worst of the health crisis – though a second wave of infections as restrictions are lifted is possible – and there have already been three times as many deaths in Italy, and twice as many in Spain, as in China (although there is increasing doubt about the accuracy of China’s figures).

However, it is not only authoritarian states that seem so far to have coped relatively well with the virus. In fact, some East Asian democracies appear to have done even better than China. At the time of writing South Korea, with a population of 51.5 million, has had only 144 death rates so far. Taiwan, with a population of nearly 24 million, has had only two deaths.

So rather than thinking in terms of the relative performance of authoritarian states and democracies, perhaps instead we should be asking what we in Europe can learn from East Asian democracies.

It is not yet clear why East Asian democracies were able to respond so effectively, especially as they did not all follow exactly the same approach. Whereas some quickly imposed restrictions on travel (for example, Taiwan suspended flights from China and then prohibited the entry of people from China and other affected countries) and quarantines, others used extensive testing and contact tracing, often making use of personal data collected from citizens.

Whatever the exact strategy they used, though, they did all act quickly and decisively – and the collective memory of the SARS outbreak in 2003 and other recent epidemics seems to have played a role in this. For example, following the SARS outbreak, Taiwan created a central epidemic command center. Europe, meanwhile, was hardly affected by SARS – and we seem to have assumed the coronavirus would be the same (although that does not quite explain why we were still so slow to react in February even after it was clear that the virus had spread to Italy).

However, while the relative success of East Asian democracies may have something to do with this recent experience of epidemics, it may also have something to do with the kind of democracies they are. It may be a simple matter of competence – the bureaucracy in Taiwan and South Korea may function better, and in particular in a more coordinated way, than in many European countries.

But it may also be more than that. In particular, it could be that East Asian democracies have a kind of 'authoritarian residue' that has helped in the initial response to this crisis. South Korea and Taiwan are certainly vibrant democracies – but they are also relatively new democracies compared to many in Europe. As a result, citizens may have a different relationship with the state and be more willing to accept sudden restrictions of freedoms, in particular on movement, and the use of personal data – at least in a crisis.

In that sense, the pandemic may be a challenge not to democracy as such but to liberal democracy in particular – in other words, a system of popular sovereignty together with guaranteed basic rights, such as including freedom of association and expression and checks and balances on executive power. There may now be difficult trade-offs to be made between those basic rights and security – and, after the experience of coronavirus, many citizens may choose security.

This brings us back to the issues we discussed in our research paper. Even before the coronavirus hit, there was already much discussion of a crisis of liberal democracy. In particular, there has been a debate about whether liberalism and democracy, which had long been assumed to go together, were becoming decoupled.

In particular, ‘illiberal democracies’ seemed to be emerging in many places including Europe (although, as we discuss in the paper, some analysts argue that the term is incoherent). This model of ‘illiberal democracy’ – in other words, one in which elections continue to be held but some individual rights are curtailed – may emerge stronger from this new crisis.

It is striking that Singapore – also seen as responding successfully to coronavirus – was seen as a paradigmatic ‘illiberal democracy’ long before Hungarian Prime Minister Viktor Orbán embraced the idea. In particular, there is little real opposition to the People’s Action Party, which has been in power since 1959.

Since this new crisis began, Orbán has gone further in suspending rights in Hungary. On March 11, he declared a state of emergency – as many other European countries have also done. But he has now gone further by passing legislation that allows him to govern by decree indefinitely and make it illegal to spread misinformation that undermines the government’s response to the pandemic. Clearly, this is a further decisive step in the deconsolidation of liberal democracy in Hungary.

So far, though, much of the discussion, particularly in the foreign policy world, has focused mainly on how to change popular perceptions that liberal democracies are failing in this crisis. For example, High Representative Josep Borrell, the European Union’s foreign minister, wrote last week of a 'battle of narratives'.

But this misses the point. It is not a matter of spinning the European model, but of taking seriously the substantial questions raised by the coronavirus about the ability of liberal democracies to adequately protect their citizens.




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Source:

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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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