The association between glucose metabolism status,diabetes severity and a history of fractures and recent falls in participants of 50 years and older—the Maastricht Study

Summary

In this cohort of relatively young and well-treated participants with type 2 diabetes, we found no association between diabetes status and a history of previous fractures and recent falls. Furthermore, no association between diabetes severity and previous fractures or recent falls was found.

Introduction

In this study, we examined the association between glucose metabolism status and historical fractures or recent falls and the effect of diabetes severity (glucose control, insulin use, and diabetes duration) on falls and fractures in the participants with type 2 diabetes.

Methods

Cross-sectional data from 2005 participants of the Maastricht Study. Falls in the past 6 months and fractures ≥age 50 were assessed by questionnaire. Glucose metabolism status (normal glucose metabolism, impaired glucose metabolism, or type 2 diabetes) was based on the oral glucose tolerance test and medication use.

Results

In the completely adjusted model, the odds for a fall were not significantly higher in those with impaired glucose metabolism status (OR (95%CI) 1.28 (0.93–1.77)) or with type 2 diabetes (OR (95%CI) 1.21 (0.80–1.81)) compared with the group with normal glucose metabolism. Within the group with type 2 diabetes, there were no significant differences with regard to reported falls between participants with HbA1c >7 % (53 mmol/mol) versus HbA1c ≤7 % (OR (95%CI) 1.05 (0.58–1.90)), insulin users versus non-insulin users (OR (95%CI) 1.51 (0.79–2.89)), and with a diabetes duration >5 versus ≤5 years (OR (95%CI) 0.52 (0.46–1.47)). Similarly, neither glucose metabolism status nor diabetes severity was associated with prior fractures.

Conclusions

Glucose metabolism status was not significantly associated with previous fractures and recent falls. In addition, in this cohort of relatively young and well-treated participants with type 2 diabetes, diabetes severity was not associated with previous fractures and recent falls.

     

Cause and treatment of anorexia nervosa

The hypothesis that eating disorders are caused by an antecedent mental disorder, presently believed to be an obsessive compulsive disorder, has been clinically implemented during many years but has not improved treatment outcome. Alternatively, eating disorders are eating disorders and the symptoms of anorexic patients and probably bulimic patients as well, are epiphenomena which emerge as a consequence of starvation. This hypothesis is supported by the observations of the effects of a 6 month long period of semi-starvation on healthy human volunteers, which demonstrated not only the emergence of psychiatric symptoms but also the reduction in eating rate which is typical of anorexia nervosa patients. On this framework training anorexic patients how to eat may be a useful intervention. We report that anorexic patients, either with a body mass index<14 or >15.5 display the same pattern of eating behavior, with a low level of intake, a slow eating rate and a high level of satiety. They also have the same, high level of psychiatric symptoms, including obsessive compulsive symptoms. Training patients to eat more food at a progressively higher rate reverses these symptoms and patients remain free of symptoms during an extended period of follow-up. It is suggested that the pattern of eating behavior mediates between the starved condition and the psychopathology of anorexia nervosa.     

基于增强图卷积神经网络的病毒形态识别方法研究

背景 透射电子显微镜（TEM）是检测病毒的重要手段,传统TEM检测常依靠专家手工观察,操作步骤繁琐,且已有机器学习方法易受到背景、噪声的影响,导致病毒检测方法准确率差、效率低且耗时长。 目的 探讨增强图卷积神经网络（EGCN）对TEM图像中的病毒形态自动识别问题,以提高TEM病毒检测的效率。 方法 EGCN模型利用卷积神经网络（CNN）提取像素间的局部特征信息,并结合样本特征之间的最近邻关系利用图卷积网络（GCN）进行图特征学习。在模型优化中联合优化群体超分类损失和分类交叉熵损失以提高EGCN模型对病毒类别信息特征的提取能力,较CNN对TEM病毒图像特征具备更强的特征提取能力。 结果 通过不同方法在15类TEM病毒图像数据集上开展实验,EGCN达到3.40%的top-1错误率、1.88%的top-2错误率、96.65%的精确度和96.60%的召回率,并通过一系列对比实验表明EGCN模型可以有效避免TEM图像中背景、噪声等的影响,提高对病毒识别的准确率。 结论 EGCN可以有效解决病毒形态识别任务,为病毒的诊断提供重要的参考价值。     

Novel Tools to Improve Patient Selection and Monitoring on Active Surveillance for Low-risk Prostate Cancer: A Systematic Review

Context

Active surveillance (AS) is an alternative to initial radical treatment of low-risk prostate cancer (PCa). Current criteria for selection and follow-up incorrectly exclude some patients eligible for AS and misclassify some who actually harbour significant disease. Better prediction of cancer behaviour at diagnosis would allow less strict monitoring and may improve acceptance of AS.

Objective

To review and critically analyse the literature on the value of novel clinical tools for patient selection and monitoring on AS.

Evidence acquisition

A comprehensive search of the PubMed database until July 10, 2013, was performed according to Preferred Reporting Items for Systematic Reviews and Meta-analysis statement guidelines. Studies assessing novel markers and diagnostics for patient selection for AS and follow-up during AS were included. Studies analysing only classic clinical parameters used in current protocols (prostate-specific antigen, prostate volume, number of (positive) prostate biopsies, percentage malignant tissue, Gleason score) were excluded. This review focuses only on the AS setting and not on predicting insignificant disease in general.

Evidence synthesis

Of 787 studies on AS, 30 were included in this review: 14 on magnetic resonance imaging (MRI), 5 on serum markers, 5 on urinary markers, 4 on histopathology markers, and 2 on germline genetic markers. Several of these markers improve the prediction of tumour volume, tumour grade, or time to active treatment. MRI has a high specificity for low-risk PCa; new serum markers are associated with unfavourable disease. In none of the studies was the new marker used as the primary decision tool. Long-term outcome measures such as mortality were not assessed. The definition of indolent PCa is disputable.

Conclusions

Imaging and serum markers may improve future patient selection for AS and follow-up during AS. Prospective studies should aim to further evaluate the clinical utility of these new markers with respect to longer term outcomes of AS.

Patient summary

We searched the literature for articles reporting new ways to safely monitor low-risk prostate cancer for patients who have not had radical treatment. We found 30 articles. The most promising tools appear to be magnetic resonance imaging scans and various new blood markers. These may be used in the future within active surveillance regimens.     

Rapid prenatal diagnosis of beta thalassemia using DNA amplification and nonradioactive probes

We used in vitro DNA amplification by the polymerase chain reaction and nonradioactive probes for prenatal diagnosis of beta thalassemia in Chinese from the Guangdong province. Exact molecular diagnoses were made in all 20 fetuses studied over a 6-month period. We conclude that this method of prenatal diagnosis for beta thalassemia is a viable approach in many parts of the world where this disease is common.     

鞍山市铁东区公共场所使用化妆品存在的主要卫生问题及对策

目的了解鞍山市铁东区公共场所使用化妆品卫生问题,保障使用者身体健康。方法对2013年度鞍山市铁东区卫生防疫站辖区内监管的公共场所随机抽检化妆品,对公共场所使用化妆品单位数及比例,化妆品标签标识卫生问题等进行描述。结果住宿业化妆品使用情况为56%,其他三种场所100%使用。化妆品标签标识检查住宿业合格率最低,仅为50%。国产特殊用途化妆品持有效证件率仅为65%,普通的仅为62%。标签标识问题突出,进货渠道复杂。化妆品抽检合格率低。结论公共场所的化妆品卫生质量令人担忧。