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U.N. triples coronavirus aid appeal to help most vulnerable countries

The United Nations more than tripled its humanitarian aid appeal on Thursday from $2 billion to $6.7 billion to accommodate its updated global plan to help the poorest nations fight the coronavirus pandemic.




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Chinese exports up in April, Beijing’s data show

China's exports rebounded in April, growing 3.5 percent, according to the latest data from Beijing's General Administration of Customs on Thursday.




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Navy breaks ground on laser weapons test lab in California

Navy leaders and private contractors broke ground this week on what will become the fleet's only dedicated facility to test, fire and evaluate complete laser weapon systems in a maritime environment.




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Metformin Therapy During Pregnancy: Good for the goose and good for the gosling too?

Denice S. Feig
Oct 1, 2011; 34:2329-2330
Editorial (See Rowan et al., p. 2279)




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Dalcetrapib Reduces Risk of New-Onset Diabetes in Patients With Coronary Heart Disease

Gregory G. Schwartz
May 1, 2020; 43:1077-1084
Emerging Therapies: Drugs and Regimens




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PIONEER 1: Randomized Clinical Trial of the Efficacy and Safety of Oral Semaglutide Monotherapy in Comparison With Placebo in Patients With Type 2 Diabetes

Vanita R. Aroda
Sep 1, 2019; 42:1724-1732
Emerging Therapies: Drugs and Regimens




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Guideline Approach to Therapy in Patients With Newly Diagnosed Type 2 Diabetes

Itamar Raz
Aug 1, 2013; 36:S139-S144
Diabetes Pathophysiology




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Nutrition Therapy for Adults With Diabetes or Prediabetes: A Consensus Report

Alison B. Evert
May 1, 2019; 42:731-754
Continuing Evolution of Nutritional Therapy for Diabetes




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Effects of Gender-Affirming Hormone Therapy on Insulin Sensitivity and Incretin Responses in Transgender People

OBJECTIVE

The long-term influences of sex hormone administration on insulin sensitivity and incretin hormones are controversial. We investigated these effects in 35 transgender men (TM) and 55 transgender women (TW) from the European Network for the Investigation of Gender Incongruence (ENIGI) study.

RESEARCH DESIGN AND METHODS

Before and after 1 year of gender-affirming hormone therapy, body composition and oral glucose tolerance tests (OGTTs) were evaluated.

RESULTS

In TM, body weight (2.8 ± 1.0 kg; P < 0.01), fat-free mass (FFM) (3.1 ± 0.9 kg; P < 0.01), and waist-to-hip ratio (–0.03 ± 0.01; P < 0.01) increased. Fasting insulin (–1.4 ± 0.8 mU/L; P = 0.08) and HOMA of insulin resistance (HOMA-IR) (2.2 ± 0.3 vs. 1.8 ± 0.2; P = 0.06) tended to decrease, whereas fasting glucose (–1.6 ± 1.6 mg/dL), glucose-dependent insulinotropic polypeptide (GIP) (–1.8 ± 1.0 pmol/L), and glucagon-like peptide 1 (GLP-1) (–0.2 ± 1.1 pmol/L) were statistically unchanged. Post-OGTT areas under the curve (AUCs) for GIP (2,068 ± 1,134 vs. 2,645 ± 1,248 [pmol/L] x min; P < 0.01) and GLP-1 (2,352 ± 796 vs. 2,712 ± 1,015 [pmol/L] x min; P < 0.01) increased. In TW, body weight tended to increase (1.4 ± 0.8 kg; P = 0.07) with decreasing FFM (–2.3 ± 0.4 kg; P < 0.01) and waist-to-hip ratio (–0.03 ± 0.01; P < 0.01). Insulin (3.4 ± 0.8 mU/L; P < 0.01) and HOMA-IR (1.7 ± 0.1 vs. 2.4 ± 0.2; P < 0.01) rose, fasting GIP (–1.4 ± 0.8 pmol/L; P < 0.01) and AUC GIP dropped (2,524 ± 178 vs. 1,911 ± 162 [pmol/L] x min; P < 0.01), but fasting glucose (–0.3 ± 1.4 mg/dL), GLP-1 (1.3 ± 0.8 pmol/L), and AUC GLP-1 (2,956 ± 180 vs. 2,864 ± 93 [pmol/L] x min) remained unchanged.

CONCLUSIONS

In this cohort of transgender persons, insulin sensitivity but also post-OGTT incretin responses tend to increase with masculinization and to decrease with feminization.




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Association of Urine Haptoglobin With Risk of All-Cause and Cause-Specific Mortality in Individuals With Type 2 Diabetes: A Transethnic Collaborative Work

OBJECTIVE

Haptoglobin is an acute-phase reactant with pleiotropic functions. We aimed to study whether urine haptoglobin may predict risk of mortality in people with type 2 diabetes.

RESEARCH DESIGN AND METHODS

We employed a transethnic approach with a cohort of Asian origin (Singapore) (N = 2,061) and a cohort of European origin (France) (N = 1,438) included in the study. We used survival analyses to study the association of urine haptoglobin with risk of all-cause and cause-specific mortality.

RESULTS

A total of 365 and 525 deaths were registered in the Singapore cohort (median follow-up 7.5 years [interquartile range 3.5–12.8]) and French SURDIAGENE cohort (median follow-up 6.8 years [interquartile range 4.3–10.5], respectively. Singapore participants with urine haptoglobin in quartiles 2 to 4 had higher risk for all-cause mortality compared with quartile 1 (unadjusted hazard ratio [HR] 1.47 [95% CI 1.02–2.11], 2.28 [1.62–3.21], and 4.64 [3.39–6.35], respectively). The association remained significant in quartile 4 after multiple adjustments (1.68 [1.15–2.45]). Similarly, participants in the French cohort with haptoglobin in quartile 4 had significantly higher hazards for all-cause mortality compared with quartile 1 (unadjusted HR 2.67 [2.09–3.42] and adjusted HR 1.49 [1.14–1.96]). In both cohorts, participants in quartile 4 had a higher risk of mortality attributable to cardiovascular disease and infection but not malignant tumor.

CONCLUSIONS

Urine haptoglobin predicts risk of mortality independent of traditional risk factors, suggesting that it may potentially be a novel biomarker for risk of mortality in patients with type 2 diabetes.




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A Multinational, Multicenter, Randomized, Double-Blinded, Placebo-Controlled Trial to Evaluate the Efficacy of Cyclical Topical Wound Oxygen (TWO2) Therapy in the Treatment of Chronic Diabetic Foot Ulcers: The TWO2 Study

OBJECTIVE

Topical oxygen has been used for the treatment of chronic wounds for more than 50 years. Its effectiveness remains disputed due to the limited number of robust high-quality investigations. The aim of this study was to assess the efficacy of multimodality cyclical pressure Topical Wound Oxygen (TWO2) home care therapy in healing refractory diabetic foot ulcers (DFUs) that had failed to heal with standard of care (SOC) alone.

RESEARCH DESIGN AND METHODS

Patients with diabetes and chronic DFUs were randomized (double-blind) to either active TWO2 therapy or sham control therapy—both in addition to optimal SOC. The primary outcome was the percentage of ulcers in each group achieving 100% healing at 12 weeks. A group sequential design was used for the study with three predetermined analyses and hard stopping rules once 73, 146, and ultimately 220 patients completed the 12-week treatment phase.

RESULTS

At the first analysis point, the active TWO2 arm was found to be superior to the sham arm, with a closure rate of 41.7% compared with 13.5%. This difference in outcome produced an odds ratio (OR) of 4.57 (97.8% CI 1.19, 17.57), P = 0.010. After adjustment for University of Texas Classification (UTC) ulcer grade, the OR increased to 6.00 (97.8% CI 1.44, 24.93), P = 0.004. Cox proportional hazards modeling, also after adjustment for UTC grade, demonstrated >4.5 times the likelihood to heal DFUs over 12 weeks compared with the sham arm with a hazard ratio of 4.66 (97.8% CI 1.36, 15.98), P = 0.004. At 12 months postenrollment, 56% of active arm ulcers were closed compared with 27% of the sham arm ulcers (P = 0.013).

CONCLUSIONS

This sham-controlled, double-blind randomized controlled trial demonstrates that, at both 12 weeks and 12 months, adjunctive cyclical pressurized TWO2 therapy was superior in healing chronic DFUs compared with optimal SOC alone.




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Time Course of Normalization of Functional {beta}-Cell Capacity in the Diabetes Remission Clinical Trial After Weight Loss in Type 2 Diabetes

OBJECTIVE

To assess functional β-cell capacity in type 2 diabetes during 2 years of remission induced by dietary weight loss.

RESEARCH DESIGN AND METHODS

A Stepped Insulin Secretion Test with Arginine was used to quantify functional β-cell capacity by hyperglycemia and arginine stimulation. Thirty-nine of 57 participants initially achieved remission (HbA1c <6.5% [<48 mmol/mol] and fasting plasma glucose <7 mmol/L on no antidiabetic drug therapy) with a 16.4 ± 7.7 kg weight loss and were followed up with supportive advice on avoidance of weight regain. At 2 years, 20 participants remained in remission in the study. A nondiabetic control (NDC) group, matched for age, sex, and weight after weight loss with the intervention group, was studied once.

RESULTS

During remission, median (interquartile range) maximal rate of insulin secretion increased from 581 (480–811) pmol/min/m2 at baseline to 736 (542–998) pmol/min/m2 at 5 months, 942 (565–1,240) pmol/min/m2 at 12 months (P = 0.028 from baseline), and 936 (635–1,435) pmol/min/m2 at 24 months (P = 0.023 from baseline; n = 20 of 39 of those initially in remission). This was comparable to the NDC group (1,016 [857–1,507] pmol/min/m2) by 12 (P = 0.064) and 24 (P = 0.244) months. Median first-phase insulin response increased from baseline to 5 months (42 [4–67] to 107 [59–163] pmol/min/m2; P < 0.0001) and then remained stable at 12 and 24 months (110 [59–201] and 125 [65–166] pmol/min/m2, respectively; P < 0.0001 vs. baseline) but lower than that of the NDC group (250 [226–429] pmol/min/m2; P < 0.0001).

CONCLUSIONS

A gradual increase in assessed functional β-cell capacity occurred after weight loss, becoming similar to that of NDC group participants by 12 months. This result was unchanged at 2 years with continuing remission of type 2 diabetes.




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USCIS Fee Increase Proposed Rule Could Represent the Latest Step in Reshaping Immigration to United States

While much attention has been given to the move by U.S. Citizenship and Immigration Services to raise its application fees—including an 83 percent hike to apply for U.S. citizenship—the policy changes embedded in the proposed rule have been less scrutinized. The changes, including the elimination of most fee waivers for lower-income applicants, would likely reduce the number and shift the profile of those getting a green card or other immigration status.




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Snapshots of American Dentistry

Average educational indebtedness of graduating students from U.S. dental schools has increased an average of 3.5% annually between 2000 and 2018 after adjusting for inflation.




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Scholarship applicants sought for 2020 Institute for Teaching and Learning

This year’s Institute for Teaching Learning program is scheduled for Aug. 23-26 in Atlanta. Now in its 14th year, with over 700 alumni, the program combines presentations, discussions, small group activities and peer-to-peer learnings to give participants new teaching skills. The onsite program is followed by a six-month distance learning experience that include online activities and interactive webinars.




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Snapshots of American Dentistry

International dental school graduates in U.S. dental schools




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ADA unveils dental licensure interactive map

The ADA Council on Dental Education and Licensure launched in December an interactive map in an effort to assist dentists with keeping track of current initial licensure requirements by state.




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ADA joins coalition calling for vaping regulation

The American Dental Association, along with 75 organizations, is urging Congress to support legislation to regulate vaping devices and liquids in the same manner the Food and Drug Administration regulates cigarettes and other tobacco products.




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HIPAA fee limitation no longer applies to third-party access to health records

Following a ruling in federal court two days prior, the Department of Health and Human Services announced Jan. 25 that the Health Insurance Portability and Accountability Act Privacy Rule fee limitations do not apply to requests to transmit copies of records to third-parties.




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Snapshots of American Dentistry

Advanced dental education program enrollment by gender




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ADA seeks applicants for standards awards

The American Dental Association is accepting submissions for awards that honor standards-based research.




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ADA seeks appointee to Joint Commission board

The Association is calling for nominations of qualified individuals to serve as the ADA appointee to the Joint Commission Board of Commissioners.




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FDA approves combination ibuprofen-acetaminophen drug for U.S.

The Food and Drug Administration has approved the first over-the-counter ibuprofen and acetaminophen combination drug for the U.S.




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Vaping bill passes House

The U.S. House of Representatives Feb. 28 passed a comprehensive bill designed to address the youth tobacco epidemic.




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ADA, AAPD file joint comments with CMS

The American Dental Association and American Academy of Pediatric Dentistry filed comments Feb. 28 on the Centers for Medicare and Medicaid Services’ proposed 2021 notice of benefit and payment parameters for the Affordable Care Act.




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ADA to stream dental insurance webinar in April

Trying to navigate the world of dental benefits can be full of choppy seas, and the ADA is holding a free webinar in April to help dentists and their staff find a safe harbor full of information.




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Snapshots of American Dentistry

Allied dental vs predoctoral dental graduates




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Infection control webinar from ADA, OSAP available late March 20

On March 20, the ADA will release an on-demand webinar offering answers to frequently asked questions about infection control protocol and procedures related to COVID-19.




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Dental Trade Alliance appoints new CEO

Arlington, Va. — The Dental Trade Alliance announced March 10 that it appointed Gregory Chavez as CEO. Mr. Chavez, formerly the executive vice president of operations and membership at The Vision Council, will be taking over for Gary Price.




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Scholarship due date for dental education program for directors pushed to April 15

The extension comes after it was announced the program will now be held Oct. 22-23 in Atlanta due to concerns over COVID-19. LEAP was originally set for May 7-8.




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April JADA compares zirconia-ceramic fixed dental prostheses with metal-ceramic

Posterior multiunit zirconia-ceramic restorations are slightly more susceptible to chipping of the veneering ceramic than metal-ceramic restorations, but they are considered a reliable treatment in the medium term, according to a systematic review and meta-analysis published in the April issue of The Journal of the American Dental Association.




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University of Minnesota dental school appoints Dr. Keith A. Mays as interim dean

The University of Minnesota School of Dentistry announced March 19 that it named Dr. Keith A. Mays, Ph.D, as its interim dean for two years beginning May 15.




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University of Washington School of Dentistry appoints Dr. Gary Chiodo as dean

The University of Washington School of Dentistry announced March 26 that Dr. Gary Chiodo, its interim dean since August 2018, will now serve a full five-year term as dean.




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ADA joins other health care organizations in appeal for more PPE, other supplies

The ADA and other health care organizations signed a public statement March 27 saying they “strongly” support emergency efforts at the federal level to dramatically increase the production and distribution of personal protective equipment (PPE) and other necessary medical equipment and supplies during the COVID-19 pandemic.




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ADA offers free e-books on professional risk, OSHA from April 1-7

As part of its ongoing efforts to support dentists during the COVID-19 pandemic, the ADA is offering members two free e-books the week of April 1-7: “Managing Professional Risks: Best Practices” and “The ADA Practical Guide to OSHA Training: Compliance for Dental Professionals.”




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ADA urges dentists to heed April 30 interim postponement recommendation

In a statement issued April 1, the ADA issued an interim recommendation that “dentists keep their offices closed to all but urgent and emergency procedures until April 30 at the earliest.”




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Code Maintenance Committee approves new codes associated with vaping, teledentistry

On the heels of the ADA’s December interim policy on vaping comes a new CDT code that references counseling services about high-risk substance use including vaping.




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Small Business Administration: Dentists can apply for both economic injury disaster and paycheck protection program loans

Dentists can apply for both Economic Injury Disaster Loans and Paycheck Protection Program 7(a) loans, the Small Business Administration told the American Dental Association on April 6.




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ADA offers free e-books on managing finances, HIPAA training April 8-14

As part of its ongoing efforts to support dentists during the COVID-19 pandemic, the ADA is offering members two free e-books the week of April 8-14: “Managing Finances: Best Practices” and “The ADA Practical Guide to HIPAA Training.”




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ADA free webinar exploring radiographs, diagnostic imaging

In a time when teledentistry is gaining more attention during the COVID-19 pandemic, the ADA will stream a free webinar in May that takes a close look at the different types of images needed for diagnosis, treatment planning and operative procedures.




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ADA urges third-party payers to adapt coding, billing procedures to help patients recover

The American Dental Association sent a letter to third-party payers urging that administrators of dental benefit plans adjust and adapt reimbursement procedures important to dentists and patients — including coverage for temporary procedures and adjusting fee schedules to account for cost of increasing infection control procedures ¬— in the midst of the “unprecedented and extraordinary circumstances dentists and their patients face” during the pandemic.




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ADA Board of Trustees holds historic all-digital meeting April 3

The ADA Board of Trustees traditionally holds six meetings a year at Association Headquarters in Chicago, but this year, for the first time, the Board held its April meeting via Zoom — an all digital meeting.




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ADA asks Congress to ensure appropriate PPE for all health care workers

The ADA is calling on Congress to help ensure there is appropriate personal protective equipment available to all health care providers — including dentists — who continue to provide emergency care during the COVID-19 pandemic.




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ADA president appoints task force for dental practice recovery after COVID-19 pandemic

American Dental Association President Chad P. Gehani has assembled an advisory task force to oversee the ADA’s development of tools for dentists as they bounce back from the effects of practice restrictions and closures caused by the COVID-19 pandemic.




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North Carolina interactive map launches to help public find emergency dental treatment during pandemic

A North Carolina oral health coalition, in collaboration with multiple state partners, has developed an interactive map to help guide the public to sites where emergency dental services are available throughout the Tar Heel State both during and after the COVID-19 outbreak.




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Dental groups seek federal approval to administer COVID-19 tests

The Organized Dentistry Coalition is asking the U.S. Department of Health and Human Services to “extend federal authorization for licensed dentists to conduct Food and Drug Administration-authorized, point-of-care testing” during the COVID-19 pandemic.




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ADA streams webinar April 27 on respiratory protection

A recorded webinar will stream April 27 outlining the Association’s interim recommendation for personal protective equipment in dental settings as some states consider loosening social distancing mandates.




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Be ready to apply for SBA loan

A $484 billion coronavirus relief bill passed Congress April 23, and will provide additional funds to the Paycheck Protection Program and Economic Injury Disaster Loans as well as the Economic Injury Disaster loan advances.




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SBA will resume accepting Paycheck Protection Program applications April 27

The Small Business Administration will resume accepting Paycheck Protection Program loan applications at 10:30 a.m. EST on April 27 from “approved lenders on behalf of any eligible borrower,” the agency said.




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ADA president: Reopening dental practices needs a team approach

As some dental practices begin plans to reopen and provide nonemergency care — as some states reopen following the direction of their state — the Association is urging dentists to have robust communication and engage their dental team members to address any concerns related to returning to work amid the COVID-19 pandemic.