As the Mets, Nationals and Phillies have made multiple upgrades, Braves GM Alex Anthopoulos has thus far limited his offseason activity to giving Josh Donaldson a record one-year deal and bringing to fruition the desires of Brian McCann and Nick Markakis to play for the Braves.

Bastiaan Bloem, consultant neurologist at Radboud University Nijmegen Medical Centre, Netherlands, discussing his revolutionary approach to patient centred care. Read more from the summit: http://www.bmj.com/content/350/bmj.h1172

The Alzheimer’s society, in the UK, predicts that if the rates of dementia remain constant there’ll be 1.7 million people in the country living with the condition by 2050. We also know that things like improvements in cardiovascular health are changing those rates. New research published on bmj.com attempts to model what the outcomes of those...

In this EBM round-up, Carl Heneghan, Helen Macdonald and Duncan Jarvies are back to give you an update Dual vs single therapy for prevention of TIA or minor stroke - how does the advice that dual work better translate in the UK? Carl explains why Japan can teach us to get active and, how GPs can use that information to "drop a decade" in...

David E. Cummings
Aug 1, 2001; 50:1714-1719
Rapid Publications

Patrice D. Cani
Jul 1, 2007; 56:1761-1772
Obesity Studies

KINGSTOWN, St Vincent, CMC – St Vincent and the Grenadines students in Jamaica wanting to return home amid the coronavirus (COVID-19, including locked borders, must each pay an estimated US$1,3339 for a return flight. In a letter to the...

Glucagon-like peptide 1 (GLP-1) mimetics are effective drugs for treatment of type 2 diabetes, and there is consequently extensive interest in increasing endogenous GLP-1 secretion and L-cell abundance. Here we identify G-protein–coupled bile acid receptor 1 (GPBAR1) as a selective regulator of intestinal L-cell differentiation. Lithocholic acid and the synthetic GPBAR1 agonist, L3740, selectively increased L-cell density in mouse and human intestinal organoids and elevated GLP-1 secretory capacity. L3740 induced expression of Gcg and transcription factors Ngn3 and NeuroD1. L3740 also increased the L-cell number and GLP-1 levels and improved glucose tolerance in vivo. Further mechanistic examination revealed that the effect of L3740 on L cells required intact GLP-1 receptor and serotonin 5-hydroxytryptamine receptor 4 (5-HT4) signaling. Importantly, serotonin signaling through 5-HT4 mimicked the effects of L3740, acting downstream of GLP-1. Thus, GPBAR1 agonists and other powerful GLP-1 secretagogues facilitate L-cell differentiation through a paracrine GLP-1–dependent and serotonin-mediated mechanism.

THE EDITOR, Madam: On May 5, 2020, at about 8:40 a.m., I went completely berserk, telling two staff members of the Bank of Nova Scotia from the Liguanea branch some proper Jamaica vernaculars, long like the Holland Bamboo. I was astonished by my...

Invitation Only Research Event

Invitation Only Research Event

Event participants

Dr Ashwini Swain, Fellow, CUTS Institute for Regulation and Competition
Glada Lahn, Senior Research Fellow, Energy, Environment and Resources, Chatham House
Dr Gareth Price, Senior Research Fellow, Asia Programme, Chatham House

The present study examined the predictive values of amyloid PET, ¹⁸F-FDG PET, and nonimaging predictors (alone and in combination) for development of Alzheimer dementia (AD) in a large population of patients with mild cognitive impairment (MCI). Methods: The study included 319 patients with MCI from the Alzheimer Disease Neuroimaging Initiative database. In a derivation dataset (n = 159), the following Cox proportional-hazards models were constructed, each adjusted for age and sex: amyloid PET using ¹⁸F-florbetapir (pattern expression score of an amyloid-β AD conversion–related pattern, constructed by principle-components analysis); ¹⁸F-FDG PET (pattern expression score of a previously defined ¹⁸F-FDG–based AD conversion–related pattern, constructed by principle-components analysis); nonimaging (functional activities questionnaire, apolipoprotein E, and mini-mental state examination score); ¹⁸F-FDG PET + amyloid PET; amyloid PET + nonimaging; ¹⁸F-FDG PET + nonimaging; and amyloid PET + ¹⁸F-FDG PET + nonimaging. In a second step, the results of Cox regressions were applied to a validation dataset (n = 160) to stratify subjects according to the predicted conversion risk. Results: On the basis of the independent validation dataset, the ¹⁸F-FDG PET model yielded a significantly higher predictive value than the amyloid PET model. However, both were inferior to the nonimaging model and were significantly improved by the addition of nonimaging variables. The best prediction accuracy was reached by combining ¹⁸F-FDG PET, amyloid PET, and nonimaging variables. The combined model yielded 5-y free-of-conversion rates of 100%, 64%, and 24% for the low-, medium- and high-risk groups, respectively. Conclusion: ¹⁸F-FDG PET, amyloid PET, and nonimaging variables represent complementary predictors of conversion from MCI to AD. Especially in combination, they enable an accurate stratification of patients according to their conversion risks, which is of great interest for patient care and clinical trials.

In glioma patients, differentiation between tumor progression (TP) and treatment-related changes (TRCs) remains challenging. Difficulties in classifying imaging alterations may result in a delay or an unnecessary discontinuation of treatment. PET using O-(2-¹⁸F-fluoroethyl)-l-tyrosine (¹⁸F-FET) has been shown to be a useful tool for detecting TP and TRCs. Methods: We retrospectively evaluated 127 consecutive patients with World Health Organization grade II–IV glioma who underwent ¹⁸F-FET PET imaging to distinguish between TP and TRCs. ¹⁸F-FET PET findings were verified by neuropathology (40 patients) or clinicoradiologic follow-up (87 patients). Maximum tumor-to-brain ratios (TBR_max) of ¹⁸F-FET uptake and the slope of the time–activity curves (20–50 min after injection) were determined. The diagnostic accuracy of ¹⁸F-FET PET parameters was evaluated by receiver-operating-characteristic analysis and ² testing. The prognostic value of ¹⁸F-FET PET was estimated using the Kaplan–Meier method. Results: TP was diagnosed in 94 patients (74%) and TRCs in 33 (26%). For differentiating TP from TRCs, receiver-operating-characteristic analysis yielded an optimal ¹⁸F-FET TBR_max cutoff of 1.95 (sensitivity, 70%; specificity, 71%; accuracy, 70%; area under the curve, 0.75 ± 0.05). The highest accuracy was achieved by a combination of TBR_max and slope (sensitivity, 86%; specificity, 67%; accuracy, 81%). However, accuracy was poorer when tumors harbored isocitrate dehydrogenase (IDH) mutations (91% in IDH-wild-type tumors, 67% in IDH-mutant tumors, P < 0.001). ¹⁸F-FET PET results correlated with overall survival (P < 0.001). Conclusion: In our neurooncology department, the diagnostic performance of ¹⁸F-FET PET was convincing but slightly inferior to that of previous reports.

Posttreatment high-grade gliomas are usually monitored with contrast-enhanced MRI, but its diagnostic accuracy is limited as it cannot adequately distinguish between true tumor progression and treatment-related changes. According to recent Response Assessment in Neuro-Oncology recommendations, PET overcomes this limitation. However, it is currently unknown which tracer yields the best results. Therefore, a systematic review and metaanalysis were performed to compare the diagnostic accuracy of the different PET tracers in differentiating tumor progression from treatment-related changes in high-grade glioma patients. Methods: PubMed, Web of Science, and Embase were searched systematically. Study selection, data extraction, and quality assessment were performed independently by 2 authors. Metaanalysis was performed using a bivariate random-effects model when at least 5 studies were included. Results: The systematic review included 39 studies (11 tracers). ¹⁸F-FDG (12 studies, 171 lesions) showed a pooled sensitivity and specificity of 84% (95% confidence interval, 72%–92%) and 84% (95% confidence interval, 69%–93%), respectively. O-(2-¹⁸F-fluoroethyl)-l-tyrosine (¹⁸F-FET) (7 studies, 172 lesions) demonstrated a sensitivity of 90% (95% confidence interval, 81%–95%) and specificity of 85% (95% confidence interval, 71%–93%). For S-¹¹C-methyl)-l-methionine (¹¹C-MET) (8 studies, 151 lesions), sensitivity was 93% (95% confidence interval, 80%–98%) and specificity was 82% (95% confidence interval, 68%–91%). The numbers of included studies for the other tracers were too low to combine, but sensitivity and specificity ranged between 93%–100% and 0%–100%, respectively, for ¹⁸F-FLT; 85%–100% and 72%–100%, respectively, for 3,4-dihydroxy-6-¹⁸F-fluoro-l-phenylalanine (¹⁸F-FDOPA); and 100% and 70%–88%, respectively, for ¹¹C-choline. Conclusion: ¹⁸F-FET and ¹¹C-MET, both amino-acid tracers, showed a comparably higher sensitivity than ¹⁸F-FDG in the differentiation between tumor progression and treatment-related changes in high-grade glioma patients. The evidence for other tracers is limited; thus, ¹⁸F-FET and ¹¹C-MET are preferred when available. Our results support the incorporation of amino-acid PET tracers for the treatment evaluation of high-grade gliomas.

 British Caribbean Insurance Company Limited, BCIC, will refund a portion of April’s premium to holders of its public passenger vehicle, PPV, and Diamond Max private motor insurance next week. The move, which is expected to cost BCIC...

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

Members Event

Event participants

Penny Mordaunt MP, Member of Parliament for Portsmouth North; Secretary of State for Defence (2019); Secretary of State for International Development (2017-2019)

Chair: Thomas Raines, Director, Europe Programme, Chatham House

Invitation Only Research Event

About 2.1 million immigrants work in jobs growing, harvesting, processing, and selling food in the United States, serving an essential role in feeding America. While immigrants accounted for 17 percent of all civilian employed workers in the United States between 2014-18, they played an outsized role in food production, making up 22 percent of workers in the U.S. food supply chain. They represent far larger shares in certain food-related occupations, and in particular states, as this infographic shows.

Award winners were honored at the second annual awards ceremony in Washington, DC, on May 18, 2010.

Winners of the 2nd annual E Pluribus Unum Prizes awarded to exceptional immigrant integration initiatives by MPI's National Center on Immigrant Integration Policy are the Illinois New Americans Integration Initiative; the Latino Community Credit Union in Durham, NC; Tacoma Community House in Tacoma, WA; and Upwardly Global in San Francisco, CA. McDonald's Corp. of Oak Brook, IL, received the sole honorable mention. The Prizes seek to reward exemplary efforts that uphold and update the ideal of "out of many, one" and inspire others to take on the important work of helping immigrants and their children join the mainstream of U.S. society as well as build stronger ties between immigrants and the native-born. Award winners were honored at the second annual awards ceremony in Washington, DC, on May 18, 2010. Watch highlights of the ceremony here.

Remain in Mexico—the Trump administration policy aimed at deterring the rising numbers of migrants from Central America by requiring them to stay in Mexico through most of their U.S. asylum adjudication process—bears striking similarities to U.S. policy in the 1980s and 1990s that sought to discourage Haitians from making the sea journey to the United States. This article explores the parallels and differences between Remain in Mexico and the earlier narrowing of asylum for Haitians.

Large outflows of educated young people escaping high levels of unemployment, in tandem with inflows of unauthorized migrants, pose a fresh set of challenges for Greek policymakers. This Transatlantic Council on Migration report examines Greek emigration, and its economic implications, before exploring policy directions to minimize the costs and maximize the benefits of this mobility.

OBJECTIVE

To improve outcomes of patients with adult type 2 diabetes by decreasing HbA_1c undertesting, reducing the proportion of patients with poor glycemic control, and lowering mean HbA_1c levels using a quality improvement (QI) program.

OBJECTIVE

To evaluate and compare the efficacy of long-term use of low-dose aspirin for the prevention of dementia in men and women.

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.

OBJECTIVE

To assess whether initiation of insulin glargine (glargine), compared with initiation of NPH or insulin detemir (detemir), was associated with an increased risk of breast cancer in women with diabetes.

OBJECTIVE

To assess the contemporaneous prevalence of diabetic peripheral neuropathy (DPN) in people with type 1 diabetes (T1D) in Scotland and study its cross-sectional association with risk factors and other diabetic complications.

Robert R. Henry
Mar 1, 2015; 38:412-419
Evolving Tactics With Inhibition of Sodium-Glucose Cotransporters

Of the more than 3 million profile views, the program found that 17% resulted in action, which include potential patients visiting a dentist’s website, calling or emailing the practice and sharing their profile. Industry average for similar sites is only 1-4%, so patients are nearly six times more likely to contact an ADA dentist through Find-a-Dentist.

Ogden, Utah — The Office for Civil Rights announced March 3 that it had reached a settlement with Dr. Steven A. Porter’s medical practice to settle a potential violation of the Health Insurance Portability and Accountability Act security rule.

The Association is asking member dentists and their dental teams to increase their vigilance over phishing emails as a result of the coronavirus, known as COVID-19.
Attackers often use emergencies as an opportunity to send fake emails tailored to that situation, the association said.

The ADA is calling on dentists everywhere to contact their legislators today ahead of the Senate’s vote on the Coronavirus Aid, Relief and Economic Security Act.

On this webinar, MPI researchers and Utah and Colorado refugee coordinators explore promising practices to better serve refugee families, including education services for refugee youth, innovative efforts to secure better jobs for adult refugees, and other services designed to aid integration over time. They also discuss the potential for implementing and supporting two-generation approaches to refugee integration at a time when the system’s funding and capacity are in peril.  

OBJECTIVE

To examine the association between manganese intake and the risk of type 2 diabetes in postmenopausal women and determine whether this association is mediated by circulating markers of inflammation.

OBJECTIVE

Preanalytical processing of blood samples can affect plasma glucose measurement because on-going glycolysis by cells prior to centrifugation can lower its concentration. In June 2017, ACT Pathology changed the processing of oral glucose tolerance test (OGTT) blood samples for pregnant women from a delayed to an early centrifugation protocol. The effect of this change on the rate of gestational diabetes mellitus (GDM) diagnosis was determined.

OBJECTIVE

In patients with type 2 diabetes (T2D) and critical limb ischemia (CLI), migration of circulating CD34⁺ cells predicted cardiovascular mortality at 18 months after revascularization. This study aimed to provide long-term validation and mechanistic understanding of the biomarker.

With the Trump administration having announced the end of the DACA program, Congress is facing growing calls to protect unauthorized immigrants who came to the U.S. as children. This fact sheet examines DREAM Act bills introduced in Congress as of mid-2017, offering estimates of who might earn conditional legal status—and ultimately legal permanent residence—based on educational, professional, and other requirements in the legislation.

Poland announced a delay of its Sunday presidential election, Europe's first planned vote during the coronavirus pandemic.

i even got this from pro trans page that say they have laws banning men from women's room & trans aka GD was put into mad house, & even then there been alot of time where rapists &perverted freaks been using other Gender's bath room too doesn't make it right, they go to prison if they find out

This webinar discusses the first-ever profile of the 30 million immigrant-origin adults in the United States who lack a postsecondary credential such as a college degree, apprenticeship certificate, or occupational license. The researchers discuss their findings and policy implications with leading experts.

Mitt Romney wants to round up 12 million illegal immigrants and deport them. John Edwards wants to put an end to lobbyists. All the Democratic and Republican presidential candidates rail against the ways of Washington.

Across Europe, grassroots efforts have emerged in the wake of crisis that draw members of the public into the process of receiving refugees and supporting their integration. This policy brief examines the many forms community-based or private sponsorship can take, what benefits such approaches may hold for European communities, and the tradeoffs policymakers face in their implementation.

One of the major challenges Canada faced during its extraordinary push to resettle 25,000 Syrian refugees during a four-month period was to find housing for these newcomers. This report explores how the government, resettlement case workers, and private citizens tackled this challenge—balancing cost and location, access to services, and more—and how lessons learned can improve refugee housing practices for other countries going forward.

Nearly 2 million college-educated immigrants in the United States, more than half coming with academic and professional credentials, are unable to fully utilize their professional skills and instead are stuck in low-skilled work or are unemployed. This report explores a range of programs and policies that are providing cutting-edge career navigation, relicensing, gap filling, and job search assistance to remedy this brain waste.

At a time when the U.S. refugee resettlement system is facing unprecedented challenges, innovative and cost-effective tools for supporting refugee integration are in demand. This report explores how a two-generation approach to service provision could help all members of refugee families—from young children to working-age adults and the elderly—find their footing.

As the U.S. workforce ages and the economy becomes ever more knowledge-based, policymakers face a key question: Do workers have the skills to meet tomorrow's demands? This report examines how immigrants and their children—the primary source of future labor-market growth—fit into the discussion. The report offers a first-ever profile of the 30 million immigrant-origin adults without a postsecondary credential.

This webinar discusses the first-ever profile of the 30 million immigrant-origin adults in the United States who lack a postsecondary credential and offers analysis of the significant payoff credentials could bring in terms of workforce participation and wages.