USE OF GLYCATED HEMOGLOBIN (HBA1C) TESTING IN THE DIAGNOSIS OF DIABETES: A SYSTEMATIC REVIEW

Early detection of diabetes is of great clinical importance in order to prevent or delay its micro- and macrovascular complications. That is why, the largest diabetes associations continue their search for the most accurate, sensitive and speci?c, reliable and reproducible diagnostic assay.ADA, the International Diabetes Federation (IDF), and the European Association for the Study of Diabetes have recommended to consider the use of glycated hemoglobin (HbA1c) testing in the diagnosis of diabetes

Hands Free Technique: New Tool Possibility for Image Capture of Sublingual Microcirculation with Handheld Vital Microscopy - HVM

ABSTRACT: New microcirculatory imaging techniques allowed direct observation of microcirculation at the bedside. This study presents a new device that assists the operator with the unprecedented Hands Free technique. To this end, a replica of Handheld Vital Microscopy was developed to simulate the method of capturing the image in the sublingual area, the most used site to assess microcirculation in critically ill patients. We achieved a reduction in the displacement of micros cope replica with a Hands Free method. The immediate consequence is an increase in the stability of HVM replica by 75 times, or more, over the current 4 seconds, during its contact with the sublingual tissue. The device also offers better control of th e pressure of the tip of the HVM replica over the sublingual area. The results demonstrated that the Hands Free technique, operating in the same sublingual area for 900 seconds, should allow for future research aimed at therapeutic maneuvers in patients with serious illnesses.

RESUMEN: Las nuevas técnicas de imagen microcirculatoria permitieron la observación directa de la microcirculación junto a la cama del paciente. Este estudio sin precedentes presenta un nuevo dispositivo que ayuda al operador con la técnica manos libres. Con este fin, se desarrolló una réplica de la Microscopía Vital Portátil para simular el método de captura de la imagen en el área sublingual, el sitio más utilizado para evaluar la microcirculación en pacientes críticos. Logramos una reducción en el desplazamiento de la réplica del microscopio con el método de manos libres. La consecuencia inmediata es un aumento en la estabilidad de la réplica de HVM en 75 veces, o más, durante los 4 segundos actuales, durante su contacto con el tejido sublingual. El dispositivo también ofrece un mejor control de la presión de la punta de la réplica de HVM sobre el área sublingual. Los resultados demostraron que la técnica de manos libres, que opera en la misma área sublingual durante 900 segundos, debería permitir futuras investigaciones destinadas a maniobras terapéuticas en pacientes con enfermedades graves.

Development of Models for Rainfall Intensity- duration-frequency for Akure, South-west, Nigeria

The rainfall Intensity-Duration-Frequency (IDF) relationship is widely used for adequate estimation of rainfall intensity over a particular catchment. A 25 year daily rainfall data were collected from Nigerian Meteorological Agency (NIMET) Abuja for Akure station. Twenty five year annual maximum rainfall amounts with durations of 5, 10, 15, 20, 30, 45, 60, 90, 120, 180, 240, 300 and 420 minutes were extracted and subjected to frequency analysis using the excel solver software wizard. A total of six (6) return period specific and one (1) general IDF models were developed for return periods of 2, 5, 10, 25, 50 and 100 years using Gumbel Extreme Value Type-1 and Log Pearson Type -3 distributions. Anderson Darling goodness of fit test was used to ascertain the best fit probability distribution. The R2 values range from 0.982 to 0.985 for GEVT -1 and 0.978 to 0.989 for Log Pearson type -3 while the Mean Squared Error from 33.56 to 156.50 for GEVT -1 and 43.01 to 150.63 Log Pearson Type III distributions respectively. The probability distribution models are recommended for the prediction of rainfall intensities for Akure metropolis.

Application of Regional Climate Models for Updating Intensity-duration-frequency Curves under Climate Change

Global Climate Models (GCMs) are currently the most powerful tools for accessing changes in the hydrological regime at the watershed scale due to climate change and variability. GCMs, however, have limitations due to their coarse spatial and temporal resolutions. Regional Climate Models (RCMs) are often referred to as suitable alternatives due to their higher resolution of the long-term climate projections. It is expected that RCMs are better for simulating extreme conditions than the GCMs. This present work, investigate the difference in updated IDF (Intensity-Duration-Frequency) relationships developed using GCMs and RCMs. The IDF updating method implemented with the IDF_CC tool for Canada has been used for comparison. The analyses are conducted using 369 selected Environment and Climate Change Canada hydro-meteorological stations from the IDF_CC tool database with record length longer than 20 years. Results for the future period (2020-2100), are based on multi-model ensembles of (i) the RCMs from the NA-CORDEX (North-American Coordinated Regional Climate Downscaling Experiment) project (ensemble 1) (ii) a sub-set of six GCMs from the GCMs available in the IDF_CC tool used as drivers for the RCMs (ensemble 2) and (iii) all 24 GCMs from the IDF_CC tool database (ensemble 3). One representative concentration pathway (RCP), RCP 8.5, is used in the analysis. The RCMs from the NA-CORDEX project selected for this study use six GCMs as drivers to produce the future predictions for the North American continent, including Canada. Two metrics are applied for the comparison of results: (i) the difference in projected precipitation using the multi-model ensemble median; and (ii) the difference in uncertainty range. The uncertainty range is defined in this study as the percentage projected change in future, 25 to 75 quantiles obtained using the RCMs a GCMs ensembles. The regional models from the NA-CORDEX project generated lower extreme precipitation projections than the GCMs for the stations located in the Canadian prairies (provinces of Alberta, Saskatchewan, Manitoba). Stations located at the East and West coasts of Canada show a smaller difference in the projected extremes obtained using GCMs and RCMs. The use of RCMs shows increase in uncertainty when compared to GCMs. This result indicates that even when using regional climate models, it’s advisable to extend the analyses and include as many as possible models from different climate centers.

Application of Disciplinary Background Knowledge in Medical Text Feature Extraction / 医学信息学杂志

The paper analyzes the conditions of research on the current scientific literature text feature extraction methods,applies the TF-IDF method based on background knowledge in the medical text feature extraction,and conducts experimental comparison in four medical fields.The result indicates that this method can obviously improve the extraction effect when there are few vocabularies to be extracted,and is obviously superior to the IDF based TF-IDF method in the aspects of filtration of commonly-used words in the text set and identification of important feature words.

Metabolic Syndrome in a Sub-population of Geriatric Nigerians in a Primary Care Clinic of a Tertiary Hospital in South-Eastern Nigeria.

Background: Research studies have shown that age is an independent risk factor for metabolic syndrome (MetS). However, as eco-demographic structure and function of Nigeria changes, geriatric Nigerians tend to adopt lifestyles that promote the emergence of metabolic syndrome. Aim: This study was aimed at determining the prevalence of metabolic syndrome and its associated risk factors in a sub-population of geriatric Nigerians in a primary care clinic of a tertiary hospital in South-eastern Nigeria. Study Design: This was a cross sectional study carried out on a sub-population of 225 geriatric Nigerians. Place and Duration of Study: The study was done in the primary care clinic of Federal Medical Centre, Umuahia, Nigeria between May 2012 and October 2012. Methodology: Two hundred and twenty five geriatric patients aged ≥ 60 years were screened for MetS using International Diabetes Federation (IDF) criteria: An Individual was considered to have MetS in the presence of waist circumference ≥94 cm for men and ≥80 cm for women plus any two or more of the following: systolic and/or diastolic blood pressure ≥130/85 mmHg and/or hypertension on treatment; fasting plasma glucose ≥ 100 mg/dL and/or diabetes mellitus on treatment; triglyceride level ≥150 mg/dL and/or hypertriglyceridaemia on treatment and high density lipoprotein (HDL-C) cholesterol <40 mg/dL for men or <50 mg/dL for women and/or HDL-C dyslipidaemia on treatment. The data collected included basic demographic and nutri-behavioural variables using structured, pretested and interviewer administered questionnaire. Results: The prevalence of MetS was 44.0%. MetS was significantly associated with female sex (P=.036), not engaged in any occupation (P=.043), and physical inactivity (P=.001). The most significant predictor of MetS was physical inactivity (P=.001, OR=2.30 (1.08-5.63). The geriatric patients with MetS were two times more likely to be physically inactive compared to their non-MetS counterparts. Conclusion: MetS occurs in a sub-population of geriatric Nigerians in primary care and is associated with female sex, not engaged in any occupation, and physical inactivity. Screening for MetS alongside its determinants should be considered for geriatric Nigerians in primary care.

study of prevalence of thyroid dysfunction in patients with metabolic syndrome.

Background: The study was undertaken with an objective to study the thyroid functions in patients with metabolic syndrome diagnosed as per International Diabetes Federation (IDF) criteria and to know the spectrum of thyroid dysfunction. Methods: A total of 300 patients with metabolic syndrome diagnosed as per IDF criteria were included in the study. A detailed history regarding symptoms of hypothyroidism and examination was done in all patients and all these patients underwent thyroid profile tests. Results: A total of 300 patients with metabolic syndrome were included in this study. Thyroid dysfunction was present in 45% of the patients. Hypothyroidism was noted in 43 patients, subclinical hypothyroidism was noted in 114 patients, subclinical hyperthyroidism in 6 patients and hyperthyroidism in 1 patient. This study included 166 males and 134 females. 10% of the patients had symptoms related to hypothyroidism. 7% had goiter on examination. Thyroid dysfunction was seen in 68% females compared to that of 47% in males. Females had higher incidence compared to males. Elderly females (42%) and males in the age group of 40-50 years (41%) had higher incidence of subclinical hypothyroidism compared to others. Conclusions: Prevalence of thyroid disorders in diabetics was 45%. Elderly population had more incidences. Sub- clinical hypothyroidism was more common among females.

Quantitative Research on Traditional Chinese Medicine Syndrome Based on TF-IDF Relative Entropy / 世界科学技术-中医药现代化

This study proposed to use Term Frequency - Inverse Document Frequency (TF-IDF) relative entropy as knowledge representation method between symptoms and syndrome. TF-IDF was originated from text mining. It was an important method in the automatic text categorization. TF-IDF also represented the automatic categorization idea in traditional Chinese medicine (TCM) syndrome. It was based on the fact that the higher frequency of one symptom in specific syndrome, the stronger ability to distinguish this syndrome (TF); and the more wide range of one symptom in all syndrome, and the lower ability to distinguish a syndrome (IDF). It was verified with specific examples.

Coincidencias y divergencias en las prevalencias del síndrome metabólico según idf y atp III en adultos de caracas / Coincidence and divergence in the prevalence of metabolic syndrome by idf and atp III in adults from caracas

El objetivo del trabajo fue conocer y comparar las prevalencias del Síndrome Metabólico (SM) según los criterios del National Cholesterol Education Program´s Adult Treatment Panel III Report (ATP III) y los de la Federación Internacional de Diabetes (IDF) en adultos. Estudio descriptivo, corte transversal que incluyó a 183 adultos (63 hombres y 120 mujeres), con edades entre 20 y 60 años, de la Universidad Simón Bolívar, Caracas - Venezuela. Se midió peso, talla y circunferencia de cintura punto medio. Se calculó la prevalencia del SM según criterios del ATP III e IDF. Los datos se analizaron, utilizando el paquete estadístico SPSS versión 19. Se calcularon el promedio y la desviación estándar de las variables, para el grupo total y por sexo. Para las diferencias entre género se utilizó la prueba “t” de Student. En las coincidencias y divergencias de las prevalencias del SM por ambos criterios se aplicó el índice de Kappa (p<0,001). Se observó prevalencia de SM entre 13 a 16 % (ATPIII e IDF respectivamente) del grupo total. Por sexo, los hombres obtuvieron una mayor prevalencia (22,2 %ATP III y 27,0% IDF) con respecto a las mujeres (9,2% ATP III y 11,7% IDF) p< 0.001. Existe una alta coincidencia entre ambos métodos (p< 0,001) valores de kappa 0,7 para grupo total. Aun cuando hubo alta coincidencia entre criterios del SM, son necesarios los puntos de cortes para la circunferencia de cintura, para identificar el valor más sensible y específico para el diagnóstico del SM en la población Venezolana(AU)

The objective of the study was to determine and compare the prevalence of metabolic syndrome (MS) according to the criteria of the National Cholesterol Education Program Adult Treatment Panel III Report (ATP III) and the International Diabetes Federation (IDF) in adults. A descriptive, cross-sectional included 183 adults (63 men and 120 women), aged between 20 and 60, from Universidad Simon Bolivar, Caracas - Venezuela. Weight, height and waist circumference midpoint were measured. Prevalence of MS according to ATP III criteria and IDF were calculated. Data were analyzed by SPSS version 19. Mean and standard deviation of the variables for the total group and by gender were calculated. A “t” Student was applied to establish differences by gender. On the similarities and differences in the prevalence of MS by both criteria was applied a Kappa test (p <0.001). The prevalence of metabolic syndrome was between 13-16% (ATP III and IDF respectively) in the total group. By sex, males obtained a higher prevalence (22.2% ATP III and IDF 27.0%) compared to females (9.2% ATP III and IDF 11.7%) p <0.001. There is a high agreement between the two methods (p <0.001) K =0.7 for the total group. Even was found a high agreement between MS criteria, further study of waist circumference cut-off points, to identify the most sensitive and specific value for diagnosis of MS in Venezuelan population(AU)

Generation of intensity duration frequency curves and intensity temporal variability pattern of intense rainfall for Lages/SC

The objective of this work was to analyze the frequency distribution and intensity temporal variability of intense rainfall for Lages/SC from diary pluviograph data. Data on annual series of maximum rainfalls from rain gauges of the CAV-UDESC Weather Station in Lages/SC were used from 2000 to 2009. Gumbel statistic distribution was applied in order to obtain the rainfall height and intensity in the following return periods: 2, 5, 10, 15 and 20 years. Results showed intensity-duration-frequency curves (I-D-F) for those return periods, as well as I-D-F equations: i=2050.Tr0,20.(t+30)-0,89, where i was the intensity, Tr was the rainfall return periods and t was the rainfall duration. For the intensity of temporal variability pattern along of the rainfall duration time, the convective, or advanced pattern was the predominant, with larger precipitate rainfalls in the first half of the duration. The same pattern presented larger occurrences in the spring and summer stations.

The Metabolic Syndrome: Comparison of Newly Proposed IDF, Modified ATP III and WHO Criteria and their Agreements.

Background: Metabolic syndrome (MS) results from clustering of cardiovascular risk factors occurring in association with insulin resistance and obesity. With the increasing prevalence of obesity worldwide, MS is of keen interest in research. The disorder is defined in various ways, but one consolidated definition is needed to make studies comparable worldwide. The study was to determine the risk factors of metabolic syndrome in Bangladesh and comparison of newly proposed definition of International Diabetes Federation (IDF), modified National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) and the World Health Organization (WHO) criteria and their agreements. Materials and Methods: This was a cross sectional hospital based study. We randomly selected 229 participants. After obtaining informed written consent data collectors collected data by interview, clinical examination, anthropometric measurement and investigations. We calculated independent sample t-test means between to distinguish which risk factors were present in participants with and without MS, using SPSS v17. Results: The percentage of risk factors of MS among subjects according to different criteria was 72% of Modified ATP-III, 69% of IDF and 39% of WHO definition .In Modified NCEP ATP III when did independent sample t-test mean of BMI, waist circumference, systolic blood pressure, diastolic blood pressure, fasting blood glucose, high density lipoprotein and triglyceride were present statistically significant difference between without MS and with MS (p<0.05). According to WHO criteria BMI, waist circumference, fasting blood glucose were statistically significant (p<0.05) and similarly fasting blood glucose & triglyceride were statistically significant difference between without MS and with MS (p<0.05) according to IDF criteria.ATP III and WHO criteria showed good agreement (k 0.56) compared to ATP III with IDF (k 0.31) and WHO with IDF (k 0.11) criteria. Conclusion: Metabolic syndrome is highly prevalent in Bangladesh. We detected the highest proportion of participants with MS using the ATP III definition, which emphasizes the predominant focus on the modified waist circumference for Asian participants. However, MS prevalence following WHO criteria in those with impaired glucose regulation is comparable with ATP III definition. Follow up study needed to examine the significance of MS following all definitions for the assessment of risk for diabetes and or cardiovascular disease.

Metabolic Syndrome Based on IDF Criteria in a Sample of Normal Weight and Obese School Children

Metabolic syndrome was once reported only in adults but is now occurring more frequently in children. This study compared the incidence of metabolic syndrome and its components among normal and obese children using the 2007 International Diabetes Federation (IDF) pediatric definition for metabolic syndrome. Subjects comprised 78 school children aged 8-10 years, with 34 obese and 44 normal weight children. Body weight, height, and waist circumference (WC) were measured and body mass index was calculated. Clinical profiles measured included fasting blood glucose, triglyceride, HDL cholesterol, LDL cholesterol, total cholesterol, and blood pressure. Metabolic syndrome (MS) was defined using the 2007 IDF pediatric criteria. Obese subjects had a significantly (p<0.001) higher mean BMI (26.0 ± 3.6 kg/m2) compared to normal weight subjects (15.1 ± 0.8 kg/m2). Only one obese subject (1.3% of subjects) had metabolic syndrome based on the IDF definition, but all obese subjects had at least one component of metabolic syndrome. In comparison, no normal weight subjects had metabolic syndrome and only 9.1% of normal weight subjects had at least one component of metabolic syndrome. The most common component was central obesity, observed in 43.6% of subjects having WC equal to or greater than the 90th percentile. In concurrence with central obesity as the core feature of the IDF criteria, WC showed the strongest correlation with indicators of obesity such as BMI (r=0.938, p<0.001), fat mass (r=0.912, p<0.001) and fat-free mass (r=0.863, p<0.001). We conclude that the problem of metabolic syndrome is more prominent among obese children, although the incidence of MS as defined by the 2007 pediatric IDF criteria, is low in this population (1.3%).

Comparison of the Predictability of Cardiovascular Disease Risk According to Different Metabolic Syndrome Criteria of American Heart Association/National Heart, Lung, and Blood Institute and International Diabetes Federation in Korean Men / 당뇨병

BACKGROUND: We compared the prevalences of two criteria of metabolic syndrome, that is, American Heart Association/National Heart, Lung, and Blood Institute (AHA/NHLBI) and International Diabetes Federation (IDF), in Korean male adults and compared the predictability of insulin resistance and future cardiovascular diseases using Framingham Risk Score. METHODS: In total 23,467 male adults (mean age 43.3 years) who participated in medical check-up in 2005, the prevalences of metabolic syndrome according to AHA/NHLBI and IDF criteria and the presence of insulin resistance, defined by the highest quartile of Homeostasis Model Assessment of insulin resistance index (HOMA-IR), were compared. The relative risk (calculated risk/average risk) for 10-year risk for coronary artery disease (CHD) assessed by Framingham Risk Score were compared. RESULTS: 5.8% of the subjects had diabetes mellitus. 20.7% and 13.2%of the subjects had metabolic syndrome defined by AHA/NHLBI and IDF criteria, and the two criteria showed high agreement with kappa value of 0.737 (P 1.0) for 10-year CHD were higher in AHA/NHLBI-defined subjects compared with IDF-defined subject (3.295 vs. 3.082). The Kappa values for the analysis of agreement between each criteria and prediction of insulin resistance or cardiovascular disease risk, were too low for comparison. CONCLUSION: In Korean males, the prevalence for metabolic syndrome defined by AHA/NHLBI criteria was higher than those defined by IDF criteria. IDF criteria detected more subjects with insulin resistance, but didn't have better predictability for CHD compared with AHA/NHLBI criteria.