AIM To investigate possible changes of blood glucose levels after oral intake of lactulose in healthy subjects.METHODS The study was performed as prospective, randomized, two-part study with 4-way cross-over design wi...AIM To investigate possible changes of blood glucose levels after oral intake of lactulose in healthy subjects.METHODS The study was performed as prospective, randomized, two-part study with 4-way cross-over design with n = 12 in each study arm. Capillary blood glucose levels were determined over a time period of 180 min after intake of a single dose of 10 g or 20 g lactulose provided as crystal or liquid formulation. During the manufacturing process of lactulose, impurities with sugars(e.g., lactose, fructose, galactose) occur. Water and 20 g glucose were used as control and reference. Because lactulose is used as a functional food ingredient, it may also be consumed by people with impaired glucose tolerance, including diabetics. Therefore, it is of interest to determine whether the described carbohydrate impurities may increase blood glucose levels after ingestion. RESULTS The blood glucose concentration-time curves after intake of 10 g lactulose, 20 g lactulose, and water were almost identical. None of the three applications showed any changes in blood glucose levels. After intake of 20 g glucose, blood glucose concentration increased by approximately 3 mmol/L(mean Cmax = 8.3 mmol/L), reaching maximum levels after approximately 30 min and returning to baseline within approximately 90 min, which was significantly different to the corresponding 20 g lactulose formulations(P < 0.0001). Comparing the two lactulose formulations, crystals and liquid, in the dosage of 10 g and 20 g, there was no difference in the blood glucose profile and calculated pharmacokinetic parameters despite the different amounts of carbohydrate impurities(1.5% for crystals and 26.45% for liquid). Anyhow, the absolute amount of single sugars was low with 0.3 g in crystals and 5.29 g in liquid formulation in the 20 g dosages. Lactulose was well tolerated by most volunteers, and only some reported mild to moderate mainly gastrointestinal side effects. CONCLUSION The unchanged blood glucose levels after lactulose intake in healthy subjects sugg展开更多
Background and purpose The impact of the cerebral collateral circulation on lesion progression and clinical outcome in ischaemic stroke is well established.Moreover,collateral status modifies the effect of endovascula...Background and purpose The impact of the cerebral collateral circulation on lesion progression and clinical outcome in ischaemic stroke is well established.Moreover,collateral status modifies the effect of endovascular treatment and was therefore used to select patients for therapy in prior trials.The purpose of this study was to quantify the effect of vessel recanalisation on lesion pathophysiology and clinical outcome in patients with a poor collateral profile.Materials and methods 129 patients who had an ischaemic stroke with large vessel occlusion in the anterior circulation and a collateral score(CS)of 0-2 were included.Collateral profile was defined using an established 5-point scoring system in CT angiography.Lesion progression was determined using quantitative lesion water uptake measurements on admission and follow-up CT(FCT),and clinical outcome was assessed using modified Rankin Scale(mRS)scores after 90 days.Results Oedema formation in FCT was significantly lower in patients with vessel recanalisation compared with patients with persistent vessel occlusion(mean 19.5%,95%CI:17%to 22%vs mean 27%,95%CI:25%to 29%;p<0.0001).In a multivariable linear regression analysis,vessel recanalisation was significantly associated with oedema formation in FCT(ß=−7.31,SD=0.015,p<0.0001),adjusted for CS,age and Alberta Stroke Program Early CT Score(ASPECTS).Functional outcome was significantly better in patients following successful recanalisation(mRS at day 90:4.5,IQR:2-6 vs 5,IQR:5-6,p<0.001).Conclusion Although poor collaterals are known to be associated with poor outcome,endovascular recanalisation was still associated with significant oedema reduction and comparably better outcome in this patient group.Patients with poor collaterals should not generally be excluded from thrombectomy.展开更多
Value delivery is becoming an important asset for an organization due to increasing competition in industry. Therefore, companies apply Agile Software Development (ASD) to be more competitive and reduce time to market...Value delivery is becoming an important asset for an organization due to increasing competition in industry. Therefore, companies apply Agile Software Development (ASD) to be more competitive and reduce time to market. Using ASD for the development of systems implies that established approaches of Requirements Engineering (RE) undergo some changes in order to be more flexible to changing requirements. To this end, the field of agile RE is emergent and different process models for agile RE have arisen. The aim of this paper is to build an abstract layer about the variety of existing process models by means of a metamodel for agile RE. It has been created in several iterations and relies on the evaluation of related process models. Furthermore, we have derived process models for agile RE in industry by presenting instances of the metamodel in two different cases: one is based on Scrum whereas the other is based on Kanban. This paper contributes to the software development body of knowledge by delivering a metamodel for agile RE that supports researchers and practitioners modeling and improving their own process models. We can conclude that the agile RE metamodel is highly relevant for the industry as well as for the research community, since we have derived it following empirical research in the field of ASD.展开更多
Lactobacilli have been consistently associated with dental caries for decades;however, knowledge of this group of bacteria in the etiology of the disease is limited to quantitative elucidation. Nowadays, explicit iden...Lactobacilli have been consistently associated with dental caries for decades;however, knowledge of this group of bacteria in the etiology of the disease is limited to quantitative elucidation. Nowadays, explicit identification of oral Lactobacillus species is possible, despite their taxonomic complexity. Here we describe a combined approach involving both cultivation and genetic methods to ascertain and characterize the diversity and abundance of the Lactobacillus population in the oral cavities of children with severe early childhood caries (S-ECC). Eighty 3- to 6-year-old children (40 S-ECC and 40 caries free) who were seeking dental care at the Pediatric Dental Clinic of Bellevue Hospital in New York City were invited to participate in this study. Clinical data on sociodemographic information and oral health behavior were obtained from the primary caregiver. The data included a detailed dental examination, children’s medical history, and a questionnaire survey. Combined non-stimulated saliva and supragingival plaque samples were collected from each child and cultivated on selective media for quantitative measures of lactobacilli levels. The procedure for Lactobacillus species screening will include the random selection of 50 colonies per plate, ex- traction of DNA from each colony, and genotyping by arbitrarily primed polymerase chain reaction (AP-PCR). Each unique Lactobacillus AP-PCR genotype will be selected for taxonomic assessment by 16S rRNA gene sequencing analysis. Lactobacillus species will be identified by comparing the 16S rRNA sequences with the Ribosomal Database and the Human Oral Microbiome Database. Meanwhile, the same set of clinical samples will be independently subjected to genomic DNA isolation, 16S rRNA amplification with Lactobacillus genus-specific primers, sequencing, and taxonomic identification, both at genus and species levels with a customized pipeline. The distribution and phylogenetic differences of these Lactobacillus species will be compared between children with or without S展开更多
文摘AIM To investigate possible changes of blood glucose levels after oral intake of lactulose in healthy subjects.METHODS The study was performed as prospective, randomized, two-part study with 4-way cross-over design with n = 12 in each study arm. Capillary blood glucose levels were determined over a time period of 180 min after intake of a single dose of 10 g or 20 g lactulose provided as crystal or liquid formulation. During the manufacturing process of lactulose, impurities with sugars(e.g., lactose, fructose, galactose) occur. Water and 20 g glucose were used as control and reference. Because lactulose is used as a functional food ingredient, it may also be consumed by people with impaired glucose tolerance, including diabetics. Therefore, it is of interest to determine whether the described carbohydrate impurities may increase blood glucose levels after ingestion. RESULTS The blood glucose concentration-time curves after intake of 10 g lactulose, 20 g lactulose, and water were almost identical. None of the three applications showed any changes in blood glucose levels. After intake of 20 g glucose, blood glucose concentration increased by approximately 3 mmol/L(mean Cmax = 8.3 mmol/L), reaching maximum levels after approximately 30 min and returning to baseline within approximately 90 min, which was significantly different to the corresponding 20 g lactulose formulations(P < 0.0001). Comparing the two lactulose formulations, crystals and liquid, in the dosage of 10 g and 20 g, there was no difference in the blood glucose profile and calculated pharmacokinetic parameters despite the different amounts of carbohydrate impurities(1.5% for crystals and 26.45% for liquid). Anyhow, the absolute amount of single sugars was low with 0.3 g in crystals and 5.29 g in liquid formulation in the 20 g dosages. Lactulose was well tolerated by most volunteers, and only some reported mild to moderate mainly gastrointestinal side effects. CONCLUSION The unchanged blood glucose levels after lactulose intake in healthy subjects sugg
文摘Background and purpose The impact of the cerebral collateral circulation on lesion progression and clinical outcome in ischaemic stroke is well established.Moreover,collateral status modifies the effect of endovascular treatment and was therefore used to select patients for therapy in prior trials.The purpose of this study was to quantify the effect of vessel recanalisation on lesion pathophysiology and clinical outcome in patients with a poor collateral profile.Materials and methods 129 patients who had an ischaemic stroke with large vessel occlusion in the anterior circulation and a collateral score(CS)of 0-2 were included.Collateral profile was defined using an established 5-point scoring system in CT angiography.Lesion progression was determined using quantitative lesion water uptake measurements on admission and follow-up CT(FCT),and clinical outcome was assessed using modified Rankin Scale(mRS)scores after 90 days.Results Oedema formation in FCT was significantly lower in patients with vessel recanalisation compared with patients with persistent vessel occlusion(mean 19.5%,95%CI:17%to 22%vs mean 27%,95%CI:25%to 29%;p<0.0001).In a multivariable linear regression analysis,vessel recanalisation was significantly associated with oedema formation in FCT(ß=−7.31,SD=0.015,p<0.0001),adjusted for CS,age and Alberta Stroke Program Early CT Score(ASPECTS).Functional outcome was significantly better in patients following successful recanalisation(mRS at day 90:4.5,IQR:2-6 vs 5,IQR:5-6,p<0.001).Conclusion Although poor collaterals are known to be associated with poor outcome,endovascular recanalisation was still associated with significant oedema reduction and comparably better outcome in this patient group.Patients with poor collaterals should not generally be excluded from thrombectomy.
基金supported by the Pololas project(TIN2016-76956-C3-2-R)of the Spanish Ministry of Economy and Competitiveness.
文摘Value delivery is becoming an important asset for an organization due to increasing competition in industry. Therefore, companies apply Agile Software Development (ASD) to be more competitive and reduce time to market. Using ASD for the development of systems implies that established approaches of Requirements Engineering (RE) undergo some changes in order to be more flexible to changing requirements. To this end, the field of agile RE is emergent and different process models for agile RE have arisen. The aim of this paper is to build an abstract layer about the variety of existing process models by means of a metamodel for agile RE. It has been created in several iterations and relies on the evaluation of related process models. Furthermore, we have derived process models for agile RE in industry by presenting instances of the metamodel in two different cases: one is based on Scrum whereas the other is based on Kanban. This paper contributes to the software development body of knowledge by delivering a metamodel for agile RE that supports researchers and practitioners modeling and improving their own process models. We can conclude that the agile RE metamodel is highly relevant for the industry as well as for the research community, since we have derived it following empirical research in the field of ASD.
基金supported by the National Institute of Dental and Craniofacial Research(R01DE019455).
文摘Lactobacilli have been consistently associated with dental caries for decades;however, knowledge of this group of bacteria in the etiology of the disease is limited to quantitative elucidation. Nowadays, explicit identification of oral Lactobacillus species is possible, despite their taxonomic complexity. Here we describe a combined approach involving both cultivation and genetic methods to ascertain and characterize the diversity and abundance of the Lactobacillus population in the oral cavities of children with severe early childhood caries (S-ECC). Eighty 3- to 6-year-old children (40 S-ECC and 40 caries free) who were seeking dental care at the Pediatric Dental Clinic of Bellevue Hospital in New York City were invited to participate in this study. Clinical data on sociodemographic information and oral health behavior were obtained from the primary caregiver. The data included a detailed dental examination, children’s medical history, and a questionnaire survey. Combined non-stimulated saliva and supragingival plaque samples were collected from each child and cultivated on selective media for quantitative measures of lactobacilli levels. The procedure for Lactobacillus species screening will include the random selection of 50 colonies per plate, ex- traction of DNA from each colony, and genotyping by arbitrarily primed polymerase chain reaction (AP-PCR). Each unique Lactobacillus AP-PCR genotype will be selected for taxonomic assessment by 16S rRNA gene sequencing analysis. Lactobacillus species will be identified by comparing the 16S rRNA sequences with the Ribosomal Database and the Human Oral Microbiome Database. Meanwhile, the same set of clinical samples will be independently subjected to genomic DNA isolation, 16S rRNA amplification with Lactobacillus genus-specific primers, sequencing, and taxonomic identification, both at genus and species levels with a customized pipeline. The distribution and phylogenetic differences of these Lactobacillus species will be compared between children with or without S
