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"Murphy, R"
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Japan and the shackles of the past
\"A penetrating overview of Japan, from a historical, social, political, economic, and cultural perspective\"-- Provided by publisher.
Book
Continuous glucose monitoring targets in type 1 diabetes pregnancy: every 5% time in range matters
With randomised trial data confirming that continuous glucose monitoring (CGM) is associated with improvements in maternal glucose control and neonatal health outcomes, CGM is increasingly used in antenatal care. Across pregnancy, the ambition is to increase the CGM time in range (TIR), while reducing time above range (TAR), time below range (TBR) and glycaemic variability measures. Pregnant women with type 1 diabetes currently spend, on average, 50% (12 h), 55% (13 h) and 60% (14 h) in the target range of 3.5–7.8 mmol/l (63–140 mg/dl) during the first, second and third trimesters, respectively. Hyperglycaemia, as measured by TAR, reduces from 40% (10 h) to 33% (8 h) during the first to third trimester. A TIR of >70% (16 h, 48 min) and a TAR of <25% (6 h) is achieved only in the final weeks of pregnancy. CGM TBR data are particularly sensor dependent, but regardless of the threshold used for individual patients, spending ≥4% of time (1 h) below 3.5 mmol/l or ≥1% of time (15 min) below 3.0 mmol/l is not recommended. While maternal hyperglycaemia is a well-established risk factor for obstetric and neonatal complications, CGM-based risk factors are emerging. A 5% lower TIR and 5% higher TAR during the second and third trimesters is associated with increased risk of large for gestational age infants, neonatal hypoglycaemia and neonatal intensive care unit admissions. For optimal neonatal outcomes, women and clinicians should aim for a TIR of >70% (16 h, 48 min) and a TAR of <25% (6 h), from as early as possible during pregnancy.
Journal Article
Toleration : a very short introduction
\"\"It is now no more that toleration is spoken of,\" President George Washington wrote to the Hebrew Congregation of Newport, Rhode Island, in 1790, \"as if it was by the indulgence of one class of people, that another enjoyed the exercise of their inherent natural rights.\" Despite Washington's confident assertion that the young nation had moved beyond toleration, however - to say nothing of the countless Americans who, even as he wrote, had yet to enjoy \"the exercise of their inherent natural rights\" - toleration is still \"spoken of.\" Celebrated by some, excoriated by others; praised as a noble aspiration in some settings, lamented as a half-hearted half-measure in others, toleration continues to evoke roughly equal parts admiration and condemnation in a polarized world riven by religious discord and cultural conflict. Depending on one's perspective, it represents a cardinal achievement of modern political regimes, a grudging and insufficient measure of civil respect, or a set of practices hopelessly tainted by their association with imperialism, colonialism, and Eurocentrism. Or, perhaps, a bit of all three\"-- Provided by publisher.
BOOK
A Clinical Update on Gestational Diabetes Mellitus
Abstract
Gestational diabetes mellitus (GDM) traditionally refers to abnormal glucose tolerance with onset or first recognition during pregnancy. GDM has long been associated with obstetric and neonatal complications primarily relating to higher infant birthweight and is increasingly recognized as a risk factor for future maternal and offspring cardiometabolic disease. The prevalence of GDM continues to rise internationally due to epidemiological factors including the increase in background rates of obesity in women of reproductive age and rising maternal age and the implementation of the revised International Association of the Diabetes and Pregnancy Study Groups’ criteria and diagnostic procedures for GDM. The current lack of international consensus for the diagnosis of GDM reflects its complex historical evolution and pragmatic antenatal resource considerations given GDM is now 1 of the most common complications of pregnancy. Regardless, the contemporary clinical approach to GDM should be informed not only by its short-term complications but also by its longer term prognosis. Recent data demonstrate the effect of early in utero exposure to maternal hyperglycemia, with evidence for fetal overgrowth present prior to the traditional diagnosis of GDM from 24 weeks’ gestation, as well as the durable adverse impact of maternal hyperglycemia on child and adolescent metabolism. The major contribution of GDM to the global epidemic of intergenerational cardiometabolic disease highlights the importance of identifying GDM as an early risk factor for type 2 diabetes and cardiovascular disease, broadening the prevailing clinical approach to address longer term maternal and offspring complications following a diagnosis of GDM.
Graphical Abstract
Graphical Abstract
Journal Article
علاج التشتت وعدم التركيز
سوف تجد في هذا الكتاب أحدث معلومات حول العلاج بالعقاقير الطبية ومناهج علمية أخرى، البصيرة النفسية إلي أعماق السلوكيات الانفعالية وكيفية تناولها ونصائح وإرشادات حول كيفية ترويض أعراض Add وتحسين المهارات السلوكية، استراتيجيات التكيف مع Add في العلاقات الأسرية والاجتماعية في أماكن العمل ويوفر دليل إرشادي رائع لمرضي Add وأسرهم حول كل شيء يريدون أن يفهموه من خلال سلسلة من المداخل العلمية للعيش بصورة جيدة مع أعراض Add والتي تتركز حول (الغفلة-الإفراط في النشاط-الاندفاعية) وبالرغم من أنه كتب من أجل الأفراد الذين يعانون من اضطرابات Add فإنه مرجع قيم للآباء والمهنيين أطباء ونفسانيين الإخوة والأخوات وأيضا أصحاب العمل.
BOOK
A joint NCBI and EMBL-EBI transcript set for clinical genomics and research
Comprehensive genome annotation is essential to understand the impact of clinically relevant variants. However, the absence of a standard for clinical reporting and browser display complicates the process of consistent interpretation and reporting. To address these challenges, Ensembl/GENCODE
1
and RefSeq
2
launched a joint initiative, the Matched Annotation from NCBI and EMBL-EBI (MANE) collaboration, to converge on human gene and transcript annotation and to jointly define a high-value set of transcripts and corresponding proteins. Here, we describe the MANE transcript sets for use as universal standards for variant reporting and browser display. The MANE Select set identifies a representative transcript for each human protein-coding gene, whereas the MANE Plus Clinical set provides additional transcripts at loci where the Select transcripts alone are not sufficient to report all currently known clinical variants. Each MANE transcript represents an exact match between the exonic sequences of an Ensembl/GENCODE transcript and its counterpart in RefSeq such that the identifiers can be used synonymously. We have now released MANE Select transcripts for 97% of human protein-coding genes, including all American College of Medical Genetics and Genomics Secondary Findings list v3.0 (ref.
3
) genes. MANE transcripts are accessible from major genome browsers and key resources. Widespread adoption of these transcript sets will increase the consistency of reporting, facilitate the exchange of data regardless of the annotation source and help to streamline clinical interpretation.
Matched Annotation from NCBI and EMBL-EBI (MANE) delivers joint transcript sets from Ensembl/GENCODE and RefSeq for standardizing variant reporting in clinical genomics and research.
Journal Article
Global gain modulation generates time-dependent urgency during perceptual choice in humans
Decision-makers must often balance the desire to accumulate information with the costs of protracted deliberation. Optimal, reward-maximizing decision-making can require dynamic adjustment of this speed/accuracy trade-off over the course of a single decision. However, it is unclear whether humans are capable of such time-dependent adjustments. Here, we identify several signatures of time-dependency in human perceptual decision-making and highlight their possible neural source. Behavioural and model-based analyses reveal that subjects respond to deadline-induced speed pressure by lowering their criterion on accumulated perceptual evidence as the deadline approaches. In the brain, this effect is reflected in evidence-independent urgency that pushes decision-related motor preparation signals closer to a fixed threshold. Moreover, we show that global modulation of neural gain, as indexed by task-related fluctuations in pupil diameter, is a plausible biophysical mechanism for the generation of this urgency. These findings establish context-sensitive time-dependency as a critical feature of human decision-making.
Decision-making balances the benefits of additional information with the cost of time, but it is unclear whether humans adjust this balance within individual decisions. Here, authors show that we do make such adjustments to suit contextual demands and suggest that these are driven by modulation of neural gain.
Journal Article
HARKing
The practice of hypothesizing after results are known (HARKing) has been identified as a potential threat to the credibility of research results. We conducted simulations using input values based on comprehensive meta-analyses and reviews in applied psychology and management (e.g., strategic management studies) to determine the extent to which two forms of HARKing behaviors might plausibly bias study outcomes and to examine the determinants of the size of this effect. When HARKing involves cherry-picking, which consists of searching through data involving alternative measures or samples to find the results that offer the strongest possible support for a particular hypothesis or research question, HARKing has only a small effect on estimates of the population effect size. When HARKing involves question trolling, which consists of searching through data involving several different constructs, measures of those constructs, interventions, or relationships to find seemingly notable results worth writing about, HARKing produces substantial upward bias particularly when it is prevalent and there are many effects from which to choose. Results identify the precise circumstances under which different forms of HARKing behaviors are more or less likely to have a substantial impact on a study’s substantive conclusions and the field’s cumulative knowledge. We offer suggestions for authors, consumers of research, and reviewers and editors on how to understand, minimize, detect, and deter detrimental forms of HARKing in future research.
Journal Article