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Determinants of neonatal and maternal hypoglycemia in women with gestational diabetes treated with glyburide
No full textLe diabète gestationnel (DG), dont la prévalence était de 10,8% en 2016 en France, est associée à une morbidité maternelle et néonatale. Actuellement, le traitement de référence est l’insulinothérapie. Le glyburide est efficace notamment sur le contrôle de l’équilibre glycémique par rapport à l'insuline. Cependant, il serait associé à une augmentation du risque d’hypoglycémie maternelle et néonatale en comparaison à l’insulinothérapie.L’objectif général de cette thèse était de mieux comprendre les déterminants de l’hypoglycémie maternelle et de l’hypoglycémie néonatale à partir d’analyses ancillaires et secondaires issues de l’essai randomisé national INDAO, publié en 2018.Les objectifs spécifiques étaient d’étudier 1-le passage transplacentaire de glyburide à l'accouchement, 2-l'association entre les mesures anthropométriques néonatales (rapport poids-taille (RPT) et poids de naissance) et l'hypoglycémie néonatale chez les femmes bénéficiant d’un traitement médicamenteux du DG, 3-l'association entre l’hypoglycémie maternelle et les variants à fonction diminuée CYP2C9*2 et les variants perte de fonction CYP2C9*3 et OATP1B3*4, puis l'association entre la dose quotidienne de glyburide et les porteurs de variants perte et diminution de fonction.Nous avons montré qu’il existait un passage placentaire du glyburide avec un rapport de la concentration de glyburide fœtus/mère de 0,62 (IC 95% : 0,50-0,74). Le risque d'hypoglycémie néonatale augmentait de manière significative avec l’augmentation de la concentration de glyburide dans le cordon ombilical, indépendamment de la macrosomie néonatale. Ensuite, nous avons montré que le risque accru d'hypoglycémie néonatale est associé de manière indépendante à des valeurs extrêmes du RPT, pour un faible Z-score du RPT (inférieur à -1,28), et un Z-score du RPT élevé (supérieur à 1,28), indépendamment du traitement maternel. Enfin, nous avons constaté un taux augmenté d'hypoglycémie maternelle au début du traitement par glyburide dans le groupe variant comprenant les porteuses de l’allèle CYP2C9*3 et/ou d'OATP1B*4 à l’état homozygote, associé à une augmentation moindre de la dose de glyburide et à une dose plus faible de glyburide atteinte en fin de traitement.Ces travaux apportent de nouvelles connaissances concernant le mécanisme d’action du glyburide chez les femmes enceintes, permettant une meilleure utilisation dans le traitement du DG. Demeurent cependant pour l’enfant les conséquences potentielles à long terme de l’exposition prolongée in utero au glyburide.Gestational diabetes (GD), whose prevalence in France was 10.8% in 2016, is associated with maternal and neonatal morbidity. Currently, the reference treatment is insulin therapy. Glyburide is effective, particularly in achieving glycemic control, compared with insulin. However, according to some studies, it is associated with an increased risk of maternal and neonatal hypoglycemia compared to insulin therapy.The main objective of this thesis was to better understand the determinants of maternal hypoglycemia and neonatal hypoglycemia based on ancillary and secondary analyses from the national randomized INDAO trial, published in 2018. The specific objectives were to investigate 1-the transplacental transfer of glyburide at delivery, 2-the association between neonatal anthropometric measures (weight-for-length ratio [WLR] and birth weight) and neonatal hypoglycemia in women receiving drug therapy for GD, 3-the association between maternal hypoglycemia and CYP2C9*2 reduced-function variants and CYP2C9*3 and OATP1B3*4 loss-of-function variants, and then in a second step to investigate the association between daily glyburide dose and carriers of loss-of-function and reduced-function variants.First, we showed that there was a placental transfer of glyburide with a fetal/maternal glyburide concentration ratio of 0.62 (95% CI 0.50-0.74). The risk of neonatal hypoglycemia increased significantly with increasing umbilical cord blood glyburide concentration, regardless of neonatal macrosomia. Second, we showed that the increased risk of neonatal hypoglycemia was independently associated with extreme values of WLR, for a low WLR Z-score (less than -1.28) and a high WLR Z-score (greater than 1.28), regardless of maternal treatment. Finally, we found an increased rate of maternal hypoglycemia at the beginning of glyburide treatment in the variant group including carriers of the CYP2C9*3 and/or OATP1B*4 allele in a homozygous state, associated with a smaller glyburide dose increment and a lower glyburide dose reached at the end of treatment.This thesis work provides new insights into the mechanism of action of glyburide in pregnant women, allowing for better use in the treatment of GD. However, the potential long-term consequences for the child of prolonged in utero exposure to glyburide remain
Déterminants de l’hypoglycémie néonatale et maternelle chez les femmes ayant un diabète gestationnel traité par glyburide
No full textGestational diabetes (GD), whose prevalence in France was 10.8% in 2016, is associated with maternal and neonatal morbidity. Currently, the reference treatment is insulin therapy. Glyburide is effective, particularly in achieving glycemic control, compared with insulin. However, according to some studies, it is associated with an increased risk of maternal and neonatal hypoglycemia compared to insulin therapy.The main objective of this thesis was to better understand the determinants of maternal hypoglycemia and neonatal hypoglycemia based on ancillary and secondary analyses from the national randomized INDAO trial, published in 2018. The specific objectives were to investigate 1-the transplacental transfer of glyburide at delivery, 2-the association between neonatal anthropometric measures (weight-for-length ratio [WLR] and birth weight) and neonatal hypoglycemia in women receiving drug therapy for GD, 3-the association between maternal hypoglycemia and CYP2C9*2 reduced-function variants and CYP2C9*3 and OATP1B3*4 loss-of-function variants, and then in a second step to investigate the association between daily glyburide dose and carriers of loss-of-function and reduced-function variants.First, we showed that there was a placental transfer of glyburide with a fetal/maternal glyburide concentration ratio of 0.62 (95% CI 0.50-0.74). The risk of neonatal hypoglycemia increased significantly with increasing umbilical cord blood glyburide concentration, regardless of neonatal macrosomia. Second, we showed that the increased risk of neonatal hypoglycemia was independently associated with extreme values of WLR, for a low WLR Z-score (less than -1.28) and a high WLR Z-score (greater than 1.28), regardless of maternal treatment. Finally, we found an increased rate of maternal hypoglycemia at the beginning of glyburide treatment in the variant group including carriers of the CYP2C9*3 and/or OATP1B*4 allele in a homozygous state, associated with a smaller glyburide dose increment and a lower glyburide dose reached at the end of treatment.This thesis work provides new insights into the mechanism of action of glyburide in pregnant women, allowing for better use in the treatment of GD. However, the potential long-term consequences for the child of prolonged in utero exposure to glyburide remain.Le diabète gestationnel (DG), dont la prévalence était de 10,8% en 2016 en France, est associée à une morbidité maternelle et néonatale. Actuellement, le traitement de référence est l’insulinothérapie. Le glyburide est efficace notamment sur le contrôle de l’équilibre glycémique par rapport à l'insuline. Cependant, il serait associé à une augmentation du risque d’hypoglycémie maternelle et néonatale en comparaison à l’insulinothérapie.L’objectif général de cette thèse était de mieux comprendre les déterminants de l’hypoglycémie maternelle et de l’hypoglycémie néonatale à partir d’analyses ancillaires et secondaires issues de l’essai randomisé national INDAO, publié en 2018.Les objectifs spécifiques étaient d’étudier 1-le passage transplacentaire de glyburide à l'accouchement, 2-l'association entre les mesures anthropométriques néonatales (rapport poids-taille (RPT) et poids de naissance) et l'hypoglycémie néonatale chez les femmes bénéficiant d’un traitement médicamenteux du DG, 3-l'association entre l’hypoglycémie maternelle et les variants à fonction diminuée CYP2C9*2 et les variants perte de fonction CYP2C9*3 et OATP1B3*4, puis l'association entre la dose quotidienne de glyburide et les porteurs de variants perte et diminution de fonction.Nous avons montré qu’il existait un passage placentaire du glyburide avec un rapport de la concentration de glyburide fœtus/mère de 0,62 (IC 95% : 0,50-0,74). Le risque d'hypoglycémie néonatale augmentait de manière significative avec l’augmentation de la concentration de glyburide dans le cordon ombilical, indépendamment de la macrosomie néonatale. Ensuite, nous avons montré que le risque accru d'hypoglycémie néonatale est associé de manière indépendante à des valeurs extrêmes du RPT, pour un faible Z-score du RPT (inférieur à -1,28), et un Z-score du RPT élevé (supérieur à 1,28), indépendamment du traitement maternel. Enfin, nous avons constaté un taux augmenté d'hypoglycémie maternelle au début du traitement par glyburide dans le groupe variant comprenant les porteuses de l’allèle CYP2C9*3 et/ou d'OATP1B*4 à l’état homozygote, associé à une augmentation moindre de la dose de glyburide et à une dose plus faible de glyburide atteinte en fin de traitement.Ces travaux apportent de nouvelles connaissances concernant le mécanisme d’action du glyburide chez les femmes enceintes, permettant une meilleure utilisation dans le traitement du DG. Demeurent cependant pour l’enfant les conséquences potentielles à long terme de l’exposition prolongée in utero au glyburide
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Full text linkWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
Dispelling the Myths Behind First-author Citation Counts
Full text linkWe conducted a full-scale evaluative citation analysis study of scholars in the XML research field to explore just how different from each other author rankings resulting from different citation counting methods actually are, and to demonstrate the capability of emerging data and tools on the Web in supporting more realistic citation counting methods. Our results contest some common arguments for the continued
use of first-author citation counts in the evaluation of scholars, such as high correlations between author rankings by first-author citation counts and other citation
counting methods, and high costs of using more realistic citation counting methods that are not well-supported by the ISI databases. It is argued that increasingly available digital full text research papers make it possible for citation analysis studies to go beyond what the ISI databases have directly supported and to employ more
sophisticated methods
koamabayili/VECTRON-author-checklist: VECTRON author checklist
No full textWe have done our best to complete the author checklist relating to the use of animals in the hut study. Note that the objective for the hut study was to evaluate the IRS treatment applications for residual efficacy against Anopheles mosquitoes, including the local An. coluzzii mosquito population. Cows were only used to attract mosquitoes into the huts and no tests were carried out directly on the cows. The author checklist is intended for use with studies where experiments are carried out on animals, which is why we have had such difficulty in completing this for the hut study, as many of the questions do not relate to how the cows were used
Author-wise bibliometric analysis based on entropy.
No full textAuthor-wise bibliometric analysis based on entropy.</p
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