155 research outputs found
'Huidig populisme is een correctie: Oude volkspartijen hebben hun werk niet goed gedaan' Interview met Mark Bovens, hoogleraar Bestuurskunde
No full textPopulistische partijen als de PVV, TON en de LPF worden vaak in een adem genoemd met een nieuwe culturele scheidslijn die tegenwoordig het Nederlandse politieke landschap verdeelt: die tussen de voor- en tegenstanders van het in ijltempo voortschrijdende proces van globalisering en europeanisering. Hebben we hier inderdaad te maken met een nieuwe scheidslijn? Of moeten we Geert Wilders en de zijnen eerder zien als de nieuwe spreekbuizen van een oude onderklasse? En waar in de huidige discussie over populisme minstens zoveel aandacht voor is: moeten we ons zorgen maken over de grote populariteit waarin deze nieuwe partijen en hun leiders zich tegenwoordig mogen verheugen?Multi Actor SystemsTechnology, Policy and Managemen
Precision Medicine in Diabetes
No full textTailoring treatment or management to groups of individuals based on specific clinical, molecular, and genomic features is the concept of precision medicine. Diabetes is highly heterogenous with respect to clinical manifestations, disease progression, development of complications, and drug response. The current practice for drug treatment is largely based on evidence from clinical trials that report average effects. However, around half of patients with type 2 diabetes do not achieve glycaemic targets despite having a high level of adherence and there are substantial differences in the incidence of adverse outcomes. Therefore, there is a need to identify predictive markers that can inform differential drug responses at the point of prescribing. Recent advances in molecular genetics and increased availability of real-world and randomised trial data have started to increase our understanding of disease heterogeneity and its impact on potential treatments for specific groups. Leveraging information from simple clinical features (age, sex, BMI, ethnicity, and co-prescribed medications) and genomic markers has a potential to identify sub-groups who are likely to benefit from a given drug with minimal adverse effects. In this chapter, we will discuss the state of current evidence in the discovery of clinical and genetic markers that have the potential to optimise drug treatment in type 2 diabetes
Bibliometric and scientometric analysis of acarological publications in Türkiye between the years 1992-2023
No full textA bibliometric and scientometric analysis of acarological studies conducted in Türkiye between 1992 and 2023 were performed by searching the Clarivate Thomson Reuters WoS database using 525 keywords. The first publication from Türkiye appeared in WoS in 1992. A total of 1,344 articles, 52 reviews, 30 progress reports, eight letters, eight early access documents, seven editorials, three conference abstracts and one note were found. The 1,453 articles written by Turkish scientists were published in 420 different sources (books, journals, etc.) with an annual growth rate of 16.3% and an average number of references of 10.39. Overall, 149 (10.25%) of the publications were written by a single author, while the remaining 1,304 articles had an average of 4.36 authors and 23.47% of them were written in collaboration with international experts. With some slight fluctuations, the number of publications increased over the years, with the highest number of publications being recorded in 2021 and 2023. Again, a steady increase in total and annual citations was observed, with some slight fluctuations. Systematic and Applied Acarology and International Journal of Acarology were the journals with the highest number of publications, while Experimental and Applied Acarology (n=1,202) was the journal with the highest number of citations to Turkish publications. Experimental and Applied Acarology and Veterinary Parasitology were the journals with the highest H-index. The most prolific authors were Salih Doğan (n=77), İsmail Döker (n=67) and Sultan Çobanoğlu (n=64), while the most cited publications were those of Salih Doğan, Nusret Ayyıldız and Adem Keskin. Münir Aktaş, Salih Doğan and Adem Keskin were the authors with the highest H-index. With 199 publications, Ankara University was the institution with the highest number of publications. The 1,453 publications were produced in collaboration with researchers from 87 countries. The highest number of collaborative publications was with researchers from the United States of America (n=89). The Scientific and Technological Research Council of Türkiye was the institution that founded the highest number of studies.</jats:p
Validation of a modified version of the adult developmental eye movement test
No full textThis study evaluates in terms of reliability, internal consistency, and validity a modification of the Adult Developmental Eye Movement (ADEM) test, ADEM with distractors (ADEMd), designed to analyse oculomotor system, visual processing and visual attentional behaviour. 302 healthy subjects participated in the study (20–86 years old). Intrasession repeatability was evaluated by analysing the correlation between the time needed to read different parts of the test. Inter-session analyses were carried in 40 subjects by calculating intraclass correlation coefficients and using the Bland–Altman method. Validity was assessed in the outcomes obtained according to age as well as investigating the correlation between ADEMd and attentional useful field of vision (UFOV) test. Correlation coefficients between times need to read each sheet were ≥ 0.95 (p < 0.001). The inter-session intraclass correlation coefficient ranged from 0.81 in the horizontal distractor sheet to 0.97 in the vertical sheet. Bland–Altman analysis showed clinically acceptable limits of agreement. Statistically significant correlations were found between age and ADEMd outcomes (r ≥ 0.55, p < 0.001). Processing velocity, divided attention and selective attention measured with the UFOV were correlated with the horizontal distractor times (r ≥ 0.32, p < 0.001). ADEMd test may be a useful clinical tool to evaluate the combined interaction of ocular movements and visual attentional behaviour.The author David P. Piñero has been supported by the Ministry of Economy, Industry and Competitiveness of Spain within the program Ramón y Cajal, RYC-2016-20471
Pharmacogenomics in diabetes mellitus:insights into drug action and drug discovery
No full textGenomic studies have greatly advanced our understanding of the multifactorial aetiology of type 2 diabetes mellitus (T2DM) as well as the multiple subtypes of monogenic diabetes mellitus. In this Review, we discuss the existing pharmacogenetic evidence in both monogenic diabetes mellitus and T2DM. We highlight mechanistic insights from the study of adverse effects and the efficacy of antidiabetic drugs. The identification of extreme sulfonylurea sensitivity in patients with diabetes mellitus owing to heterozygous mutations in HNF1A represents a clear example of how pharmacogenetics can direct patient care. However, pharmacogenomic studies of response to antidiabetic drugs in T2DM has yet to be translated into clinical practice, although some moderate genetic effects have now been described that merit follow-up in trials in which patients are selected according to genotype. We also discuss how future pharmacogenomic findings could provide insights into treatment response in diabetes mellitus that, in addition to other areas of human genetics, facilitates drug discovery and drug development for T2DM.</p
Utilizing Large Electronic Medical Record Data Sets to Identify Novel Drug–Gene Interactions for Commonly Used Drugs
No full textReal-world prescribing of drugs differs from the experimental systems, physiological-pharmacokinetic models, and clinical trials used in drug development and licensing, with drugs often used in patients with multiple comorbidities with resultant polypharmacy. The increasing availability of large biobanks linked to electronic healthcare records enables the potential to identify novel drug–gene interactions in large populations of patients. In this study we used three Scottish cohorts and UK Biobank to identify drug–gene interactions for the 50 most commonly used drugs and 162 variants in genes involved in drug pharmacokinetics. We defined two phenotypes based upon prescribing behavior—drug-stop or dose-decrease. Using this approach, we replicate 11 known drug–gene interactions including, for example, CYP2C9/CYP2C8 variants and sulfonylurea/thiazolidinedione prescribing and ABCB1/ABCG2 variants and statin prescribing. We identify eight novel associations after Bonferroni correction, three of which are replicated or validated in the UK Biobank or have other supporting results: The C-allele at rs4918758 in CYP2C9 was associated with a 25% (15–44%) lower odds of dose reduction of quinine, P = 1.6 × 10 −5; the A-allele at rs9895420 in ABCC3 was associated with a 46% (24–62%) reduction in odds of dose reduction with doxazosin, P = 1.2 × 10 −4, and altered blood pressure response in the UK Biobank; the CYP2D6*2 variant was associated with a 30% (18–40%) reduction in odds of stopping ramipril treatment, P = 1.01 × 10 −5, with similar results seen for enalapril and lisinopril and with other CYP2D6 variants. This study highlights the scope of using large population bioresources linked to medical record data to explore drug–gene interactions at scale. </p
Weight variability and cardiovascular outcomes: a systematic review and meta-analysis
No full textThe association between body weight variability and the risk of cardiovascular disease (CVD) has been investigated previously with mixed findings. However, there has been no extensive study which systematically evaluates the current evidence. Furthermore, the impact of ethnicity and type 2 diabetes on this phenomena has not yet been investigated. Therefore, the aim of this study was to comprehensively evaluate the effect of weight variability on risk of CVD (any cardiovascular (CV) event, composite CV outcome, CV death, Stroke, Myocardial Infarction) and the influence of ethnicity and type 2 diabetes status on the observed association. A systematic review and meta-analysis was performed according to the meta-analyses of observational studies in epidemiology (MOOSE) guidelines. The electronic databases PubMed, Web of Science, and the Cochrane Library were searched for studies that investigated the relationship between body weight or BMI variability and CV diseases using Medical Subject Headings (MeSH) terms and keywords. The relative risks (RRs) for the outcomes were collected from studies, pooled, and analysed using a random-effects model to estimate the overall relative risk. Of 5645 articles screened, 23 studies with a total population of 15,382,537 fulfilled the prespecified criteria and were included. Individuals in the highest strata of body weight variability were found to have significantly increased risk of any CV event (RR = 1.27; 95% Confidence Interval (CI) 1.17–1.38; P < 0.0001; I(2) = 97.28%), cardiovascular death (RR = 1.29; 95% CI 1.03–1.60; P < 0.0001; I(2) = 55.16%), myocardial infarction (RR = 1.32; 95% CI 1.09–1.59; P = 0.0037; I(2) = 97.14%), stroke (RR = 1.21; 95% CI 1.19–1.24; P < 0.0001; I(2) = 0.06%), and compound CVD outcomes (RR = 1.36; 95% CI 1.08–1.73; P = 0.01; I(2) = 92.41%). Similar RRs were observed regarding BMI variability and per unit standard deviation (SD) increase in body weight variability. Comparable effects were seen in people with and without diabetes, in White Europeans and Asians. In conclusion, body weight variability is associated with increased risk of CV diseases regardless of ethnicity or diabetes status. Future research is needed to prove a causative link between weight variability and CVD risk, as appropriate interventions to maintain stable weight could positively influence CVD. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12933-022-01735-x
Curriculum y Pertinencia
No full textEl artículo que se presenta es parte de una investigación que se realizó con el propósito de formular un modelo de análisis sobre la pertinencia curricular de la Universidad Centroccidental “Lisandro Alvarado” (UCLA) donde, además del currículum, se abordaron otras categorías de análisis tales como contexto, organización, recursos, calidad y egresados. En este caso particular, por lo limitado del espacio asignado, se presentará únicamente la categoría del diseño curricular y su contribución al logro de una educación con alto sentido de pertinencia. La investigación es de tipo descriptivo-cualitativo y en ella se utiliza el modelo de Miles y Huberman (1984), el método comparativo de Glaser y Strauss (1967), el análisis de contenido para la revisión bibliográfica y del discurso para los entrevistados. El procedimiento contempla 3 fases: 1) elaboración del modelo conceptual del autor, 2) elaboración del modelo experiencial de los entrevistados, y 3) elaboración del modelo integrado propuesto. Este último modelo permitió identificar incidentes, factores coincidentes y generar acciones para formular un diseño curricular pertinente. Además de los elementos ya señalados, se plantean brevemente algunas precisiones conceptuales sobre currículo y pertinencia y finalmente se presentan las conclusiones propias de la investigación.AbstractThe article presented is part of a research carried out with the purpose of proposing a model of analysis about university curriculum petinency of the Universidad Centroccidental “Lisandro Alvarado” (UCLA) in wish, in addition to curriculum matter, other categories such as context, organization, resource, qualities and graduates are raised. In this particular case, due to the limited space provided, only the curricular design category and its contribution to an education with a high sense of pertinency is developed. The research is a descriptive-qualitative type that uses the model of Miles and Huberman (1984), the comparative method of Glasser and Strauss (1967), content analysis for literature review and discourse analysis for the interviewee. The procedure considers three phases: 1) elaboration of the author conceptual model, 2) elaboration of the interviewee experiential model, 3) elaboration of the integrated model proposed. The last model is used to identify incidents, common factors and to generate actions in order to formulate a pertinent curriculum design. Besides the elements already mentioned, some conceptual considerations about curriculum and pertinency are briefly set out , and finally, conclusion derived from the research are presented
Three-Dimensional (3D) Columellar Strut Graft in Rhinoplasty
No full textBackground: Nasal tip surgery is the most important and most difficult step of an aesthetic rhinoplasty operation. Various suture and grafting techniques have been described for adequate tip rotation and projection in nasal tip surgery. Objectives: The author describes his technique of "three-dimensional (3D) columellar strut graft" in nasal tip surgery. Methods: Each patient is treated using the open technique rhinoplasty. The author's technique uses a 3D dorsal columellar strut with a special anatomy in the shape of a Y- on a horizontal plane. When the dorsal columellar strut is placed in a way to maintain the interdomal angle, this technique perfectly stabilizes the lower lateral cruses (LLCs) that have been shaped with cephalic dome suture (CDS). Results: A retrospective analysis of 78 patients, who underwent 3D columellar strut graft technique, were included in the study. The mean follow-up period was 15 months. All of the patients were satisfied with their tip shapes. Conclusions: The 3D dorsal columellar strut graft technique is an easily administered technique with reliable outcomes. The purpose of this graft is to support the reshaped LLCs with a perfect anatomic alignment. It does not require any additional cartilaginous graft in patients undergoing a reduction of the dorsum. © 2016 The American Society for Aesthetic Plastic Surgery, Inc
The Genetics of Adverse Drug Outcomes in Type 2 Diabetes:A Systematic Review
No full textBackground: Adverse drug reactions (ADR) are a major clinical problem accounting for significant hospital admission rates, morbidity, mortality, and health care costs. One-third of people with diabetes experience at least one ADR. However, there is notable interindividual heterogeneity resulting in patient harm and unnecessary medical costs. Genomics is at the forefront of research to understand interindividual variability, and there are many genotype-drug response associations in diabetes with inconsistent findings. Here, we conducted a systematic review to comprehensively examine and synthesize the effect of genetic polymorphisms on the incidence of ADRs of oral glucose-lowering drugs in people with type 2 diabetes. Methods: A literature search was made to identify articles that included specific results of research on genetic polymorphism and adverse effects associated with oral glucose-lowering drugs. The electronic search was carried out on 3rd October 2020, through Cochrane Library, PubMed, and Web of Science using keywords and MeSH terms. Result: Eighteen articles consisting of 10, 383 subjects were included in this review. Carriers of reduced-function alleles of organic cation transporter 1 (OCT 1, encoded by SLC22A1) or reduced expression alleles of plasma membrane monoamine transporter (PMAT, encoded by SLC29A4) or serotonin transporter (SERT, encoded by SLC6A4) were associated with increased incidence of metformin-related gastrointestinal (GI) adverse effects. These effects were shown to exacerbate by concomitant treatment with gut transporter inhibiting drugs. The CYP2C9 alleles, * 2 (rs1799853C>T) and * 3 (rs1057910A>C) that are predictive of low enzyme activity were more common in subjects who experienced hypoglycemia after treatment with sulfonylureas. However, there was no significant association between sulfonylurea-related hypoglycemia and genetic variants in the ATP-binding cassette transporter sub-family C member 8 (ABCC8)/Potassium Inwardly Rectifying Channel Subfamily J Member 11 (KCNJ11). Compared to the wild type, the low enzyme activity C allele at CYP2C8* 3 (rs1057910A>C) was associated with less weight gain whereas the C allele at rs6123045 in the NFATC2 gene was significantly associated with edema from rosiglitazone treatment. Conclusion: In spite of limited studies investigating genetics and ADR in diabetes, some convincing results are emerging. Genetic variants in genes encoding drug transporters and metabolizing enzymes are implicated in metformin-related GI adverse effects, and sulfonylurea-induced hypoglycemia, respectively. Further studies to investigate newer antidiabetic drugs such as DPP-4i, GLP-1RA, and SGLT2i are warranted. In addition, pharmacogenetic studies that account for race and ethnic differences are required.</p
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