3,392 research outputs found
Long-term study of patients with type 2 diabetes and moderate renal impairment shows that dapagliflozin reduces weight and blood pressure but does not improve glycemic control.
No full textIn patients with diabetes, glycemic improvement by sodium-glucose cotransporter-2 inhibition depends on the kidney’s ability to filter glucose. Dapagliflozin, a sodium-glucose cotransporter-2 inhibitor, reduces hyperglycemia in patients with diabetes and normal or mildly impaired renal function. In this randomized, double-blind, placebo-controlled study we assessed daily treatment with dapagliflozin in 252 patients with inadequately controlled type 2 diabetes and moderate renal impairment. The primary endpoint, the mean change in HbA1c, was not statistically different from placebo after 24 weeks (-0.41% and -0.44% for 5- and 10-mg doses, respectively, and -0.32% for placebo). The mean weight change from baseline was -1.54 and -1.89kg for the 5- and 10-mg doses, respectively, and +0.21kg for placebo. The mean systolic and diastolic blood pressure decreased in the dapagliflozin groups compared to placebo. Through 104 weeks, 13 patients receiving dapagliflozin and no patients receiving placebo experienced bone fracture. At 1 week, the mean serum creatinine increased with dapagliflozin 5mg (+0.13mg/dl) and 10mg (+0.18mg/dl) and did not change further after 104 weeks. Mean serum electrolytes did not change in any group, and there were fewer episodes of hyperkalemia with dapagliflozin than placebo. Thus, in patients with moderate renal impairment, dapagliflozin did not improve glycemic control, but reduced weight and blood pressure
Dapagliflozin Monotherapy in Type 2 Diabetic Patients With Inadequate Glycemic Control by Diet and Exercise A randomized, double-blind, placebo-controlled, phase 3 trial
No full textOBJECTIVE - Dapagliflozin, a highly selective inhibitor of the renal sodium-glucose co-transporter-2, increases urinary excretion of glucose and lowers plasma glucose levels in an insulin-independent manner. We evaluated the efficacy and safety of dapagliflozin in treatment-naive patients with type 2 diabetes. RESEARCH DESIGN AND METHODS - This was a 24-week parallel-group, double-blind, placebo-controlled phase 3 trial. Patients with A1C 7.0-10% (n = 485) were randomly assigned to one of seven arms to receive once-daily placebo or 2.5, 5, or 10 mg dapagliflozin once daily in the morning (main cohort) or evening (exploratory cohort). Patients with A1C 10.1-12% (high-A1C exploratory cohort, it n=73) were randomly assigned 1:1 to receive blinded treatment with a morning close of 5 or 10 mg/day dapagliflozin. The primary end point was change from baseline in A1C in the main cohort, statistically tested using an ANCOVA. RESULTS - In the main cohort, mean A1C changes from baseline at week 24 were -0.23% with placebo and -0.58, -0.77 (P = 0.0005 vs. placebo), and -0.89% (P < 0.0001, vs. placebo) with 2.5, 5, and 10 mg dapagliflozin, respectively. Signs, symptoms, and other reports suggestive of urinary tract infections and genital infection were more frequently noted in the dapagliflozin arms. There were no major episodes of hypoglycemia. Data from exploratory cohorts were consistent with these results. CONCLUSIONS - Dapagliflozin lowered hyperglycemia in treatment-naive patients with newly diagnosed type 2 diabetes. The near absence of hypoglycemia and an insulin-independent mechanism of action make dapagliflozin a unique addition to existing treatment options for type 2 diabetes
Returning Home After a Disaster: Supply List
No full textWhen you return home after a disaster, you will want to have sturdy shoes, proper tools, clothes and medications for several days, and a first-aid kit. This publication also includes a list of necessary cleaning supplies
Development of B1-level JF Can-do Aimed for Supporting Task-based Educational Practice
No full textB1レベルの課題遂行を目標とした教育実践の支援を目的として、『まるごと 日本のことばと文化』中級1、2の言語活動をもとにしたJF Can-do（B1）の作成を行った。本稿では、CEFRの枠組み（レベルとカテゴリー）を維持した作成プロセスと、教育現場での活用につなげるために考慮した点について述べる。本Can-do作成では、CEFRの共通参照レベルを維持するため、「Can-doのレベル別特徴一覧」とCan-doの構造モデルを参照した。また、『まるごと』に提示される各言語活動の特徴を踏まえ、CEFRと共通するJFSのカテゴリーを付与した。Can-doの記述は、各教育現場が学習者に合わせて活用しやすいこと、またB1のレベルや言語活動の幅をより把握しやすくなることを意図し、言語活動の場面や話題を限定的にしすぎず、幅を持たせた記述とした。This paper describes the development of B1-level JF Can-do based on communicative language activities in “Marugoto : Japanese Language and Culture (Intermediate 1, Intermediate 2)”, aimed for supporting task-based educational practice. It reports on the development process that maintained the CEFR illustrative descriptors framework (levels and categories) and the points that were considered for its use in educational settings. To maintain the CEFR common reference levels, the “List of Characteristics of Each Can-do Level” and the structural model of Can-dos were referred in the course of development. Furthermore, JFS categories common to that of CEFR were assigned to the Can-dos based on the characteristics of each corresponding Japanese communicative language activity presented in ‟Marugoto”. Additionally, to enable users to utilize the Can-dos according to their learners and better grasp the level and range of the communicative language activities of B1-level, restrictions to the situations and topics of communicative language activities were minimalized when writing the Can-do descriptions.departmental bulletin pape
Business Model Innovation of JF Logistics Company
No full text摘要 随着全球化经济的发展，市场竞争变得越来越复杂。信息时代使得物流供应链管理已上升到企业的战略管理高度。在这样的背景下，本文应用翁君奕老师的介观商务模式创新观点，对JF物流公司所处行业现状进行剖析，重新审视了外部客户市场以及内部自身情况，找出了JF物流公司自身的优势，并结合外部市场客户的需求，提出了“为客户提供个性化的集物流、资金流、信息流于一体的供应链物流服务”这一价值主张，并在此基础上，重新定位客户市场，创新服务产品，理顺内部管理架构和业务流程以支撑和保持这一价值主张。文中同时以例证来说明依据新价值主张所创新的服务产品给JF物流公司所带来的变化，以此说明通过商务模式创新来实行自身的战略...Abstract With the development of the global economy, the competition in market becomes more complicated. In the era of information, logistics and supply chain management is regarded as important as part of the company strategy. Under such background , the author of this essay uses the concept of “JieGuan Business Model Innovation” proposed by Professor Weng Junyi of Xiamen University, and analy...学位：管理学硕士院系专业：管理学院高级经理教育中心（EMBA项目）_管理经济学学号：X200615614
Green plants in the red : a baseline global assessment for the IUCN Sampled Red List Index for Plants
No full textPlants provide fundamental support systems for life on Earth and are the basis for all terrestrial ecosystems; a decline in plant diversity will be detrimental to all other groups of organisms including humans. Decline in plant diversity has been hard to quantify, due to the huge numbers of known and yet to be discovered species and the lack of an adequate baseline assessment of extinction risk against which to track changes. The biodiversity of many remote parts of the world remains poorly known, and the rate of new assessments of extinction risk for individual plant species approximates the rate at which new plant species are described. Thus the question 'How threatened are plants?' is still very difficult to answer accurately. While completing assessments for each species of plant remains a distant prospect, by assessing a randomly selected sample of species the Sampled Red List Index for Plants gives, for the first time, an accurate view of how threatened plants are across the world. It represents the first key phase of ongoing efforts to monitor the status of the world's plants. More than 20% of plant species assessed are threatened with extinction, and the habitat with the most threatened species is overwhelmingly tropical rain forest, where the greatest threat to plants is anthropogenic habitat conversion, for arable and livestock agriculture, and harvesting of natural resources. Gymnosperms (e.g. conifers and cycads) are the most threatened group, while a third of plant species included in this study have yet to receive an assessment or are so poorly known that we cannot yet ascertain whether they are threatened or not. This study provides a baseline assessment from which trends in the status of plant biodiversity can be measured and periodically reassessed.Peer reviewe
Temporal and spatial variability in speakers with Parkinson's Disease and Friedreich's Ataxia
No full textSpeech variability in groups of speakers with Parkinson's disease (PD) and with Friedreich's ataxia was compared with healthy controls. Speakers repeated the same phrase 20 times at one of two rates (fast or habitual). A non-linear analysis of variability was performed which used some of the principles behind the spatio-temporal index (STI). The STI usually employs variation in lip displacement over repetitions of the same utterance and a linear analysis of such signals is conducted to represent the combined variation in spatial and temporal control. When working with patients, audio measures (here we used speech energy) are preferred over kinematics ones as they are minimally disruptive to speech. Non-linear methods allow spatial variability to be estimated separately from temporal variability. The results are tentatively interpreted as showing that PD speakers were distinguished from healthy control speakers in spatial variability and ataxic speakers were distinguished from controls in temporal variability. These findings are consistent with the speech symptoms reported for these disorders. We conclude that the non-linear analysis using the speech energy measure is worth investigating further as it is potentially revealing of the differences underlying these two pathologies
Ocena kvaliteta rada mikser distributer prikolice jf-stoll u pripremi tmr obroka za muzne krave
No full textQuality of TMR feed homogenization and distribution is analyzed in this
paper. TMR feed mixture for lactating cows feeding was prepared in vertical mixer
distribution trailer JF- Stoll VM 8 1S. The mixture was consisted of components that are
defined for dairy cows in the first lactation phase, with the milk production of about
40 l/day. Physical and chemical parameters are analyzed according to the regulations of
quality and other requirements for animal feeds (Official Journal of SRJ nr. 20/00
38/01), such as contents of moisture, ash, fats, cellulose, proteins and non nitrogen
extractive matter. For sampling and analysis are applied standard and non standard
methods.U radu je analiziran kvalitet homogenizacije i distribucije TMR obroka za
muzne krave koji je formiran u vertikalnoj mikser distributer prikolici JF-Stoll VM 8 1S.
TMR obrok je sastavljen po recepturi za grla u muži u prvoj fazi laktacije sa
proizvodnjom mleka od oko 40 l/dan. Analizirani su fizičko hemijski sastojci u skladu sa
pravilnikom o kvalitetu i drugim zahtevima za hranu za životinje (sl. list SRJ br.20/00
38/01), kao što su sadržaj vlage, sadržaj pepela, sadržaj masti, sadržaj celuloze, sadržaj
proteina, sadržaj bezazotnih ekstraktivnih materija. Za uzorkovanje i nalalizu su
primenjene standardne i nestandardne metode
Ocena kvaliteta rada mikser distributer prikolice JF-Stoll u pripremi TMR obroka za muzne krave
No full textQuality of TMR feed homogenization and distribution is analyzed in this paper. TMR feed mixture for lactating cows feeding was prepared in vertical mixer distribution trailer JF- Stoll VM 8 1S. The mixture was consisted of components that are defined for dairy cows in the first lactation phase, with the milk production of about 40 l/day. Physical and chemical parameters are analyzed according to the regulations of quality and other requirements for animal feeds (Official Journal of SRJ nr. 20/00 38/01), such as contents of moisture, ash, fats, cellulose, proteins and non nitrogen extractive matter. For sampling and analysis are applied standard and non standard methods.U radu je analiziran kvalitet homogenizacije i distribucije TMR obroka za muzne krave koji je formiran u vertikalnoj mikser distributer prikolici JF-Stoll VM 8 1S. TMR obrok je sastavljen po recepturi za grla u muži u prvoj fazi laktacije sa proizvodnjom mleka od oko 40 l/dan. Analizirani su fizičko hemijski sastojci u skladu sa pravilnikom o kvalitetu i drugim zahtevima za hranu za životinje (sl. list SRJ br.20/00 38/01), kao što su sadržaj vlage, sadržaj pepela, sadržaj masti, sadržaj celuloze, sadržaj proteina, sadržaj bezazotnih ekstraktivnih materija. Za uzorkovanje i analizu su primenjene standardne i nestandardne metode
Post-communism and the abandonment of mixed-member electoral systems
No full textMany countries adopted mixed-member (MM) electoral systems in the 1990s, but several switched to list proportional representation (PR) recently. Most switchers are post-communist countries that used the semi-proportional mixed-member majoritarian (MMM) system, often associated with dominant parties. List PR was adopted under competitive conditions in some cases (Albania, Bulgaria, Croatia, Macedonia, Ukraine), while in places where authoritarian control remains (Russia, Kazakhstan, Kyrgyzstan), list PR appears to be used as a means of reducing competition and undermining multiparty democracy
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