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Aim: To evaluate the efficacy and safety of DBPR108 (prusogliptin), a novel dipeptidyl peptidase‐4 (DPP‐4) inhibitor, as an add‐on therapy in patients with type 2 diabetes (T2D) that is inadequately controlled with metformin. Materials and Methods: In this 24‐week, multi‐centre, randomized, double‐blind, placebo‐controlled, superiority, phase III study, adult T2D patients with HbA1c levels ranging from 7.0% to 9.5% on stable metformin were enrolled and randomized (2:1) into the DBPR108 + metformin and placebo + metformin groups. The primary endpoint was the change from baseline in HbA1c at week 24 of DBPR108 versus placebo as an add‐on therapy to metformin. Results: At week 24, the least‐square mean (standard error) change from baseline in HbA1c was significantly greater in the DBPR108 group (−0.70% [0.09%]) than in the placebo group (−0.07% [0.11%]) (P <.001), with a treatment difference of −0.63% (95% confidence interval: −0.87%, −0.39%) on the full analysis set. A higher proportion of patients achieved an HbA1c of 6.5% or less (19.7% vs. 8.5%) and an HbA1c of 7.0% or less (50.0% vs. 21.1%) at week 24 in the DBPR108 + metformin group. Furthermore, add‐on DBPR108 produced greater reductions from baseline in fasting plasma glucose and 2‐hour postprandial plasma glucose without causing weight gain. The overall frequency of adverse events was similar between the two groups. Conclusions: DBPR108 as add‐on therapy to metformin offered a significant improvement in glycaemic control, was superior to metformin monotherapy (placebo) and was safe and well‐tolerated in patients with T2D that is inadequately controlled with metformin. [ABSTRACT FROM AUTHOR]

Background: Humane treatment requires the provision of appropriate sedation and analgesia during medical diagnosis and treatment. However, limited information is available about the status of procedural analgesic interventions in Chinese hospitals. Therefore, a nationwide survey was established to identify challenges and propose potential improvement strategies. Methods: Forty-three members of the Pain Group of Chinese Society of Anesthesiology established and reviewed the questionnaire, which included (1) general information on the hospitals, (2) the sedation/analgesia rate in gastrointestinal endoscopy, labor, flexible bronchoscopy, hysteroscopy in China, (3) staff assignments, (4) drug use for procedural analgesic interventions, and (5) difficulties in procedural analgesic interventions. The data were obtained using an online questionnaire sent to the chief anesthesiologists of Chinese hospitals above Grade II or members of the Pain Group of Chinese Society of Anesthesiology. Results: Valid and complete questionnaires were received from 2198 (44.0%) hospitals, of which 64.5% were Grade III. The overall sedation/analgesia rates were as follows: gastroscopy (50.6%), colonoscopy (53.7%), ERCP (65.9%), induced abortion (67.5%), labor (42.3%), hysteroscopy (67.0%) and fiber bronchoscopy (52.6%). Compared with Grade II hospitals, Grade III hospitals had a higher proportion of procedural analgesic interventions services except for induced abortion. On average (median [IQR]), each anesthesiologist performed 5.7 [2.3—11.4] cases per day, with 7.3 [3.2—13.6] performed in Grade III hospitals and 3.4 [1.8—6.8] performed in Grade II hospitals (z = -7.065, p < 0.001). Conclusions: Chinese anesthesiologists have made great efforts to achieve procedural analgesic interventions, as evidenced by the increased rate. The uneven health care provided by hospitals at different levels and in different regions and the lack of anesthesiologists are the main barriers to optimal procedural analgesic interventions. [ABSTRACT FROM AUTHOR]

Purpose: A unique advantage of the brain positron emission tomography (PET) imaging is the ability to image different biological processes with different radiotracers. However, the diversity of the brain PET image patterns also makes their spatial normalization challenging. Since structural MR images are not always available in the clinical practice, this study proposed a PET-only spatial normalization method based on adaptive probabilistic brain atlas. Methods: The proposed method (atlas-based method) consists of two parts, an adaptive probabilistic brain atlas generation algorithm, and a probabilistic framework for registering PET image to the generated atlas. To validate this method, the results of MRI-based method and template-based method (a widely used PET-only method) were treated as the gold standard and control, respectively. A total of 286 brain PET images, including seven radiotracers (FDG, PIB, FBB, AV-45, AV-1451, AV-133, [18F]altanserin) and four groups of subjects (Alzheimer disease, Parkinson disease, frontotemporal dementia, and healthy control), were spatially normalized using the three methods. The results were then quantitatively compared by using correlation analysis, meta region of interest (meta-ROI) standardized uptake value ratio (SUVR) analysis, and statistical parametric mapping (SPM) analysis. Results: The Pearson correlation coefficient between the images computed by atlas-based method and the gold standard was 0.908 ± 0.005. The relative error of meta-ROI SUVR computed by atlas-based method was 2.12 ± 0.18%. Compared with template-based method, atlas-based method was also more consistent with the gold standard in SPM analysis. Conclusion: The proposed method provides a unified approach to spatially normalize brain PET images of different radiotracers accurately without MR images. A free MATLAB toolbox for this method has been provided. [ABSTRACT FROM AUTHOR]

[Display omitted] • The 3D fictive temperature model of fused silica optics was established. • Role of fictive temperature 3D distribution of fused silica optics was explored. • The fictive temperature after CO 2 laser polishing was reduced from 1854 K to 1687 K. • An optimization strategy was proposed with even distribution of fictive temperature. CO 2 laser polishing process is a highly effective way for enhancing the surface quality and laser-induced damage threshold of fused silica optics. Nevertheless, due to the thermal history and spatial gradient of the thermodynamic temperature, the heat-affected zones can be formed unevenly on the surface with an increased fictive temperature, which causes the material densification and residual stress. In this work, a 3D model of structural relaxation coupled with temperature and flow fields was innovatively established to explore the role of fictive temperature distribution involved in CO 2 laser polishing of fused silica. The Raman spectrum was applied to verify this model. Subsequently, the impacts of laser beam power, scanning speed, track overlapping, substrate temperature on the fictive temperature were discussed. The results indicate that decreasing the scanning speed and increasing the substrate temperature can decrease the fictive temperature. Additionally, a higher track overlapping can reduce the height of the fictive temperature "tool mark". Moreover, an optimization strategy based on laser beam scanning speed was proposed based on the uniform distribution of fictive temperature. The depth difference of the heat-affected zones was reduced from 164.26 μm to 31.74 μm. This work could be used to quantitatively predict the 3D fictive temperature distribution and proposed an optimization strategy based on scanning speed to suppress the non-uniformity of fictive temperature distribution, which can provide significant theoretical guidance for CO 2 laser polishing technology of fused silica optics. [ABSTRACT FROM AUTHOR]