Similar glycaemic control with less nocturnal hypoglycaemia in a 38-week trial comparing the IDegAsp co-formulation with insulin glargine U100 and insulin aspart in basal insulin-treated subjects with type 2 diabetes mellitus.

AIMS: To confirm non-inferiority of insulin degludec/insulin aspart (IDegAsp) once-daily (OD) versus insulin glargine (IGlar) U100 OD + insulin aspart (IAsp) OD for HbA1c after 26 weeks, and compare efficacy and safety between groups at W26 + W38. METHODS: A 38-week, randomised, open-label, treat-to-target (HbA1c < 7.0%) trial in adults with type 2 diabetes mellitus (on basal insulin ±â€¯oral antidiabetic drugs; HbA1c 7.0-10.0%). Randomisation (1:1): IDegAsp or IGlar U100 + IAsp. Intensification to IDegAsp twice daily (BID) was permitted at W26 + W32, or with additional IAsp injections at W26 (maximum IAsp BID) or W32 (maximum IAsp three-times daily). RESULTS: For W0-W26, mean percentage-change (standard deviation) HbA1c was: IDegAsp, -1.1 (0.9); IGlar U100 + IAsp, -1.1 (0.8); estimated treatment difference: 0.07% (95% confidence interval [CI]: -0.06; 0.21) confirmed non-inferiority. At W26 and W38, target HbA1c achievement, and mean fasting and postprandial glucose were similar across groups. At W38, more subjects achieved target HbA1c without hypoglycaemia with IDegAsp (22.5%) than with IGlar U100 + IAsp (21.1%), with significantly fewer nocturnal episodes (W0-W38, estimated rate ratio: 0.61 [95% CI: 0.40; 0.93]). Safety profiles were similar across treatment groups throughout. CONCLUSIONS: IDegAsp OD/BID are effective treatment intensification options versus multiple injection basal-bolus therapies, achieving similar glycaemic control, with significantly less nocturnal hypoglycaemia.

Control of malaria outbreak due to Plasmodium vivax in Aswan Governorate, Egypt.

In 2014, after several years of maintaining zero malaria indigenous cases, Egypt had an outbreak of Plasmodium vivax: 21 confirmed cases during May-June 2014. In response to the outbreak, the Ministry of Health and Population (MoHP) launched an emergency response through early detection and prompt treatment of cases, vector control, public education and intersectoral collaboration. Twenty cases (95.2%) were residents of El-Sheikh Mostafa village, Edfu district, Aswan governorate, southern Egypt. All cases, consequent to the index case were identified through house-to-house surveillance visits. One P. falciparum-infected case was also identified in the same village. Treatment of all infected cases was initiated following laboratory confirmation. The MoHP's rapid response to and containment of the outbreak demonstrates the institutional capacity for detection and control of outbreaks which can occur after elimination.

Brassinosteroid regulates fiber development on cultured cotton ovules.

Our current understanding of the role of phytohormones in the development of cotton fibers is derived largely from an amenable culture system in which cotton ovules, collected on the day of anthesis, are floated on liquid media. Under these conditions, supplemental auxin and gibberellin were found to promote fiber initiation and elongation. More recently, addition of low concentrations of the brassinosteroid brassinolide (BL) were also found to promote fiber elongation while a brassinosteroid biosynthesis inhibitor brassinazole2001 (Brz) inhibited fiber development. In order to elucidate the role of brassinosteroid in cotton fiber development further, we have performed a more detailed analysis of the effects of these chemicals on cultured cotton ovules. Our results confirm that exogenous BL promotes fiber elongation while treatment with Brz inhibits it. Furthermore, treatment of cotton floral buds with Brz results in the complete absence of fiber differentiation, indicating that BR is required for fiber initiation as well as elongation. Expression of fiber genes associated with cell elongation increased in ovules treated with BL and was suppressed by Brz treatment, establishing a correlation between brassinosteroid-regulated gene expression and fiber elongation. These results establish a clear connection between brassinosteroid and fiber development and open the door for genetic analysis of cotton development through direct modification of the brassinosteroid signal transduction pathway.

Unusual circular annulate lamellae in hepatocytes of Torpedo marmorata.

This report describes an unusual morphology of annulate lamellae (AL) in the hepatocytes of Torpedo marmorata Risso. These Als and fragments are detected amidst the main glycogen and lipid deposits. AL cisterns are circumscribed by parts of the smooth endoplasmic reticulum. Based on the finding of these unusual annular ALs, accompanied by other subcellular lesions such as a number of membranous whorls and altered mitochondria. These findings can concur and support other authors' observations suggesting that these adult hepatocytes transient changes reflect that this species could be exposed to local, natural or likely human coastal seabed pollutants.

Treatment of winter depression in Norway. II. A comparison of the selective monoamine oxidase A inhibitor moclobemide and placebo.

Thirty-four patients with seasonal affective disorder, winter depression type (WD) were randomly distributed to receive the selective monoamine oxidase-A inhibitor moclobemide (400 mg daily) or placebo in a double-blind, parallel group study lasting for up to 14 weeks. Severity measures were the Montgomery-Asberg Depression Rating Scale (MADRS) extended with characteristic symptoms of WD; summed score of the "atypical" symptoms hypersomnia, hyperphagia and carbohydrate craving; and Clinical Global Impressions (CGI). After 3 weeks, patients with unsatisfactory response were switched to open moclobemide. Three patients on placebo dropped out before 3 weeks. Extended MADRS and CGI showed no significant difference between the groups at 3 weeks, whereas the atypical score was reduced significantly more on moclobemide than on placebo already after one week. Nonresponders after 3 weeks (9 of 16 on moclobemide and 7 of 15 on placebo) improved rapidly after being given open moclobemide. Predictor analysis showed a remarkably high negative correlation between improvement at 3 weeks (extended MADRS) and age in the placebo group and a strong, nonsignificant trend in the same direction in the moclobemide group. Dichotomizing the patients according to the median age (45 years) resulted in a somewhat better effect of moclobemide than placebo in the older age group. There were no significant differences in side effects between moclobemide and placebo.

Treatment of winter depression in Norway. I. Short- and long-term effects of 1500-lux white light for 6 days.

Patients with seasonal affective disorder (winter depression) from the Oslo area (at about 60 degrees N) recruited through mass media advertising were treated with 1500-lx white full-spectrum light for 2 h in the morning for 6 days. Their clinical state was assessed at baseline and 1, 3, 6, 10 and 14 weeks after commencement of treatment with an extended version of Montgomery-Asberg Depression Rating Scale (MADRS) and Clinical Global Impression. Forty patients (35 women, 5 men, age range 24 to 64 years) completed 1 week of light treatment. A subgroup of 9 patients received light in addition to ongoing drug treatment. The mean reduction in total extended MADRS score at week 1 was 48% in patients receiving only light and 56% in patients receiving light in addition to drugs. In spite of the low dose of light given, this is comparable to other reported results using light treatment for winter depression. In contrast to most other studies, however, the improvement at week 1 was maintained for the rest of the season in most patients. Only 5 patients were given another light treatment course, and another 5 were switched to drug treatment due to their unsatisfactory response to light treatment.

Seasonal mood variation: an epidemiological study in northern Norway.

In an epidemiological study carried out in the town of Tromsö in northern Norway an extensive questionnaire was sent twice, in summer and winter, to 1000 subjects to investigate the degree of symptoms of mood variation (depression or hypomania) during the polar winter night and midnight sun seasons. The results suggest that the general population north of the Arctic Circle shows a major seasonal mood variation. It is suggested that seasonal mood variation is a chronobiological mood disturbance related to and probably precipitated by extreme variations in light. The therapeutic implications and preventive measures are discussed.

Parasuicidal snow-wandering in Arctic northern Norway.

Psychiatric morbidity in the Arctic has not been extensively studied. Seasonal variations in climate, light and darkness are unique for these areas and impose special kinds of strains on the population. Three case-histories focusing on snow-wandering as a parasuicidal act are presented. One of them bears some resemblance to the Arctic hysteria described among Eskimoes. Reasons for choosing snow-wandering as an alternative to other kinds of suicide are discussed and a hypothesis is suggested. The psychological and physiological factors as explanations for post snow-wandering amnesia are discussed.

Neutron activation analysis by standard addition and solvent extraction: Determination of impurities in aluminium.

A separation scheme based on selective extraction in conjunction with the standard addition technique has been developed for the determination of impurities in aluminium by neutron activation. Preliminary investigations have been carried out on the extractability of Sc, Co, Hf, Fe, Sn, Cd, Zn, Ag, Cr, Ce, Cs and Rb by TDA and TBP from acidic media. The best conditions are predicted for the separation of these elements into fractions suitable for analysis by gamma-ray spectrometry. Recovery values of approximately 90% were obtained for all the elements.