Physical performance and glycemic control under SGLT-2-inhibitors in patients with type 2 diabetes and established atherosclerotic cardiovascular diseases or high cardiovascular risk (PUSH): Design of a 4-week prospective observational study.

Background: Type 2 diabetes (T2D) is associated with limitation in physical performance. Results from animal studies report enhancement of physical performance in T2D rodents treated with sodium glucose cotransporter 2 inhibitors (SGLT2is). However, in human patients with T2D and established atherosclerotic cardiovascular disease (ASCVD) or high cardiovascular risk, the impact of guideline directed SGLT2i medication on physical performance has not been sufficiently examined. Objectives: The main objectives of this study are thus firstly, to assess the changes in physical performance after 4 weeks of exercise therapy in patients with established ASCVD or high cardiovascular risk categorized into three groups according to their glycemic control at baseline. Secondly, to investigate the association of glycemic control at baseline and new guideline directed antidiabetic treatment (inadequate glycemic control and diabetes + new SGLT2i vs. adequate glycemic control and diabetes vs. no diabetes) with change in physical performance. Methods and design: This is a 4-week prospective observational study of 450 participants with established ASCVD or high cardiovascular risk with or without T2D and without previous SGLT2i medication undergoing exercise therapy during inpatient rehabilitation in a single center in Switzerland. Upon admission, participants are categorized into 3 groups of 150 participants each according to their glycemic control. Group I consisting of participants with inadequately controlled T2D defined as mean fasting plasma glucose (FPG) of ≥7 mmol/L, who are consequently administered new treatment with an SGLT2i. Group II comprises of participants with adequately controlled T2D with mean FPG of <7 mmol/L requiring no antidiabetic medication change. Group III consists of participants with no diabetes and mean FPG of ≤ 5.5 mmol/L. Primary outcomes are 6-min walk distance and rate of perceived exertion. Secondary outcomes are echocardiographic parameters (left ventricular mass index; global longitudinal strain average; end-diastolic volume), fatigue, muscle, metabolic, and anthropometric measures. Ethics and dissemination: This study is conducted in accordance with the Declaration of Helsinki with ethical approval from the Cantonal Ethical Commission of Bern, Switzerland. The results will be published in a peer-reviewed journal. The implementation and reporting will be according to the SPIRIT guidelines. Study protocol registration: https://www.clinicaltrials.gov/, identifier: NCT03422263.

Interproximal distance analysis of stereolithographic casts made by CAD-CAM technology: An in vitro study.

STATEMENT OF PROBLEM: The accuracy of interproximal distances of the definitive casts made by computer-aided design and computer-aided manufacturing (CAD-CAM) technology is not yet known. PURPOSE: The purpose of this in vitro study was to compare the interproximal distances of stereolithographic casts made by CAD-CAM technology with those of stone casts made by the conventional method. MATERIAL AND METHODS: Dentoform teeth were prepared for a single ceramic crown on the maxillary left central incisor, a 3-unit fixed dental prosthesis (FDP) on the second premolar for a metal-ceramic crown, and a maxillary right first molar for a metal crown. Twenty digital intraoral impressions were made on the dentoform with an intraoral digital impression scanner. The digital impression files were used to fabricate 20 sets of stereolithographic casts, 10 definitive casts for the single ceramic crown, and 10 definitive casts for the FDP. Furthermore, 20 stone casts were made by the conventional method using polyvinyl siloxane impression material with a custom tray. Each definitive cast for stereolithographic cast and stone cast consisted of removable die-sectioned casts (DC) and nonsectioned solid casts (SC). Measurements of interproximal distance of each cast were made using CAD software to provide mean ±standard deviation (SD) values. Data were first analyzed by repeated measures analysis of variance (ANOVA), using different methods of cast fabrication (stone and stereolithography) as one within subject factor and different cast types (DC and SC) as another within subject factor. Post hoc analyses were performed to investigate the differences between stone and stereolithographic casts depending upon the results from the repeated measures ANOVA (α=.05). RESULTS: Analysis of interproximal distances showed the mean ±SD value of the single ceramic crown group was 31.2 ±24.5 µm for stone casts and 261.0 ±116.1 µm for stereolithographic casts, whereas the mean ±SD value for the FDP group was 46.0 ±35.0 µm for stone casts and 292.8 ±216.6 µm for stereolithographic casts. For both the single ceramic crown and the FDP groups, there were significant differences in interproximal distances between stereolithographic casts and stone casts (P<.001). In addition, the comparisons of DC with SC of stone and stereolithographic casts for the single ceramic crown and FDP groups demonstrated there was statistically significant differences among interproximal distances between DC stereolithographic casts and SC stereolithographic casts only for the FDP group (P<.001). CONCLUSIONS: For both the single ceramic crown and the FDP groups, the stereolithographic cast group showed significantly larger interproximal distances than the stone cast group. In terms of the comparison between DC and SC, DC stereolithographic casts for the FDP group only showed significantly larger interproximal values than those of the SC stereolithographic casts for the FDP group.

Measuring bystander attitudes and behavior to prevent sexual violence.

OBJECTIVE: The purpose of this study is to further investigate the factor structure and strength of the Bystander Attitude Scale-Revised and Bystander Behavior Scale-Revised (BAS-R and BBS-R). PARTICIPANTS: First-year students (N = 4,054) at a large public university in the Northeast completed a survey in 2010 as part of a larger longitudinal study of a sexual violence bystander education intervention program on campus. METHODS: Exploratory structural equation modeling was used to analyze survey responses to the BAS-R and BBS-R. RESULTS: For BAS-R, the best fit was a 4-factor model: (1) high-risk situations, (2) postassault support for victims, (3) postassault reporting of perpetrators, and (4) proactive opportunities. BBS-R was a 2-factor model: (1) intervention opportunities before, during, or after an assault, and (2) proactive opportunities. CONCLUSION: The BAS-R and BBS-R provide reliable tools that can be utilized to evaluate sexual violence bystander programs.