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The Igls criteria were developed to provide a consensus definition for outcomes of β-cell replacement therapy in the treatment of diabetes during a January 2017 workshop sponsored by the International Pancreas & Islet Transplant Association (IPITA) and the European Pancreas & Islet Transplant Association (EPITA). In July 2019, a symposium at the 17 th IPITA World Congress was held to examine the Igls criteria after two years in clinical practice, including validation against continuous glucose monitoring (CGM)-derived glucose targets, and to propose future refinements that would allow for comparison of outcomes with artificial pancreas system approaches.
Utilization of the criteria in various clinical and research settings were illustrated by population as well as individual outcome data of four islet and/or pancreas transplant centers. Validation against CGM metrics was conducted in 55 islet transplant recipients followed-up to 10 years from a fifth center.
The Igls criteria provided meaningful clinical assessment on an individual patient and treatment group level, allowing for comparison both within and between different β-cell replacement modalities. Important limitations include the need to account for changes in insulin requirements and C-peptide levels relative to baseline. FX11 In islet transplant recipients, CGM glucose time-in-range improved with each category of increasing β-cell graft function.
Future Igls 2.0 criteria should consider absolute rather than relative levels of insulin use and C-peptide as qualifiers with treatment success based on glucose assessment using CGM-metrics on par with assessment of HbA1c and severe hypoglycemia events.
Future Igls 2.0 criteria should consider absolute rather than relative levels of insulin use and C-peptide as qualifiers with treatment success based on glucose assessment using CGM-metrics on par with assessment of HbA1c and severe hypoglycemia events.
The relation between the menopause transition (MT) and changes in regional fat distribution is uncertain.
To determine whether the MT is associated with the development of central adiposity.
Longitudinal analysis from the Study of Women's Health Across the Nation, spanning 1996-2013 (median follow-up 11.8 years).
Community-based.
380 women with regional body composition measures by dual energy X-ray absorptiometry. Mean baseline age was 45.7 years; racial/ethnic composition was 16% Black, 41% Japanese and 43% White.
Changes in android, gynoid and visceral fat and waist and hip circumferences.
Android fat increased by 1.21% per year (py) and 5.54% py during premenopause and the MT, respectively (each p<0.05). Visceral and gynoid fat began increasing at the MT, annualized changes were 6.24% and 2.03%, respectively (each p <0.05). Postmenopausal annual trajectories decelerated to 1.47% (visceral), 0.90% (android), and -0.87% (gynoid), (all non-zero, p <0.05). Waist girth grew during premenopause (0.55% py), the MT (0.96% py), and postmenopause (0.55% py) (all non-zero, p<0.05; not statistically different from each other). Hip girth grew during premenopause (0.20% py) and the MT (0.35% py) (each non-zero, p<0.05; not statistically different from each other) and decelerated to zero slope in postmenopause. Results are for the White referent; there were statistically significant differences in some trajectories in Black and Japanese women.
The MT is associated with the development of central adiposity. Waist or hip circumferences are less sensitive to changes in fat distribution.
The MT is associated with the development of central adiposity. Waist or hip circumferences are less sensitive to changes in fat distribution.
Recent diagnostic criteria updates of the tall cell variant of papillary thyroid carcinoma (TCPTC) by the World Health Organization (WHO) have determined the inclusion of tumours with 30-49% of tall cells. However, the impact of tall cell percentage on papillary thyroid carcinoma (PTC) patients' prognosis is still debated. We aimed to evaluate whether tall cell percentage affects patients' outcome in the absence of aggressive features.
Rates of aggressive features, recurrence-free survival (RFS) and distant RFS (DRFS) (5-year median follow-up) were compared among tumours with less than 30%, 30-49% and at least 50% of tall cells. We also evaluated the impact of the new tall cell cut-off on patient management.
Overall, 3092 tumours (15.7% of all PTC) were collected 792 PTC had less than 30%, 503 had 30-49%, and 1797 had 50% or more tall cell areas. With the new definition of WHO, the number of TCPTC increased by 28%. There were no differences in recurrence rates according to tall cell percentage. The coexistence of BRAF and TERT promoter mutations predicted a worse RFS. Considering the new definition of TCPTC, the level of risk according to the American Thyroid Association increased from low to intermediate in 4.2% of cases. However, the recurrence rate within this subgroup was comparable to low-risk.
TCPTC and PTC with tall cell areas can be considered as a unique group with similar recurrence risk. However, whenever aggressive features are absent, tumors have a low risk of recurrence independently of tall cell percentage.
TCPTC and PTC with tall cell areas can be considered as a unique group with similar recurrence risk. However, whenever aggressive features are absent, tumors have a low risk of recurrence independently of tall cell percentage.
To analyze the biomechanical system of anterior retraction with clear aligner therapy (CAT) with and without an anterior mini-screw and elastics.
Models including a maxillary dentition (without first premolars), maxilla, periodontal ligaments (PDLs), attachments, and aligners were constructed and imported to finite element software. Three model groups were created (1) control (CAT alone), (2) labial elastics (CAT with elastics between the anterior mini-screw and buttons on central incisors), and (3) linguoincisal elastics (CAT with elastics between the anterior mini-screw and precision cuts on the lingual sides of the aligner). Elastic forces (0-300 g, in 50 g increments) were applied.
CAT alone caused lingual tipping and extrusion of the incisors. Labial elastics caused palatal root torquing and intrusion and mesial tipping of the central incisors, while linguoincisal elastics produced palatal root torquing and intrusion of both central and lateral incisors. Second premolars were intruded in all three groups, with less intrusion in the linguoincisal elastics group.
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