Bishopchang9277

AIMS To evaluate the efficacy and safety of dapagliflozin (DAPA) + saxagliptin (SAXA) compared with glimepiride (GLIM) in patients with type 2 diabetes who were inadequately controlled [glycated haemoglobin (HbA1c) 7.5-10.5% (58-91 mmol/mol)] on metformin monotherapy. MATERIALS AND METHODS This 52-week, multicentre, double-blind, active-controlled study (NCT02419612) randomized (11) patients on metformin to add-on DAPA 10 mg + SAXA 5 mg (n = 227) or GLIM 1-6 mg (titrated; n = 217). The primary efficacy endpoint was change in HbA1c from baseline to week 52. RESULTS Baseline mean ± standard deviation of age, duration of diabetes and HbA1c were 56.1 ± 9.7 years, 7.8 ± 6.4 years and 8.5% ± 0.8% (69 ± 9.0 mmol/mol), respectively. Adjusted mean change from baseline in HbA1c was -1.35% (-14.8 mmol/mol) with DAPA + SAXA versus -0.98% (-10.7 mmol/mol) with GLIM (P  less then 0.001). Changes from baseline in body weight and systolic blood pressure were -3.1 kg and -2.6 mmHg with DAPA + SAXA versus +1.0 kg (P  less then 0.001) and +1.0 mmHg (P = 0.007) with GLIM. More patients achieved HbA1c less then 7.0% (53 mmol/mol) (44.3% vs. 34.3%; P = 0.044), and fewer patients required treatment intensification (1.3% vs. 8.8%; P = 0.002) with DAPA + SAXA than with GLIM. CONCLUSIONS Compared with GLIM, concurrent addition of DAPA + SAXA significantly improved glycaemic control, body weight and other metabolic parameters in patients inadequately controlled on metformin. Trial NCT02419612, ClinicalTrials.gov. © 2020 The Authors. Diabetes, Obesity and Metabolism published by John Wiley & Sons Ltd.We are thankful for the critical thoughts on our research by Yang et al. Adagrasib in vitro We agree that the availability of biopsy results might have an impact on the rate of newly detected PBC cases. However, we regard this only as a minor limitation in our study. The high number of de novo PBC cases in the referenced study of Sun et al is likely not applicable to our cohort for a number of reasons. This article is protected by copyright. All rights reserved.AIM We employed the job demands-resources model to examine the impacts of job demands and resources on Chinese nurses' mental health and patient safety. BACKGROUND Employee mental health and patient safety represent important organizational goals in most hospitals. However, their relationships to insomnia, professional resources, and job crafting, as related to the job demands-resources model among nurses, remains unclear. METHODS A convenience sample of 2095 registered hospital nurses were recruited from 25 provinces of mainland China from June 2019 to July 2019. Data were collected using self-reported questionnaires that included the following instruments the Chinese version of the Athens Insomnia Scale, the Practice Environment Scale of the Nursing Work Index, and the Job Crafting scale, the Emotional Exhaustion scale, the Utrecht Work Engagement Scale, the General Health Questionnaire, and the Safety Attitudes Questionnaire. RESULTS The final model confirmed our hypotheses burnout mediated the relationship between actual job demands and mental health; work engagement mediated the relationship between perceived job resources and attitudes with regard to patient safety; and job crafting enhanced work engagement and practice environment. CONCLUSION The job demands-resources model was extended based on the nurses' job characteristics and mental health, as well as patient safety. IMPLICATIONS FOR NURSING MANAGEMENT These findings may contribute to nursing management strategies that encourage employees to prevent burnout, promote work engagement and job crafting, and in turn promote nurses' mental health and patient safety. This article is protected by copyright. All rights reserved.BACKGROUND Home healthcare workers (HHWs) provide medical and nonmedical services to home-bound patients. They are at great risk of experiencing violence perpetrated by patients (type II violence). Establishing the reliable prevalence of such violence and identifying vulnerable subgroups are essential in enhancing HHWs' safety. We, therefore, conducted meta-analyses to synthesize the evidence for prevalence and identify vulnerable subgroups. METHODS Five electronic databases were searched for journal articles published between 1 January 2005 and 20 March 2019. A total of 21 studies were identified for this study. Meta-analyses of prevalence were conducted to obtain pooled estimates. Meta-regression was performed to compare the prevalence between professionals and paraprofessionals. RESULTS Prevalence estimates for HHWs were 0.223 for 12 months and 0.302 for over the career for combined violence types, 0.102 and 0.171, respectively, for physical violence, and 0.364 and 0.418, respectively, for nonphysical violence. The prevalence of nonphysical violence was higher than that of physical violence for professionals in 12 months (0.515 vs 0.135) and over the career (0.498 vs 0.224) and for paraprofessionals in 12 months (0.248 vs 0.086) and over the career (0.349 vs 0.113). Professionals reported significantly higher nonphysical violence for 12-month prevalence than paraprofessionals did (0.515 vs 0.248, P = .015). CONCLUSION A considerable percentage of HHWs experience type II violence with higher prevalence among professionals. Further studies need to explore factors that can explain the differences in the prevalence between professionals and paraprofessionals. The findings provide support for the need for greater recognition of the violence hazard in the home healthcare workplace. © 2020 Wiley Periodicals, Inc.OBJECTIVE Sex differences in bipolar disorder are well recognized but little attention has been paid to sex differences in homocysteine or hyperhomocysteinemia in bipolar patients. This study compared gender differences in homocysteine levels and rates of hyperhomocysteinemia in Chinese inpatients with bipolar disorder. METHODS A total of 198 BD patients and 84 healthy controls were enrolled. The Young Mania Rating Scale, Hamilton Depression Rating Scale, and the Clinical Global Impressions-Severity scale were used to assess the affective symptomatology. Fasting plasma Hcy levels were measured by high-performance liquid chromatography. RESULTS Men had higher homocysteine levels than women and the prevalence of hyperhomocysteinemia in male patients was approximately twice that in female patients. Logistic regression analyses showed that HHcy was associated with less frequent use of valproate in males and being overweight in females. Further correlation analysis and multivariate regression analysis demonstrated that Hcy levels were inversely correlated with valproate treatment in men and positively associated with overweight in women.