Diabetes types as well as the impaired

Diabetes types 2 as well as the impaired fasting glucose (IFG) are common among Jordanian population. The estimated age standardized prevalence rate of (IFG) and diabetes were 7.8% and 17.1%, respectively, with no significant gender differences according to a recent study (Ajlouni et al., 2008). To complicate things further, there are alarming rates of obesity and its associated co-morbidities among Jordanians, especially among women (Khader et al., 2008). This study aims to evaluate the serum levels of adiponectin in type 2 diabetic patients and to establish a correlation between adiponectin serum levels and insulin resistance in those patients. In contrast, previous studies had investigated the association of adiponectin serum levels and obesity and DM type 2. Jordan is an ideal place to conduct the current study due to the high prevalence of DM type 2 and prediabetes, as mentioned earlier.


The clinical and demographic characteristics of the study population are presented in Table 1. In the study population, diabetic patients had lower adiponectin serum level compared to non-diabetics control group. However, statistically this difference was not significant (Fig. 1A).

Females had a significantly higher adiponectin serum levels than males. A possible explanation for this gender based difference in adiponectin serum levels might be due to the following reasons; first, is the effect of sex hormones on the production of adiponectin rate (Kadowaki et al., 2006). Experimental studies have proved that androgens have an inhibitory effect on adiponectin secretion (Bottner et al., 2004; Nishizawa et al., 2002). Second, is the different body fat distribution between males and females. It has been reported that the number of fat Calcium Ionophore I and their size are possible determinants of adiponectin production rates since it is mainly secreted from adipocytes (Cnop et al., 2003).
It is known that insulin resistance increases with age, which would predict the lower adiponectin levels in the elderly (Cnop et al., 2003). Interestingly, our study has shown that the adiponectin levels were correlated positively with age. The increase in adiponectin levels with age could be explained by the fact that the decline in sex steroidal hormones with age might rise the adiponectin levels in the elderly (Bottner et al., 2004; Nishizawa et al., 2002). Moreover, the decline in renal function with aging might reduce the adiponectin clearance by kidney (Isobe et al., 2005).
Generally, obesity is associated with insulin resistance (Cnop et al., 2002). Abdominal obesity, where the fat is centrally distributed, is particularly an important determinant of insulin resistance (Cnop et al., 2003; Gierach et al., 2014). It has been reported that abdominal obesity, measured by waist circumferences, is strongly associated with lower levels of adiponectin and decrease in insulin sensitivity among diabetic patients (Cnop et al., 2003; Mohammadzadeh and Ghaffari, 2014).
This study has shown low levels of adiponectin in both obese diabetic patients and patients with abdominal obesity and negative correlation between adiponectin levels and both BMI and WC. Given the fact that adiponectin is a major modulator of insulin action for its role in enhancing insulin sensitivity (Cnop et al., 2003; Schulze et al., 2004), it is therefore of critical importance to note that factors decreasing adiponectin levels such as obesity, and specially the abdominal obesity, could correlate with insulin resistance.
In addition, diabetic patients included in this study had a variable adiponectin serum levels. The majority of them had levels between (1.02–6.9)μg/ml while the remaining had levels ⩾7μg/ml. This variability in adiponectin serum levels might indicate that there are some factors affect the adiponectin levels among type 2 diabetic patients. It is important to note that the majority of diabetic patients who have adiponectin levels ⩾7μg/ml were elderly, females, and had lower mean of BMI compared to the second group (Table.4). Taken together, these characteristics of diabetic patients who have adiponectin levels ⩾7μg/ml are possible factors for increasing adiponectin level in this subgroup of diabetic patients.

Figure shows the topographical image of irregular silver nanoparticles synthesized

Figure 4 shows the topographical image of irregular silver nanoparticles synthesized by S. cumini, C. sinensis, S. tricobatum and C. asiatica. The particle size of the silver nanoparticles synthesized by commercial plant powder was found to be 53 nm, 41 nm, 52 nm and 42 nm, corresponding to S. cumini, C. sinensis, S. tricobatum and C. asiatica, respectively. Figure 5 shows the FTIR spectrum of Ag NPs. The FTIR showed the presence of bands at 1620 cm−1,1633 cm−1,1641 cm−1 and 1637 cm−1, corresponding to S. cumini, C. sinensis, S. tricobatum and C. asiatica, respectively. Synthesized Ag NPs are identified as amide I and arise due to a carbonyl stretch in the amide linkages of the proteins. The FTIR results thus indicate that the secondary structure of the proteins is not affected as a consequence of reaction with the Ag+ ions or binding with the silver nanoparticles. This result suggests that the biological molecules could possibly perform a function for the formation and stabilization of Ag NP in an aqueous medium. It is well known that proteins can bind to Ag NP through free amine groups in the proteins  [17], and, therefore, stabilization of the Ag NP by surface-bound proteins is a possibility.
Antimicrobial activity of silver nanoparticles synthesized by commercial plant powders was investigated against various pathogenic organisms, such as S. aureus, P. aeruginosa, E. coli and K. pneumoniae, using the well order Ro3306 method. The diameter of inhibition zones (mm) around each well with silver nanoparticle solutions is represented in Table 2. The highest antimicrobial activity of silver nanoparticles synthesized by C. sinensis and C. asiatica commercial plant powders was found against P. aeruginosa (16 mm). The lesser antimicrobial activity of silver nanoparticles synthesized by both C. sinensis and C. asiatica was found against S. aureus (8 mm) and E. coli (8 mm), and the S. tricobatum against K. pneumoniae (8 mm). S. cumini and C. asiatica did not show a zone of inhibition against K. pneumoniae.

We have reported order Ro3306 the synthesis of silver nanoparticles by S. tricobatum, S. cumini, C. asiatica and C. sinensis extracts, which provide simple and efficient ways for the synthesis of nanomaterials. Silver nanoparticles prepared in this process are quite fast and of low cost. The characterization of Ag+ ions exposed to these plant extracts by UV-vis and XRD techniques confirm the reduction of silver ions to silver nanoparticles. The AFM image suggests that the particles are irregular shaped. The FTIR study suggests that the protein might play an important role in the stabilization of silver nanoparticles. Biological synthesized silver nanoparticles could be of immense use in the medical field for their efficient antimicrobial function.

Nowadays, scientists constantly search for newer measures to obtain better food quality  [1]. The quality and safety control of food, especially in the food industry, play an important role in both health and the economy. Therefore, a great deal of research is being done in the area of food safety and freshness. The current progress in nanotechnology and its applications, especially in the life sciences, has attracted much attention towards applying nano material and nanostructures for the preservation of food, in the hope of achieving more reliable, safer, cheaper and less chemically influenced techniques for improving health and the longer shelf life of food. One of the most important items in the daily diet of most people is wheat and its derivatives, such as bread, cakes, cookies, and so on. Freshness and shelf life are very important factors in the bread baking industry.
Therefore, many researchers have been looking for methods that conveniently assess the degree of food fungal growth at a very early stage, and well in advance of becoming visible  [2].
As a living organism, the activation of fungi in bread is accompanied by the production of some gaseous products, such as CO2. Thus, detection of these gases at very early stages can set off alarms regarding the start of food decay. It is expected that sensing methods based on nanotechnology will help to detect gases on a molecular scale.

The prevalence of myopia reported for year old

The prevalence of myopia reported for 6year old children varies from 0.6% in Oman to 29% in Singapore. The prevalence in Oman for 6year old children was 0.6%, but the definition of myopia was more than −1.0 diopter when most studies use −0.5 diopter. The prevalence of myopia among pre-school children at King Abdulaziz Medical City, Riyadh, Saudi Arabia is 2.5%.
The visual system has an active process of emmetropization that involves defocus detection and a coordinated growth of the refractive components toward emmetropia with active structural changes. It is amazing how well emmetropization works and understanding what occurs when this process fails is the target of the research. In the first three years of life the cornea and lens change to counterbalance an approximately 20 diopter increase in axial length of the growing eye. Between ages 3 and 13 the lens and or cornea need to adjust about 3 diopters to maintain emmetropia.
As the human eye grows the lens adds layers of tissue yet thins by stretching in the equatorial plane so that it flattens, thins and loses power to compensate for the increasing axial length and maintains emmetropia. When the lens fails to stretch and thin the eye becomes myopic and the eyeball shape becomes more prolate or less oblate. The source of this interruption of equatorial expansion is unknown with one meclizine hcl being the thickening of the ciliary muscle which is found in myopic children and adults.
When myopia develops the eye is longer than it is wider (greater anteroposterior length than lateral transverse dimensions). This prolate shape of the eyeball will create a relative hyperopic defocus in the peripheral vision, along the lateral dimensions away from the macula. This peripheral vision refraction is another hypothesis as a potential impact or trigger on the active emmetropization process. Peripheral refraction in the myopic eye becomes relatively more hyperopic (Fig. 1). Local retinal regions can control local eye growth and myopia. The peripheral refractive state of the eye can affect eye development especially the progression of myopia. An interesting study found 77% of young entering emmetropic pilots with relative hyperopic defocus in their peripheral refraction developed myopia during their training. Hyperopic eyes are usually myopic in the periphery adding to the hypothesis that the periphery focus could be a trigger in eye growth. Also being investigated is the increase in the lag of accommodation during near work and the increase in myopia.
A 2010 search in PubMed yields over 14,000 citations with many research disciplines working to identify risk factors and potential interventions to help control myopia. Understanding, controlling and treating myopia are also a goal of the World Health Organization, Vision 2020 project.

Genetic factors
High heritability in myopia suggests that there is a significant genetic component to explain the variance in the population. A high heritability index is found in twin studies varying from 75% to 94%. A recent large sample study of monozygotic and dizygotic twins estimates a heritability index of 77%. However, this high index does not preclude an environmental precursor, and has some contestable assumptions (Morgan and Rose). Other genetic evidence pointed to is the prevalence of myopia in children increased with the number of myopic parents from 7.6, 14.9, to 43.6 percent for no, one or two myopic parents. However, it is an interesting observation of low heritability values in parent-offspring correlations when there has been rapid environmental change between generations. The Genes in Myopia (GEM) family study calculated the heritability index between 27% and 55%. In a non twin study heritable factors accounted for 80% of juvenile myopia.
Multiple myopia genetic loci have been identified establishing myopia as a common complex disorder. A recent review of data from the past decade in searching for myopia genes points to axial length and refraction sharing common genes and states that the majority of myopia cases are not likely caused by defects in structural proteins, but in defects involving the control of structural proteins. They conclude in discussing genes and their effects on myopia, “it is hard to show anything but a modest effect on their etiologies. Thus we are still left with the impression that the influence of environment exerts a greater effect than does the concerted action of several genes”.

br Discussion In general our findings are consistent with previous

In general, our findings are consistent with previous studies involving different populations [14,17,24–26]. A previous study conducted in a Danish general working population reported higher odds of work-related stress such as conflicts at work and low decision latitude among non–day workers compared with day workers [14]. Another epidemiological investigation was conducted among employees in the United Kingdom oil and gas industry, including those who worked on oil and gas offshore installations and onshore processing plants [24]. Researchers found that onshore shift workers had a significantly less favorable work environment including physical stressors, job demand, job control, skill discretion, supervisor support, and safety perceptions than day workers. Nabe-Nielsen et al [17] found that job demand, decision latitude, skill discretion, and supervisor support were lower in evening and night shift workers compared to day shift workers in a Danish eldercare sector. Previous studies also found that the nurses working non–day shifts have more work–family conflicts than those working day shifts [25,26].
The significant differences in the total number of stressful events that occurred in the previous month and year between non–day shift and day shift workers in the current study could be caused by differences in the intensity of work. The difference could also be caused by work content. The significant difference in the number of physical/psychological threats might illustrate that the job content was different across shift, and this difference might contribute to the difference reported for the administrative/professional pressure across shift. For example, the officers working on non–day shifts encountered significantly more physical/psychological threat-related events such as “responding to a felony in progress” and “dealing with family disputes and crisis situations”, and subsequently, they would also have a higher frequency of “court appearances on their day off or day following a night shift”, “experiencing negative attitudes toward them”, and “insufficient manpower to adequately handle a job”. Therefore, they might need a higher level of administrative and organizational support, and support from family, friends, and the WEHI-539 Supplier they served. However, these needs might not be seen from the administrators\’ perspectives [27]. The significantly fewer number of administrative and executive officers working on non-day shifts in the current study may provide evidence in support of this possibility. Furthermore, these unmet needs might be associated with the increased number of other stressors such as “fellow officers not doing their job” and “demands made by family for more time”. It would be worthwhile to investigate whether police officers working on non-day shifts encounter a higher number of stressful events in other agencies that have different supervising strategies and administration levels.
There may be an expectation that the main source of police work-related stress would be from physical/psychological threats. However, our findings showed that the police officers reported a higher frequency of administrative/professional pressure than physical/psychological threats. Most of the stressors police officers encountered in the previous month and year were not related to physical/psychological threats. This finding was consistent with a previous study showing that administrative/professional pressure was most frequently occurring among the three subscales of police stress [28]. Because physical/psychological threats are an inherent part of police work, there is relatively little that can be done to reduce their occurrence in the police workforce. However, it may be possible to reduce or eliminate many of the administrative and organizational stressors within a police department.
Our study differed from previous investigations in the way stress was measured. Boggild et al [14] used a questionnaire that was constructed from 23 questions to assess work-related psychosocial job demands, decision latitude, social support, conflicts, and job insecurity in a random sample drawn from the Central Population Register of Denmark [14]. Parkes [24] assessed perceived stress related to work environment in six dimensions taken from six questionnaires. In a health care sector, work demands, control, and support were measured using a different questionnaire [17]. Using different questionnaires in different studies may be reasonable because work stress may vary by occupational characteristics. However, whether these questionnaires were ideal to assess the specific work stress in the study population was not clear. The Spielberger Police Stress Survey questionnaire [22] used in our study was specifically designed for assessing police work-related occupational stress, and therefore, providing unique information involving police stress.

NVP-AUY922 There exist a number of biometrics methods at present e

There exist a number of biometrics methods at present, e.g. signatures, fingerprints, iris, etc. Fingerprints and iris verification require the installation of costly equipments and hence cannot be used at day to day places like banks, etc. There is considerable interest in authentication based on handwritten signature verification system as it NVP-AUY922 is the cheapest way to authenticate a person. Banks and Government bodies recognize signatures as a legal means of authentication. Signature verification technology utilizes the distinctive aspects of the signature to verify the identity of individuals. Criminal experts cannot be employed at every place and hence there has been considerable effort towards developing computerized algorithms that could verify and authenticate the individual’s identity. A handwritten signature is biologically linked to a specific individual. Modern forensic document examiners commonly compare a suspect signature with several examples of known valid signatures. They look for signs of forgery which include: Signatures written at a speed which is significantly slower than the genuine signatures; frequent change of the grasp of the writing implement; rounded line endings and beginnings; poor line quality with hesitant and shake of the line; retracing and patching; and stops in places where the writing should be free. Compared with other electronic identification methods such as fingerprints scanning and retinal vascular pattern screening, it is easier for people to migrate from using the popular pen- and paper signature to one where the online handwritten signature is captured and verified electronically. Many times the signatures are not even readable by human beings. Signature verification problem therefore is concerned with determining whether a particular signature truly belongs to a person or not. There are two approaches to signature verification, online and offline differentiated by the way data is acquired. In offline case, signature is obtained on a piece of paper and later scanned. Offline signature verification deals with a 2D static image record of the signature. It is useful in automatic signature verification found on bank checks and documents authentication. Offline verification techniques are based on limited information available only from shape and structural characteristics of the signature image. A fundamental problem in the field of offline signature recognition is the lack of a significant shape representation or shape factor. In contrast, online signature verification systems are extremely precise. It require the presence of the author during both the acquisition of the reference data and the verification process. This restrict their use to specific applications. Online handwritten signature is usually obtained on an electronic tablet and pen. Online signature verification track down path and other time-variable sequence variables using specially designed tablets or other devices during the act of signing. Automatic online signature verification is an interesting intellectual challenge with many practical applications. This technology examines the behavioral components of the signature such as: stroke order, speed, and pressure, as opposed to comparing visual images of signatures. Unlike traditional signature comparison technologies, online signature verification measures the physical activity of signing. The target of diploid research is to present online handwritten signature verification system based on DWT features extraction and neural network classification. This research paper is organized as the following. An overview on handwritten signature verification structure, specially online, is given in Section 1. Brief survey on current research area in this field and problem statement is presented in Section 2. The proposed system description is briefed in Section 3. The process of extracting features existing in handwritten signatures and discrete wavelet transform (DWT) is discussed in Section 4. Feature matching (classification) is discussed in Section 5. Experimental setup and obtained results are explained in Section 6. Finally, concluding remarks are in Section 7.

To our knowledge prior studies have not evaluated a

To our knowledge, prior studies have not evaluated a single-item screening question for sexual function distress. Research has focused on evaluating the FSDS-R single item related to sexual desire bother (item 13) rather than distress about sex life (item 1) among women with DSM-V sexual dysfunction disorders [17]. Using data from 738 women from the United States, Canada, and Europe, FSDS-R total scores and responses to FSDS-R item 13 were found to differentiate between groups with and without hypoactive sexual desire, but not between groups with other different types of sexual dysfunction. Similar analyses for distress about sex life (item 1) were not reported. In our study, item 13 did not perform as well as item 1, probably because we wished to identify an item that assessed global sexual function rather than disorders of desire. While item 13 did differentiate between high and low sexual concerns groups, it thip cost was less highly correlated with FSDS-R total, FSFI total, and FSFI domain scores in comparison with item 1. Further analyses in larger populations would be needed to determine whether FSDS-R item 1 differentiates women with different types of sexual dysfunction and whether the FSDS-R item 1 would be useful in clinical settings, opening up patient–provider discussions that otherwise rarely occur.
Correlations within the FSDS-R and between the FSDS-R and FSFI total and domain scores are somewhat difficult to interpret due to the lack of comparable published data. Several prior psychometric analyses did not report FSDS-R item to total correlations [5-8,17] or FSDS-R to FSFI correlations [5-8,17]. However, correlations were reported for the Farsi version of the FSDS-R among 1,966 Iranian women, most of whom did not report female sexual dysfunction (67%). Farsi FSDS-R item to total correlations ranged from 0.67 to 0.82 (P < .001) [18], which are lower than in our study using the English language version. In addition, correlations between the Farsi FSDS-R total and FSFI dimensions were −0.16 to 0.40 (P < .001) [18], which are comparable with our results. It is possible that the strength of correlations we observed may have varied based on a woman\'s sexual activity. For example, correlations between the Sexual Health Outcomes in Women Questionnaire (SHOW-Q) and health-related quality of life, body image, and symptom scales varied thip cost based on whether or not a woman was sexually active [19].
Limitations include the following. We did not collect data on sexual frequency, partner gender, or history of physical or sexual abuse. The number of study subjects was relatively small and limited to a single geographic area. Only women at a single MsFLASH site completed the FSDS-R due to concerns from principal investigators at all other research sites about subject burden. In addition, the sample was predominantly Caucasian, college educated, and married/living as married. The sample was (i) limited to menopausal women with hot flashes and other symptoms; and (ii) not specifically selected based on sexual dysfunction, so we relied on MENQOL items to differentiate high and low sexual concerns groups based on desire and symptoms, important aspects of DSM-V criteria. The MENQOL is a validated, widely used measure of menopausal symptoms, and the sexual function domain is a validated subscale. The FSFI is a more comprehensive measure of sexual function, but it was not used to determine high and low sexual concerns groups in this study, as then it could not have been used in the assessment of construct validity.


Despite differences in the etiologies of different pelvic pain medical diagnoses (i.e., endometriosis, vulvodynia, painful bladder syndrome, and pelvic inflammatory disease, for example), the overlap of clinical elements of women with chronic pelvic pain (CPP) makes it appropriate to group these patients under the umbrella diagnosis of “chronic pelvic pain.” These clinical elements include pain with intercourse (dyspareunia) [1-4], pain during menstruation (dysmenorrhea) [5,6], and reports of myofascial pain of the pelvic floor muscles and proximal soft tissue [2,7-9]. CPP is further described as nonmalignant, continuous or recurrent pain of structures related to the pelvis, lasting at least 6 months, and is often associated with negative sexual, cognitive, and emotional consequences [10]. This condition is also associated with dysfunction in one or usually more of the following body systems: gynecological, urological, gastrointestinal, neurological, and musculoskeletal [11]. The community prevalence of CPP is estimated at nearly 15% [12], and primary care prevalence estimates are comparable with that of low back pain and asthma [13]. The annual economic costs associated with only one type of CPP, endometriosis, have been estimated at nearly $22 billion [14]. This prevalent, costly condition is described as a “medical nightmare” for clinicians [11]. Women with CPP report depression, anxiety, and sleep disturbances, in addition to limitations in sexual activity and mobility [15,16].

br Conclusion br Introduction Fingers or digits have an important


Fingers or digits have an important role in the function and aesthetics. The loss of the digits leads to functional and psychological problems [1–3]. Silicone finger prostheses have lifelike appearance [4]. Finger or digital prosthesis have been also used to prevent and protect ulcerated finger tips in patients with microangiopathy of fingers [5].
Finger prosthesis often has low durability when compared to facial prosthesis. It needs to be frequently replaced as it can be irreversibly stained or discolored due to repeated PF-573228 and removal. Fabrication of new finger prosthesis is time consuming and requires several clinical and laboratory steps [6]. Even after fabrication of the finger prosthesis, intricate adjustments are necessary during the delivery visit to obtain a retentive fit and proper marginal adaptation. In some scenarios, a well-fitted prosthesis may need to be replaced due to discoloration or wear of the existing prosthesis.


Unlike other extraoral prosthesis, finger prostheses are commonly retained with the friction-fit or with implant [2,6,7]. The use of friction-fit is a common and economical method of retention for finger prosthesis, and is useful when a part of the stump is remaining [2,6]. Although digit prosthesis often has a high patient acceptance, retention, marginal adaptation, and color matching are important aspects that should be considered during the fabrication.
However, the impression material should be properly mixed to prevent porosities and the impression should be carefully poured to obtain an accurate working cast. A key groove or an anti-rotation feature should also be incorporated in the impression for the proper orientation of the stone stump during the duplication process. Before removal of the working model from the impression, sufficient time should be given for the wax to set in order to prevent distortions of the wax. There may be loss of some anatomical details during the duplication process and the wax replica may need minor adjustments and texturing. A ring can also be worn to hide the margins (Fig. 10). In case the previous prosthesis is significantly damaged, the duplication of previous prosthesis might not be a good option.



Introduction Diabetes mellitus is a chronic debilitating and non communicable

Diabetes mellitus is a chronic debilitating and non-communicable disease characterized by chronic hyperglycaemia and resulting from a defect in carnosic acid secretion, insulin action, or both (Alberti and Zimmet, 1998; American Diabetes Association, 2011). It has several long-term outcomes that are associated with various end organ damage, mainly the heart, blood vessels, eyes, nerves, and kidneys (ADA, 2010). Furthermore, diabetes estimated to cost the government of Saudi Arabia about $1.87 billion annually (Almalki et al., 2011).
The number of people with diabetes in 2012 has been estimated to be 381.8 million worldwide with an anticipated increase of 55% to 591.9 million by 2035 (Guariguata et al., 2014). In Saudi Arabia, the estimated prevalence of diabetes in 2011 is 16.2% and estimated to be 20.8% in 2030 (Whiting et al., 2011). There remain large variations in the burden of diabetes across countries and income groups.
Although the number of patients with diabetes that successfully achieve target levels of A1C is gradually improving, a considerable number of subjects continue to fall short of satisfactory treatment goals, leaving them at high risk for the development of diabetes-associated complications (Hoerger et al., 2008). Suggested initial therapy generally includes lifestyle management and patient education joined with metformin therapy. Although metformin is widely accepted as the preferred medication for the initial treatment of type 2 diabetes (T2DM), there is still a considerable uncertainty and lack of consensus regarding the choice of additional agents that need to be added to metformin to optimize glycaemic control (Drucker et al., 2010). Other oral hypoglycaemic agents included also Sulphonylureas such as glipizide, glimepiride, and glyburide that induce the increased secretion of insulin. Moreover, insulin, as injection, might be introduced in the early stage of diabetes, depending on the number of risk factors the patients may have and the progression/deterioration of the diabetic stage.
Various drawbacks are associated with the previously discussed available medications. Amongst the concerns attributed to the available anti-diabetic medications are that they do not stop the progressive loss of β cell function, hence, ultimately they decreased their efficacy and necessitating the need for exogenous insulin injections (Amori et al., 2007). Most of the available therapies except metformin are associated with weight gain and this is disappointing since we know the strong relationship between obesity and type 2 diabetes (Verspohl, 2009). Studies in Canada show that nearly half of all patients with T2DM and who are under medication do not attain the recommended HbA1c levels of ⩽7% (Canadian Diabetes Association, 2008).
Recent developments in the treatment of diabetes have provided additional options for the control of diabetes mellitus. Incretin-based therapies are one of the breakthroughs that stimulate insulin secretion and reduce glucagon secretion, resulting in reduction of hepatic glucose production (Perfetti et al., 2000; Tourrel et al., 2001; Hui et al., 2003). There are two classes of drugs based on the incretin system: GLP-1 receptor agonist, such as exenatide and liraglutide and DPP-4 inhibitors that delay endogenous degradation of GLP-1 inhibiting DPP-4 (Triplitt et al., 2007). There are world-wide uncertainties and controversies regarding the use of such therapies. Therefore, the aim of the review is to summarize an updated evidence of the effectiveness and safety of incretin-based agents.

Review question

We searched five databases including the following: the Cochrane library, MEDLINE, EMBASE, TRIP, and Science direct. We also searched databases of ongoing trials (clinicalTrials.gov/ and controlled-trials.com). Furthermore, we looked for other potentially eligible trials or ancillary publications by searching the reference lists of retrieved included trials, (systematic) reviews, meta-analyses and health technology assessment reports.

methysergide SOD CAT and GST activities were lower in P ridibundus

SOD, CAT and GST activities were lower in P. ridibundus. At the same time, the concentration of GSH in the liver of P. ridibundus was higher. GSH is an important radical scavenger if the reaction with SOD is prevented (Munday and Winterbourn, 1989). Lower SOD, CAT and GR activities was accompanied by higher GSH-Px activity in P. ridibundus, suggesting that coordinated action toward hydrogen peroxide induced oxidative attack.
Results of our investigation revealed similar antioxidative response in P. lessonae compared to P. ridibundus. The higher activity of liver SOD which generates H2O2 is counter balanced by lower CAT and GR activities. The produced H2O2 can be detoxified by CAT and GSH-Px. In P. lessonae, H2O2 is eliminated by higher GSH-Px activity, thus compensating for lower CAT activity.
In the liver of P. kl. esculentus we observed opposite trends in CAT and GSH-Px activities. Liver CAT activity was higher while the activity of GSH-Px was lower. Similar trends in GR and GST activities were observed. Higher GR activity can be linked with a lower GSH concentration in the liver of P. kl. esculentus and with attempts of the liver to maintain physiological GSH concentration. GR has a crucial role in preserving normal functioning of GSH-dependent methysergide (Deponte, 2013).
GST and AChE activities can be used as biomarkers of pollution with xenobiotics, especially organophosphorus and carbamate pesticides (Hayes and McLellan, 1999; Hobbiger, 1961). Booth et al. (1998) reported that two organophosphorus pesticides, chlorpyrifos and diazinon, affect GST and AChE activities in earthworm Apporectodea caliginosa. The pesticides induced opposite trends, with GST increasing and AChE decreasing (Booth et al., 1998). A similar trend was reported by Gungordu (2013) who studied different frog species exposed to pesticides. In our study, GST activity was significantly higher in the liver of P. kl. esculentus than in parental species. Lower AChE activity was reported in the liver of P. ridibundus and P. kl. esculentus when compared to P. lessonae. The results of examinations of GST and AChE activities suggest that P. kl. esculentus react to the presence of some organic xenobiotics. Fagotti et al. (2005) reported that the degree of organochlorine pesticide bioaccumulation was higher in the hybrid P. kl. esculentus than in the host species P. lessonae.
Non-denaturing electrophoresis detected CAT and SOD isoforms. Results of CAT activity revealed the presence of one isoform in all species. The band was more intense in P. kl. esculentus compared to parental species. These results are in agreement with the activities of CAT that were assessed spectrophotometrically. De Quiroga et al. (1985) also reported the presence of one CAT isoform in the liver of R. ridibunda. SOD isoforms S1 and S3 detected in all three species exhibited similar patterns, whereas isoform S2 displayed considerable variation.
Canonical discriminant analysis revealed that liver CAT, GR, GST and GSH-Px activities significantly contributed to differentiation between hybrid P. kl. esculentus and parental species P. ridibundus and P. lessonae. CAT, GR and GST activities were significantly higher in P. kl. esculentus, while GSH-Px was significantly lower when compared to the parental species. The main contributors to differentiation between parental species were SOD and AChE activities. SOD and AChE activities were significantly higher in P. lessonae.

The parental species, P. ridibundus and P. lessonae, display more similar antioxidative responses to environmental-induced oxidative stress than the hybrid P. kl. esculentus. Our results suggest that the preferred pathway of H2O2 detoxification in P. kl. esculentus utilizes CAT and GSH-Px in P. ridibundus and P. lessonae. The antioxidative strategy of P. kl. esculentus, suggests that the hybrid could be better equipped for fighting against environmental-induced oxidative stress, and the one of the reasons was it has broader environmental tolerance as compared to the parental type. The overall results supports hypothesis of heterozygote superiority. The obtained results point the way for comparative physiological studies of wildlife species. These findings are a potentially useful tool for understanding the physiology and long-term conservation of the P. esculentus complex frogs.

br Introduction Persons entering confined spaces are at risk

Persons entering confined spaces are at risk of a variety of health hazards. These hazards stem from the restricted volume of space inside such spaces and the small dimensions of the opening to the outside environment, with consequent difficulty in obtaining access to and exiting from the space, or a combination of the two. These features readily predispose those entering a confined space to exposure to changes in the atmospheric composition within that space, which may be harmful to their health. Confined spaces are most commonly encountered in work situations, and include sewers, casings, tanks, silos, vaults, tunnels, and compartments of ships [1–4].
A common atmospheric change occurring in confined spaces may involve a reduction in the volume percent of oxygen, as a result of oxygen-consuming reactions within the space, replacement of oxygen by other gases, or build-up of toxic gases. Persons entering a confined space may be incapacitated or may even die as a result of these atmospheric changes. While normal Bisindolylmaleimide V cost close to earth contains 20.9% of oxygen by volume, the Occupational Safety and Health Administration regulation and many confined-space guidance documents indicate that an atmospheric oxygen concentration of 19.5% is the lowest level acceptable for entry into such spaces [2,3].
A number of investigation reports have given data on fatalities in confined spaces. In the United States of America, the Division of Safety Research of the National Institute for Occupational Safety and Health is currently conducting the Fatal Accident Circumstances and Epidemiology project, which focuses primarily on selected electrical- and confined space-related fatalities [5,6]. Suruda et al. [7] analyzed data from the National Traumatic Occupational Fatalities surveillance system, which the National Institute for Occupational Safety and Health had assembled. During the 10-year period between 1980 and 1989, 585 separate fatal incidents occurred in confined spaces, claiming 670 victims. Seventy-two (12%) of the fatal incidents involved multiple victims.
In Thailand, cases of death in confined space occur almost every year. Between 2004 and 2008, there were eight investigation reports of 34 deaths and injuries in confined spaces [8]. An estimated 60% of the fatalities involved would-be rescuers. These rescuers had tried to help someone who had collapsed, but presumably had not given due consideration to the reason for the collapse. In one event, in 2006, three farmers died in a shallow well in a field in Kamphaengphet province, northern Thailand. According to the investigation report, local health officers who measured the gas content of the atmosphere at the bottom of the well 6 days later found the oxygen level to be only 5.9% [9]. The Bureau of Occupational and Environmental Diseases, Ministry of Public Health, then measured oxygen levels in 57 other shallow wells in the same region and found that 16% had low levels of oxygen (0.3–16%), which would have posed a hazard to anyone entering them, although toxic gases were not detected in any of the wells [10]. It was reported that the wells were used as a source of irrigation water for paddy fields, and farmers claimed that they had to enter the wells from time to time to set up the pumping system and to carry out general maintenance (Fig. 1).
While irrigation wells are a common feature of the rural landscape in the lower north of Thailand, the survey in Kamphaengphet province [10] made no mention of why some wells presented hazardous conditions while others in the same locality did not. An understanding of the factors predisposing to hazardous conditions in shallow wells would be useful in identifying unsafe wells, and possibly in identifying ways to remediate the condition of hazardous wells. Such understanding may enable the formulation of practical recommendations or guidelines for the safe use and management of shallow wells, for dissemination among farmers and other well users.