Aim To determine the absolute risk reduction (ARR) of heart failure events in people treated with sodium-glucose co-transporter-2 (SGLT2) inhibitors. Materials and Methods We searched PubMed, EMBASE, CINAHL and ISI We...
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Aim To determine the absolute risk reduction (ARR) of heart failure events in people treated with sodium-glucose co-transporter-2 (SGLT2) inhibitors. Materials and Methods We searched PubMed, EMBASE, CINAHL and ISI Web of Science for observational studies published to 9 May 2022 that explored the association between SGLT2 inhibitors and any indication for heart failure (including new diagnosis or hospitalization for heart failure) in type 2 diabetes. Identified studies were independently screened by two reviewers and assessed for bias using the Newcastle-Ottawa scale. Eligible studies with comparable outcome data were pooled for meta-analysis using random-effects models, reporting hazard ratios (HRs) with 95% confidence intervals (CIs). The ARR per 100 person-years was determined overall, and in subgroups with and without baseline cardiovascular disease (CVD). Results From 43 eligible studies, with a total of 4 818 242 participants from 17 countries, 21 were included for meta-analysis. SGLT2 inhibitors were associated with a reduced risk of hospitalization for heart failure (HR 0.65, 95% CI 0.59-0.72) overall and both in those with CVD (HR 0.78, 95% CI 0.68-0.89) and without CVD (HR 0.53, 95% CI 0.39-0.71). Risk reduction for hospitalization for heart failure in people with a history of CVD (ARR 1.17, 95% CI 0.78-1.55) was significantly greater than for those without CVD (ARR 0.39, 95% CI 0.32-0.47). The number-needed-to-treat to prevent one event of hospitalization for heart failure was 86 (95% CI 65-128) person-years of treatment for the CVD group and 256 (95% CI 215-316) person-years for those without CVD. Conclusions Real-world SGLT2 inhibitor use supports randomized trial data for the size effect of reduced hospitalization for heart failure in type 2 diabetes, although with a much lower ARR in people without CVD.
We have obtained numerical results for an acoustic wave propagating in a 3D medium with mixed boundary conditions. The specific model involves a vertical low-velocity fault zone of varying thickness embedded in an oth...
We have obtained numerical results for an acoustic wave propagating in a 3D medium with mixed boundary conditions. The specific model involves a vertical low-velocity fault zone of varying thickness embedded in an otherwise homogeneous half-space. At the fault-zone boundary, the stress and displacement are continuous;on the free surface, the stress is zero. A pseudo-spectrum method is employed to achieve sufficient resolution with reasonable computation time on a GRAY. Results show the development of guided waves trapped in the fault zone. These guided waves display large amplitudes and lengthening waveforms;they propagate at lower velocity with amplitudes that drop off mainly due to energy leakage out of the fault zone. As the width of the fault zone varies, the wave energy tends to funnel into the new low-velocity wave guide. At large distance, these guided waves become the dominant arrivals on seismograms. The waveforms are useful to recover the geometry and properties of the fault zone.
A peptide with neurotoxic effect on mammals, purified from the venom of the spider Phoneutria nigriventer, was studied regarding its primary structure and its effects on voltage-gated calcium channels. The peptide, na...
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A peptide with neurotoxic effect on mammals, purified from the venom of the spider Phoneutria nigriventer, was studied regarding its primary structure and its effects on voltage-gated calcium channels. The peptide, named omega-phonetoxin-IIA, has 76 amino acids residues, with 14 Cys forming 7 disulphide bonds, and a molecular weight of 8362.7 Da. The neurotoxicity is a consequence of the peptide's blocking effects on high-voltage-activated (HVA) calcium channels. N-type HVA calcium channels of rat dorsal root ganglion neurons are blocked with affinity in the sub-nanomolar concentration range. The toxin also blocks L-type channels of rat beta pancreatic cells, with an affinity 40 times lower. Although not studied in detail, evidence indicates that the toxin also blocks other types of HVA calcium channels, such as P and Q. No effect was observed on low-voltage-activated, T-type calcium channels. The significant homologies between omega-phonetoxin-IIA and the peptides of the omega-agatoxin-III family, and the overlapping inhibitory effects on calcium channels are discussed in terms of the structure-activity relationship.
A measurement oriented formulation of rigid body dynamics is applied to a special class of planar linkage systems. It leads to a diagonal moment of inertia matrix, and thus simplifies the feedforward computations in t...
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A measurement oriented formulation of rigid body dynamics is applied to a special class of planar linkage systems. It leads to a diagonal moment of inertia matrix, and thus simplifies the feedforward computations in the controller. On the other hand, if measurements are not available or measurements are not allowed, the computational burden shifts to the feedback computation of the generalized or internal forces. This formulation may find applications in off-line digital computer simulations and on-line control of the rigid body systems via the inverse dynamics methods. It may also underly computations in natural and biological systems that are rich with sensory modalities and processes. The computational burden in this model is shifted from the inverse of moment of inertia matrix to the derivation of the forces of constraint, contact, connection, internal or generalized. When these forces are available from measurements, the computations are indeed reduced and consequently on-line control problems are rendered easier. As a consequence of this representation the problems of transmission delay, and predictive compensation become important as is shown via an example. The investigation of the range of intermediate representations where computations and measurements are combined remains a fertile subject.
BACKGROUND:The population of Portugal is aging. The lack of data on older adults' nutritional status and the lack of nutrition knowledge amongst health professionals, caregivers, and older adults themselves, remai...
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BACKGROUND:The population of Portugal is aging. The lack of data on older adults' nutritional status and the lack of nutrition knowledge amongst health professionals, caregivers, and older adults themselves, remains a challenge.
OBJECTIVE:The Nutrition UP 65 study aims to reduce nutritional inequalities in the older Portuguese adult population and improve knowledge regarding older Portuguese adults' nutritional status, specifically relating to undernutrition, obesity, sarcopenia, frailty, hydration, sodium, and vitamin D statuses.
METHODS:A representative sample of older Portuguese adults was selected. Sociodemographic, lifestyle, anthropometric, functional, and clinical data were collected. Sodium excretion, hydration, and vitamin D statuses were assessed.
RESULTS:Data collection (n=1500) took place between December, 2015 and June, 2016. Results will be disseminated in national and international scientific journals, and via Portuguese media.
CONCLUSIONS:Nutrition UP 65 results will provide evidence for the design and implementation of effective preventive public health strategies regarding the elderly. These insights may represent relevant health gains and costs savings.
Relatively scant chemical information has been available on the proteinases and peptidases of spirochetes in spite of the association of spirochetes with several serious infections known to plague humans and other ani...
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Relatively scant chemical information has been available on the proteinases and peptidases of spirochetes in spite of the association of spirochetes with several serious infections known to plague humans and other animal species. This situation has partly resulted from difficulties in growing some spirochetes under laboratory conditions. The cells of Treponema denticola, a spirochete suggested to be associated with periodontal infections, have turned out to be a good source of new chemical information on those enzymes. Latest studies suggest that the outer cell envelope or the periplasmic space of T. denticola contains several novel proteinases and peptidases (hence called ''ectoenzymes'') which may contribute to the chronicity of periodontal infections. Some of the oligopeptidases discovered are specific for proline-containing host tissue peptides such as substance P, bradykinin, neurotensin, etc., and possibly small collagen fragments. The only spirochetal peptidases purified to give a single band on sodium dodecyl sulfate-polyacrylamide gel electrophoresis have been obtained from T. denticola. One particular peptidase, suggested to be similar to the oligopeptidase B (EC 3.4.21.83) of Escherichia coli seems to be present in the cell envelope or in the periplasmic space at quite large concentrations. The presence of this and several other peptidases in the outer cell structures of the treponemes suggests that such enzymes are important for the nutrition of these highly motile and invasive organisms. The biological role of these enzymes can thus be envisaged in the peptidolytic processing of host tissue proteins and peptides to gradually smaller molecules to fulfill the nutritional requirements of these organisms. Although the genetic similarity between T. denticola and some other treponemes and spirochetes can be hotly debated, it is nevertheless now possible to use T. denticula enzymes as suitable objects for comparison when the chemistry of other spirochetes is s
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