The majority of people with hypertension require more than one medication to achieve blood pressure control. Many patients are prescribed multipill antihypertensive regimens rather than single-pill ...fixed-dose combination (FDC) treatment. Although FDC use may improve medication adherence, the impact on patient outcomes is unclear. We compared clinical outcomes and medication adherence with FDC therapy versus multipill combination therapy in a real-world setting using linked clinical and administrative databases.
We conducted a population-based retrospective cohort study of 13,350 individuals 66 years and older in Ontario, Canada with up to 5 years of follow-up. We included individuals who were newly initiated on one angiotensin-converting enzyme inhibitor (ACEI) or angiotensin II-receptor blocker (ARB) plus one thiazide diuretic. High-dimensional propensity score matching was used to compare individuals receiving FDC versus multipill therapy. The primary outcome was a composite of death or hospitalization for acute myocardial infarction (AMI), heart failure, or stroke. We conducted 2 analyses to examine the association between adherence and patient outcomes. First, we performed an on-treatment analysis to determine whether outcomes differed between groups while patients were on treatment, censoring patients when they first discontinued treatment, defined as not receiving medications within 150% of the previous days' supply. Second, we conducted an intention-to-treat analysis that followed individuals allowing for breaks in treatment to quantify the difference in drug adherence between groups and assess its impact on clinical outcomes. As expected, there was no significant difference in the primary outcome between groups in the on-treatment analysis (HR 1.06, 95% CI 0.86-1.31, P = 0.60). In the intention-to-treat analysis, the proportion of total follow-up days covered with medications was significantly greater in the FDC group (70%; IQR 19-98) than in the multipill group (42%, IQR 11-91, P < 0.01), and the primary outcome was less frequent in FDC recipients (3.4 versus 3.9 events per 100 person-years; HR 0.89, 95% CI 0.81-0.97, P < 0.01). The main limitations of this study were the lack of data regarding cause of death and blood pressure measurements and the possibility of residual confounding.
Among older adults initiating combination antihypertensive treatment, FDC therapy was associated with a significantly lower risk of composite clinical outcomes, which may be related to better medication adherence.
ABSTRACT
We present a reduction and analysis of the James Webb Space Telescope (JWST) SMACS 0723 field using new post-launch calibrations to conduct a search for ultra-high-redshift galaxies (z > 9) ...present within the Epoch of Reionization. We conduct this search by modelling photometric redshifts in several ways for all sources and by applying conservative magnitude cuts (mF200W < 28) to identify strong Lyman breaks greater than 1 mag. We find four z > 9 candidate galaxies which have not previously been identified, with one object at z = 11.5, and another which is possibly a close pair of galaxies. We measure redshifts for candidate galaxies from other studies and find the recovery rate to be only 23 per cent, with many being assigned lower redshift, dusty solutions in our work. Most of our z > 9 sample show evidence for Balmer-breaks, or extreme emission lines from H β and O iii, demonstrating that the stellar populations could be advanced in age or very young depending on the cause of the F444W excess. We discuss the resolved structures of these early galaxies and find that the Sérsic indices reveal a mixture of light concentration levels, but that the sizes of all our systems are exceptionally small (<0.5 kpc). These systems have stellar masses M* ∼ 109.0 M⊙, with our z ∼ 11.5 candidate a dwarf galaxy with a stellar mass M* ∼ 107.8–108.2 M⊙. These candidate ultra high-redshift galaxies are excellent targets for future NIRSpec observations aimed to better understand their physical nature.
► We present bulk modulus for cubic perovskites with the help of ionic charge theory. ► The proposed model only the lattice parameter is required as input. ► The method turns out to be widely ...applicable.
In this paper, semiempirical formula for the bulk modulus (B in GPa) of perovskite structured solids are elaborated in terms of lattice constant (a in Å) and product of ionic charges (ZaZbZc) of the bonding. Values of bulk modulus, of the group A+1B+2X3, (X=F, Cl, Br), A+2B+4O3 and A+3B+3O3 cubic perovskites exhibit a linear relationship when plotted against the lattice constant (a) normalization, but fall on different straight lines according to the product of ionic charges of the compounds. The resulting expressions can be applied to a broad selection of perovskite (ABX3=A: large cation with different valence, B: transition metal and X: oxides and halides) materials and their modulus predictions are in good agreement with the experimental data and those from ab initio calculations.
The present study introduces "rock slope instability score (RSIS)" a novel classification system for assessing rock slope stability. It takes into account geological and geotechnical parameters, as ...well as the impact of human activities and triggering parameters, which have become more frequent due to climate change and few of them have been ignored in existing classifications. The study focuses on rock slopes of various lithologies from the Indian Himalayas. The development of this new classification system is based on the examination of 81 different rock slopes from various states of the Indian Himalayas. Extensive field surveys, rock sampling, geotechnical laboratory tests, and ground measurements have been conducted at the various slope sites to establish a comprehensive scoring system for the stability assessment. The distributions of weightage to each parameter have been considered, corresponding to its degree of impact in causing slope instability. Sensitivity analysis of all defined parameters of RSIS system has revealed that the majority of the parameters exhibit a strong positive correlation, with Pearson correlation coefficients ranging from 0.74 to 0.61. However, two parameters, namely discontinuity dip and the relationship between slope & discontinuity direction, gives moderate relationship with correlation coefficient values of 0.48 and 0.41, respectively. To avoid any designer biasness in the system, several individuals gathered data set at different times. The proposed classification system has demonstrated a strong correlation with the actual slope condition, and it is quite promising. The outcome of RSIS classification for studied 81 slopes classified 2 slopes under stable condition, 21 slopes as partially stable, 44 as unstable, and 14 as completely unstable.
ABSTRACT
We measure the rest-frame ultraviolet (UV) luminosity function (LF) at z ∼ 4 self-consistently over a wide range in absolute magnitude (−27 ≲ MUV ≲ −20). The LF is measured with 46 904 ...sources selected using a photometric redshift approach over ∼6 $\, {\rm deg}^2$ of the combined Cosmological Evolution Survey and XMM–Newton Large-Scale Structure fields. We simultaneously fit for both active galactic nuclei (AGNs) and galaxy LFs using a combination of Schechter or double power law (DPL) functions alongside a single power law for the faint-end slope of the AGN LF. We find a lack of evolution in the shape of the bright end of the Lyman-break galaxy (LBG) component when compared to other studies at z ≃ 5 and evolutionary recipes for the UV LF. Regardless of whether the LBG LF is fit with a Schechter function or DPL, AGNs are found to dominate at MUV < −23.5. We measure a steep faint-end slope of the AGN LF with $\alpha _{\mathrm{ AGN}} = -2.09^{+0.35}_{-0.38}$ ($-1.66^{+0.29}_{-0.58}$) when fit alongside a Schechter function (DPL) for the galaxies. Our results suggest that if AGNs are morphologically selected it results in a bias to lower number densities. Only by considering the full galaxy population over the transition region from AGN to LBG domination can an accurate measurement of the total LFs be attained.
β-Glucosidases are diverse group of enzymes with great functional importance to biological systems. These are grouped in multiple glycoside hydrolase families based on their catalytic and sequence ...characteristics. Most studies carried out on β-glucosidases are focused on their industrial applications rather than their endogenous function in the target organisms. β-Glucosidases performed many functions in bacteria as they are components of large complexes called cellulosomes and are responsible for the hydrolysis of short chain oligosaccharides and cellobiose. In plants, β-glucosidases are involved in processes like formation of required intermediates for cell wall lignification, degradation of endosperm’s cell wall during germination and in plant defense against biotic stresses. Mammalian β-glucosidases are thought to play roles in metabolism of glycolipids and dietary glucosides, and signaling functions. These enzymes have diverse biotechnological applications in food, surfactant, biofuel, and agricultural industries. The search for novel and improved β-glucosidase is still continued to fulfills demand of an industrially suitable enzyme. In this review, a comprehensive overview on detailed functional roles of β-glucosidases in different organisms, their industrial applications, and recent cloning and expression studies with biochemical characterization of such enzymes is presented for the better understanding and efficient use of diverse β-glucosidases.
An effort has been made to exploit the adsorption potential of pure and doped graphene for H2S molecule using density functional theory (DFT) modelling. Boron, aluminium and gallium atoms (IIIB) are ...used as dopant. For each pure and doped graphene system optimum position of adsorbed H2S molecule is determined and adsorption energies are calculated. Further electronic properties are investigated by the analysis of Mulliken's charges and energy band-structures. The results indicate that H2S molecule weakly binds to the pure graphene and boron doped graphene with small adsorption values; on the other hand aluminium doped graphene and gallium doped graphene have large adsorption energies values and binding distances typical for the chemisorptions. Local curvature in aluminium and gallium doped graphene is mainly responsible for the increased reactivity.
A 60day growth trial was carried out to evaluate biofloc based rearing system for Labeo rohita fingerlings. The C/N ratio of 15 was maintained in four biofloc treatments (T1, T2, T3 and T4) using ...indirect and long-lasting carbon sources (tapioca, wheat, corn and sugar bagasse) along with one control (C). Each group consisted of triplicate tanks and each tank was stocked with 50 fingerlings (4.80g±0.12) of L. rohita. Fishes were challenged with A. hydrophila 60days post rearing and relative percentage survival (RPS) was recorded over 14days post challenge. Serum samples were collected on 20, 40 and 60days interval of sampling for the evaluation of non-specific immune and stress parameters. The results revealed that fishes reared in tapioca based biofloc system showed significantly (p<0.05) higher serum protein, serum albumin, total immunoglobulin, respiratory burst activity, myeloperoxidase activity and lower serum glucose and serum cortisol when compared to wheat, corn, sugar bagasse based biofloc system and control. Growth, feed conversion ratio (FCR), feed efficiency ratio (FER), and specific growth rate (SGR) of fishes in the biofloc treatments were significantly better (p<0.05) than control. Tapioca based biofloc treatment showed significantly (p<0.05) higher RPS (66.66%) than other treatments. The study suggests that the fishes reared using in-situ biofloc produced by tapioca can enhance growth and non-specific immune responses under zero water exchange system and hence ensures sustainability.
•Zero water exchange reduces water scarcity and pollution problems•Improves welfare of the animals by stimulating immunity and protection against diseases•In-situ production of valuable microbial protein thus reducing dependence on fishmeal.
•Biofloc technology using organic carbon sources to study growth and immunity of Labeo rohita under zerowater exchange.•Tapioca biofloc system showed improved non-specific immune response and biochemical parameters.•Higher resistance against Aeromonas hydrophila infection in terms of relative percentage survival was recorded in Tapioca biofloc.
The SHINING survey offers a great opportunity to study the properties of the ionized and neutral media of galaxies from prototypical starbursts and active galactic nuclei (AGNs) to heavily obscured ...objects. Based on Herschel/PACS observations of the main far-infrared (FIR) fine-structure lines, in this paper, we analyze the physical mechanisms behind the observed line deficits in galaxies, the apparent offset of luminous infrared galaxies (LIRGs) from the mass-metallicity relation, and the scaling relations between C ii 158 m line emission and star formation rate (SFR). Based on a toy model and the Cloudy code, we conclude that the increase in the ionization parameter with FIR surface brightness can explain the observed decrease in the line-to-FIR continuum ratio of galaxies. In the case of the C ii line, the increase in the ionization parameter is accompanied by a reduction in the photoelectric heating efficiency and the inability of the line to track the increase in the FUV radiation field as galaxies become more compact and luminous. In the central approximately kiloparsec regions of AGN galaxies, we observe a significant increase in the O i 63 m/C ii line ratio; the AGN impact on the line-to-FIR ratios fades on global scales. Based on extinction-insensitive metallicity measurements of LIRGs, we confirm that they lie below the mass-metallicity relation, but the offset is smaller than those reported in studies that use optical-based metal abundances. Finally, we present scaling relations between C ii emission and SFR in the context of the main sequence of star-forming galaxies.
The current knowledge of Mercury’s orbit has mainly been gained by direct radar ranging obtained from the 60s to 1998 and by five Mercury flybys made with Mariner 10 in the 70s, and with MESSENGER ...made in 2008 and 2009. On March 18, 2011, MESSENGER became the first spacecraft to orbit Mercury. The radioscience observations acquired during the orbital phase of MESSENGER drastically improved our knowledge of the orbit of Mercury. An accurate MESSENGER orbit is obtained by fitting one-and-half years of tracking data using GINS orbit determination software. The systematic error in the Earth-Mercury geometric positions, also called range bias, obtained from GINS are then used to fit the INPOP dynamical modeling of the planet motions. An improved ephemeris of the planets is then obtained, INPOP13a, and used to perform general relativity tests of the parametrized post-Newtonian (PPN) formalism. Our estimations of PPN parameters (γ and β) are more stringent than previous results.
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