Abstract Background Clinical trials have shown the cardiovascular protective effect of sodium–glucose cotransporter-2 (SGLT2) inhibitors and reduced hospitalization for heart failure. However, no ...study has investigated the association between SGLT2 inhibitors and the risk of arrhythmias. This study aimed to evaluate the risk of new-onset arrhythmias (NOA) and all-cause mortality with the use of SGLT2 inhibitors. Methods This was a population-based cohort study utilizing Taiwan’s National Health Insurance Research Database. Each patient aged 20 years and older who took SGLT2 inhibitors was assigned to the SGLT2 inhibitor group, whereas sex-, age-, diabetes mellitus duration-, drug index date-, and propensity score-matched randomly selected patients without SGLT2 inhibitors were assigned to the non-SGLT2 inhibitor group. The study outcome was all-cause mortality and NOA. Results A total of 399,810 patients newly diagnosed with type 2 DM were enrolled. A 1:1 matching propensity method was used to match 79,150 patients to 79,150 controls in the non-SGLT2 inhibitors group for analysis. The SGLT2 inhibitor group was associated with a lower risk of all-cause mortality adjusted hazard ratio (aHR) 0.547; 95% confidence interval (CI) 0.482–0.621; P = 0.0001 and NOA (aHR 0.830; 95% CI 0.751–0.916; P = 0.0002). Conclusions Patients with type 2 DM prescribed with SGLT2 inhibitors were associated with a lower risk of all-cause mortality and NOA compared with those not taking SGLT2 inhibitors in real-world practice.
Aeromonas are found in various habitats, particularly in aquatic environments. This study examined the presence of the most common human pathogenic Aeromonas species (Aeromonas caviae, A. hydrophila, ...and A. veronii) in surface water, sea water, and shellfish. The detection rates in fishing harbour seawater, shellfish farming seawater, and a river basin were 33.3%, 26.4%, and 29.4%, respectively, and high prevalence was observed in summer. The detection rates in shellfish procured from a fish market and shellfish farm were 34.9% and 13.3%, respectively. The most abundant species of human pathogenic Aeromonas detected via water sampling was A. caviae, whereas that obtained via shellfish sampling was A. veronii. The prevalence of human pathogenic Aeromonas in river water was lower in fishing harbours and in the estuary shellfish farming area. Here, 25 isolates of human pathogenic Aeromonas species were isolated from 257 samples and divided among 16 virulence profiles. The high virulence gene-carrying isolates (more than six genes) belonged to A. hydrophila. The shellfish-sourced isolates had the highest detection rates of act, aerA, and fla genes than of other virulence genes, and vice versa for seawater-sourced isolates. The Aeromonas isolates showed high levels of resistance to ampicillin-sulbactam; however, none were resistant to cefepime, ciprofloxacin, or gentamicin. The incidence of multiple drug resistance (MDR) in Aeromonas isolates was 20%. In this study, phylogenetic analysis with 16S rRNA sequencing, biochemical tests and enterobacterial repetitive intergenic consensus-polymerase chain reaction fingerprinting facilitated the distinct categorisation of three species of human pathogenic Aeromonas isolates. In addition, A. veronii isolates from the same geographical area were also concentrated in the same cluster. This study provides information on the risk of infection by Aeromonas with MDR and multiple virulence genes isolated from shellfish and aquatic environments.
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•Human pathogenic Aeromonas exhibit a higher prevalence in water than in shellfish.•Human pathogenic Aeromonas are easier to detect in higher temperature seasons.•Shellfish-sourced Aeromonas carrying the fla gene have a high consumption risk.•96% of Aeromonas strains exhibited ampicillin-sulbactam resistance.•ERIC-PCR is suitable for Aeromonas species and geographical classification.
Chronic kidney disease (CKD) is associated with substantial cardiovascular morbidity. Atrial fibrillation (AF) is a prevalent arrhythmia that increases the risk of both stroke and cardiovascular ...mortality. Information about the mortality risk among patients with advanced CKD and new-onset AF (NAF) in the presence and absence of dialysis is important. However, the association between advanced CKD and NAF in patients with and without dialysis is unclear.
To investigate long-term outcomes of the association between advanced CKD and NAF in patients with and without dialysis.
We conducted a nested case-control study based on the National Health Insurance Program in Taiwan. Each participant aged 20 years and older who had CKD with dialysis from 2000 to 2013 was assigned to the dialysis group, whereas sex-, age-, CKD duration-, and index date-matched participants without dialysis were randomly selected and assigned to the non-dialysis group. We used the Cox regression model to estimate the hazard ratio (HR) with the 95% confidence interval (CI) for mortality in CKD patients with combined dialysis and NAF. Patients with neither NAF nor dialysis served as the reference group.
We identified 3,673 dialysis cases and 7,346 Non-dialysis matched controls for enrolment in the study. The crude mortality rates were 3.3 (95% CI: 3.1-3.5), 10.98 (95% CI: 9.3-13.0), 9.2 (95% CI: 8.7-10.0), and 18.0 (95% CI: 15.4-21.2) in the Non-dialysis, non-NAF, Non-dialysis, NAF, Dialysis, non-NAF, and Dialysis, NAF groups, respectively. After adjustment for age, gender, and co-morbidities, the aHRs were 2.0 (95% CI: 1.7-2.3), 2.7 (95% CI: 2.5-2.9), and 3.5 (95% CI: 2.9-4.1) in the Non-Dialysis, NAF, Dialysis, non-NAF, and Dialysis, NAF groups compared with the Non-Dialysis, non-NAF group, respectively. The Kaplan-Meier survival curves showed the highest mortality risk in the Dialysis, NAF group among the study groups. Patients with concurrent peritoneal dialysis and AF had the highest mortality risk: aHR = 4.3 (95% CI: 2.3-8.0). However, there was a relatively lower effect of NAF on mortality in patients on dialysis than in patients who were not.
Patients with advanced CKD and NAF had a significantly increased risk of mortality. Dialysis is not risky for patients with concurrent CKD and NAF. Dialysis offers a sufficient survival benefit to be considered as a standard treatment, as indicated by the superior physical status of patients on dialysis.
In mammals, the two main types of adipose tissues, white and brown adipose tissues, exert different physiological functions. White adipose tissue (WAT) is for storing energy, while brown adipose ...tissue (BAT) is for energy consumption. Adipose-derived stem cells (ADSCs) are abundant in WAT and BAT, have multipotent characteristics, and are easily extracted. ADSCs can be differentiated into several cell lineages, including adipocytes, osteoblasts, chondrocytes (cartilage cells), myocytes, and neuronal cells. Therefore, ADSC could be considered as a strategy for future regenerative medicine and tissue engineering.
Some observational studies have found a significant association between the use of statin and a reduced risk of dementia. However, the results of these studies are unclear in patients with rheumatoid ...arthritis (RA). This study is to determine the association between the use of statins and the incidence of dementia according to sex and age-related differences in patients with RA.
We conducted a nationwide retrospective cohort study using the Taiwan Health Insurance Review and Assessment Service database (2003-2016). The primary outcome assessed was the risk of dementia by estimating hazard ratios (HRs) and 95% confidence intervals (CIs). Multiple Cox regression was used to estimate the adjusted hazard ratio of new-onset dementia. Subgroup analysis was also conducted.
Among the 264,036 eligible patients with RA aged > 40 years, statin users were compared with non-statin users by propensity score matching at a ratio of 1:1 (25,764 in each group). However, no association was found between the use of statins and the risk of new-onset dementia (NOD) in patients with RA (HR: 1.01; 95% CI: 0.97-1.06). The subgroup analysis identified the use of statin as having a protective effect against developing NOD in male and older patients.
No association was observed between the use of a statin and the risk of NOD in patients with RA, including patients of both genders and aged 40-60 years, but these parameters were affected by gender and age. The decreased risk of NOD in patients with RA was greater among older male patients. Use of a statin in older male (> 60 years) patients with RA may be needed in clinical practice to prevent dementia.
The objective of this work is to derive equivalent radar reflectivity factor-liquid equivalent snow rate (Z sub(e)-SR) power-law relations for snowfall using the C-band King City operational weather ...radar and a 2D video disdrometer (2DVD). The 2DVD provides two orthogonal views of each snow particle that falls through its 10 cm 10 cm virtual sensor area. The 'size' parameter used here for describing the size distribution is based on the 'apparent' volume computed from the two images, and an equivolume spherical diameter D sub(app) is defined. The determination of fall speed is based on matching two images corresponding to the same particle as it falls through two light planes separated by a precalibrated separation distance. A new 'rematching' algorithm was developed to improve the quality of the fall speed versus D sub(app) as compared with the original matching algorithm provided by the manufacturer. The snow density is parameterized in the conventional power-law form , where alpha and beta are assumed to be variable. To account for strong horizontal winds that tend to decrease the measured concentrations from the 2DVD, a third parameter gamma is introduced. The methodology estimates the three parameters ( alpha , beta , and gamma ) by minimizing the difference between the radar-measured reflectivity and the equivalent reflectivity computed from the 2DVD in a least squares sense. The optimally determined values of alpha , beta , and gamma are used to estimate the SR and the coefficient and exponent of the Z sub(e) = a(SR) super(b) relation. For validation, the accumulation from the SR is compared with the manually recorded accumulations from the double-fence international reference (DFIR) gauge. The data were collected during the Canadian Cloudsat Cloud-Aerosol Lidar and Infrared Pathfinder Satellite Observations (CALIPSO) Validation Project (C3VP) conducted in Ontario, Canada, during the 2006/07 winter season. A total of seven snow days were analyzed and the accumulation intercomparisons gave a fractional standard deviation of 26% and normalized bias 2.1%. The range of the a and b values for the seven days appear reasonable and similar to conventional Z sub(e)-R relations.
ABSTRACT
Growing evidence suggests that the hydrochemical properties of geothermal fumaroles may play a crucial role in shaping the diversity and functions of microbial communities in various ...environments. In the present study, the impact of geothermal furaneols on the microbial communities and their metabolic functions across the rock‐soil‐plant continuum was explored considering varying distances from the fumarole source. The results revealed that bacterial phylum Proteobacteria was predominant in all sample types, except in the 10 m rock sample, irrespective of the sampling distance. Archaeal phyla, such as Euryarchaeota and Crenarchaeota, were more prevalent in rock and soil samples, whereas bacterial phyla were more prevalent in plant samples. Thermoacidophilic archaeons, including Picrophilus, Ferroplasma, and Thermogymnomonas were dominant in rocks and soil samples of 1 and 5 m distances; acidophilic mesophiles, including Ferrimicrobium and Granulicella were abundant in the rhizoplane samples, whereas rhizosphere‐associated microbes including Pseudomonas, Pedobacter, Rhizobium, and Novosphingobium were found dominant in the rhizosphere samples. The functional analysis highlighted the higher expression of sulfur oxidative pathways in the rock and soil samples; dark iron oxidation and nitrate/nitrogen respiratory functions in the rhizosphere samples. The findings underscore microbial adaptations across the rock‐soil‐plant continuum, emphasizing the intricate relationship between geothermal fumaroles and microbial communities in adjacent ecosystems. These insights offer a crucial understanding of the evolution of microbial life and highlight their pivotal roles in shaping ecosystem dynamics and functions.
quantitative precipitation estimation (QPE) of snowfall has generally been expressed in power-law form between equivalent radar reflectivity factor (Z.sub.e) and liquid equivalent snow rate (SR). It ...is known that there is large variability in the prefactor of the power law due to changes in particle size distribution (PSD), density, and fall velocity, whereas the variability of the exponent is considerably smaller. The dual-wavelength radar reflectivity ratio (DWR) technique can improve SR accuracy by estimating one of the PSD parameters (characteristic diameter), thus reducing the variability due to the prefactor. The two frequencies commonly used in dual-wavelength techniques are Ku- and Ka-bands. The basic idea of DWR is that the snow particle size-to-wavelength ratio is falls in the Rayleigh region at Ku-band but in the Mie region at Ka-band.
The availability of high quality surface observations of precipitation and volume observations by polarimetric operational radars make it possible to constrain, evaluate, and validate numerical ...models with a wide variety of microphysical schemes. In this article, a novel particle-based Monte-Carlo microphysical model (called McSnow) is used to simulate the outer rain bands of Hurricane Dorian which traversed the densely instrumented precipitation research facility operated by NASA at Wallops Island, Virginia. The rain bands showed steady stratiform vertical profiles with radar signature of dendritic growth layers near −15 °C and peak reflectivity in the bright band of 55 dBZ along with polarimetric signatures of wet snow with sizes inferred to exceed 15 mm. A 2D-video disdrometer measured frequent occurrences of large drops >5 mm and combined with an optical array probe the drop size distribution was well-documented in spite of uncertainty for drops <0.5 mm due to high wind gusts and turbulence. The 1D McSnow control run and four numerical experiments were conducted and compared with observations. One of the main findings is that even at the moderate rain rate of 10 mm/h collisional breakup is essential for the shape of the drop size distribution.
This study aimed to show that the efficacy of 1PC111 is superior to that of either ezetimibe or pitavastatin alone (monotherapy) for the treatment of hypercholesterolemia.
This was a multicenter, ...randomized, double-blind, Phase III study. Patients with hypercholesterolemia or mixed dyslipidemia were randomized to receive 1PC111 (which was a fixed-dose combination of pitavastatin 2 mg and ezetimibe 10 mg), pitavastatin 2 mg, or ezetimibe 10 mg daily for 12 weeks. The primary end point was the difference in the percent change in LDL-C from baseline to week 12 between the 1PC111 and each monotherapy group. The secondary end points were the percent change in other lipid profiles from baseline to each visit. All patients were assessed for adverse events until end of study.
A total of 388 patients were randomly assigned to the 1PC111 (n = 128), pitavastatin (n = 132), or ezetimibe (n = 128) group. Generally, baseline characteristics were similar among the 3 groups. A statistically significant decrease in the LDL-C level at week 12 was observed in the 1PC111 group (–50.50% 14.9%) compared with either the pitavastatin (–36.11% 11.4%; P < 0.001) or ezetimibe (–19.85% 12.4%; P < 0.001) group. Also, there was a statistically significant difference between 1PC111 and each monotherapy group in the reduction in total cholesterol, non–HDL-C, and apolipoprotein B levels. Moreover, there was a trend toward more efficient lowering of LDL-C levels in elderly patients (age ≥65 years) than in younger patients (age <65 years) by 1PC111 treatment. In patients given a class I recommendation for atherosclerotic cardiovascular disease prevention, the percentage of patients achieving the LDL-C target of <100 mg/dL at week 12 was significantly higher in the 1PC111 group than in both monotherapy groups (P < 0.001). Overall, the incidence of adverse events was similar among 3 groups.
1PC111 was more effective in improving lipid profiles and achieving the LDL-C goal than pitavastatin or ezetimibe alone for hypercholesterolemia treatment. Furthermore, 1PC111 may provide more benefit in treating elderly patients. ClinicalTrials.gov identifier: NCT04643093.
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