27 research outputs found

    Effect of sitagliptin on cardiovascular outcomes in type 2 diabetes

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    BACKGROUND: Data are lacking on the long-term effect on cardiovascular events of adding sitagliptin, a dipeptidyl peptidase 4 inhibitor, to usual care in patients with type 2 diabetes and cardiovascular disease. METHODS: In this randomized, double-blind study, we assigned 14,671 patients to add either sitagliptin or placebo to their existing therapy. Open-label use of antihyperglycemic therapy was encouraged as required, aimed at reaching individually appropriate glycemic targets in all patients. To determine whether sitagliptin was noninferior to placebo, we used a relative risk of 1.3 as the marginal upper boundary. The primary cardiovascular outcome was a composite of cardiovascular death, nonfatal myocardial infarction, nonfatal stroke, or hospitalization for unstable angina. RESULTS: During a median follow-up of 3.0 years, there was a small difference in glycated hemoglobin levels (least-squares mean difference for sitagliptin vs. placebo, -0.29 percentage points; 95% confidence interval [CI], -0.32 to -0.27). Overall, the primary outcome occurred in 839 patients in the sitagliptin group (11.4%; 4.06 per 100 person-years) and 851 patients in the placebo group (11.6%; 4.17 per 100 person-years). Sitagliptin was noninferior to placebo for the primary composite cardiovascular outcome (hazard ratio, 0.98; 95% CI, 0.88 to 1.09; P<0.001). Rates of hospitalization for heart failure did not differ between the two groups (hazard ratio, 1.00; 95% CI, 0.83 to 1.20; P = 0.98). There were no significant between-group differences in rates of acute pancreatitis (P = 0.07) or pancreatic cancer (P = 0.32). CONCLUSIONS: Among patients with type 2 diabetes and established cardiovascular disease, adding sitagliptin to usual care did not appear to increase the risk of major adverse cardiovascular events, hospitalization for heart failure, or other adverse events

    A Comprehensive Report on Environmental Sustainability: A Global Perspective

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    In the last three decades, protecting the earth's environment has become a major challenge in international relations. Hundreds of regional and bilateral agreements, as well as at least ten global environmental agreements, were negotiated. Environmentalism can be seen as a social movement that seeks to influence jobs and education to conserve natural resources and ecosystems. Concerns for environmental protection have emerged in various forms in various parts of the world throughout history. The environmental movement is a diverse scientific, social and political movement. The movement is committed to ecology, health and human rights while accepting people as workers in the ecosystem. Today, it is generally accepted that environmental protection is a part of national policies and plans. The accepted standard to achieve this reduction target is "sustainable development". In fact, all existing laws and policies on environmental protection and human development, at the national or international level, aim at achieving "sustainable development". Despite the great environmental protection that humans have used in the past three decades, global warming has not reduced the occurrence of anomalous atmospheric phenomena due to scientific knowledge and available technology. Although many environmental policies and action plans have been negotiated over the past three decades, significant gaps remain in international environmental policy law. The framework has not yet become a method or method. Rather, each is a collection of commitments related to a democratic international or regional environmental issue. Nature has become negative by affecting the climate on the one hand and the health and safety of all living and non-living beings on the other. The ecosystem resonates with abnormal noise, vibration, dust and smoke from human activities. These events remind people that the environment must be protected with all enthusiasm and energy no matter what. Given the progress we have made in destroying the earth's environment, future global environmental efforts will focus more on environmental restoration than conservation. Human rights will also provide important opportunities for better protection of the environment

    Larval growth and survival in Indian Butter Catfish, <i>Ompok bimaculatus</i> (Bloch): effect of light intensity and photoperiod

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    AbstractTwo sequential indoor rearing trials each of 21 days duration were conducted to investigate the effect of light intensity and photoperiod respectively on the growth and survival of Ompok bimaculatus larvae. In first trial, five different light intensities viz. 0, 300, 500, 900, 1200 lx were applied randomly to 800 larvae (0.003 g; 0.51 cm) stocked in triplicate following a completely randomized design into aquarium (30.0 x 15.0 x 15.0 cm) tanks. Sequentially, in second trial, five photoperiod cycles (light: dark, L: D) namely, 24L: 0D, 16L: 8D, 12L: 12D, 8L: 16D and 0L: 24D in combination with the best performing light intensity (300 lx) as observed from the first trial were employed in triplicates in similar set up. From the first trial, significantly higher survival was observed in 0 and 300 lx, whereas growth was highest in 900 lx (P &lt; 0.05). In the second trial, survival was higher in continuous darkness (0L: 24D), whereas, maximum growth was recorded in 24L: 0D and 16L: 8D groups (P &lt; 0.05). Performance index (PI) showed no significant difference (P &gt; 0.05) among 0 and 300 lx light intensities, but were reduced at higher light intensities. The lowest PI was found in 12L: 12D and 8L: 16D condition but did not have any effect in other photoperiod cycles. Overall, from the present study it can be concluded that growth of the larvae is found to be higher in higher light intensity (900lx) and longer photoperiodic cycles (24L: 0D and 16L: 8D), however, better survival was recorded in total dark conditions suggesting that continuous dark condition is recommended for better hatchery performance of the larvae.</jats:p
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