Effect of sotagliflozin as an adjunct to insulin therapy on blood pressure and arterial stiffness in adults with type 1 diabetes: A post hoc pooled analysis of inTandem1 and inTandem2

Objective: Evaluate the effect of sotagliflozin, a dual inhibitor of sodium glucose cotransporter (SGLT) 1 and 2, on arterial stiffness in patients with type 1 diabetes (T1D) treated with sotagliflozin as adjunct to optimized insulin therapy. Methods: In this post hoc analysis, indirect markers of arterial stiffness, including pulse pressure, mean arterial pressure (MAP), and double product, were calculated using observed systolic blood pressure (SBP), diastolic blood pressure (DBP), or pulse rate at 24 weeks using data from a pooled patient population from the inTandem1 and inTandem2 randomized controlled trials (n = 1575). Results: Baseline characteristics were similar among groups. Relative to placebo at Week 24, sotagliflozin 200 mg and 400 mg reduced SBP by 2.03 mm Hg (95% CI −3.30 to −0.75; p = 0.0019) and 2.85 mm Hg (−4.12 to −1.57; p < 0.0001), respectively. DBP decreased by 1.1 and 0.9 mm Hg, MAP by 1.4 and 1.6 mm Hg, and double product by 202.5 and 221.1 bpm × mm Hg, respectively (p < 0.05 for all). No increases in heart rate were observed. Conclusion: In adults with T1D, adding sotagliflozin to insulin significantly reduced blood pressure and other markers of arterial stiffness and vascular resistance

A Laser System for the Spectroscopy of Highly-Charged Bismuth Ions

We present and characterize a laser system for the spectroscopy on highly-charged ^209Bi^82+ ions at a wavelength of 243.87 nm. For absolute frequency stabilization, the laser system is locked to a near-infra-red laser stabilized to a rubidium transition line using a transfer cavity based locking scheme. Tuning of the output frequency with high precision is achieved via a tunable rf offset lock. A sample-and-hold technique gives an extended tuning range of several THz in the UV. This scheme is universally applicable to the stabilization of laser systems at wavelengths not directly accessible to atomic or molecular resonances. We determine the frequency accuracy of the laser system using Doppler-free absorption spectroscopy of Te_2 vapour at 488 nm. Scaled to the target wavelength of 244 nm, we achieve a frequency uncertainty of \sigma_{244nm} = 6.14 MHz (one standard deviation) over six days of operation.Comment: Contribution to the special issue on "Trapped Ions" in "Applied Physics B

The present and future of cardiac arrest care : international experts reach out to caregivers and healthcare authorities

The purpose of this review is to describe the epidemiology of out-of-hospital cardiac arrest (OHCA), disparities in organisation and outcome, recent advances in treatment and ongoing controversies. We also outline the standard of care that should be provided by the critical care specialist and propose future directions for cardiac arrest research. Narrative review with contributions from international resuscitation experts. Although it is recognised that survival rates from OHCA are increasing there is considerable scope for improvement and many countries have implemented national strategies in an attempt to achieve this goal. More resources are required to enable high-quality randomised trials in resuscitation. Increasing international collaboration should facilitate resuscitation research and knowledge translation. The International Liaison Committee on Resuscitation (ILCOR) has adopted a continuous evidence review process, which facilitate the implementation of resuscitation interventions proven to improve patient outcomes.Peer reviewe

Bile Acid Sequestrants for Lipid and Glucose Control

Bile acids are generated in the liver and are traditionally recognized for their regulatory role in multiple metabolic processes including bile acid homeostasis, nutrient absorption, and cholesterol homeostasis. Recently, bile acids emerged as signaling molecules that, as ligands for the bile acid receptors farnesoid X receptor (FXR) and TGR5, activate and integrate multiple complex signaling pathways involved in lipid and glucose metabolism. Bile acid sequestrants are pharmacologic molecules that bind to bile acids in the intestine resulting in the interruption of bile acid homeostasis and, consequently, reduction in low-density lipoprotein cholesterol levels in hypercholesterolemia. Bile acid sequestrants also reduce glucose levels and improve glycemic control in persons with type 2 diabetes mellitus (T2DM). This article examines the mechanisms by which bile acid–mediated activation of FXR and TGR5 signaling pathways regulate lipid and glucose metabolism and the potential implications for bile acid sequestrant–mediated regulation of lipid and glucose levels in T2DM

ERC-ESICM guidelines on temperature control after cardiac arrest in adults

The aim of these guidelines is to provide evidence based guidance for temperature control in adults who are comatose after resuscitation from either in-hospital or out-of-hospital cardiac arrest, regardless of the underlying cardiac rhythm. These guidelines replace the recommendations on temperature management after cardiac arrest included in the 2021 post-resuscitation care guidelines co-issued by the European Resuscitation Council (ERC) and the European Society of Intensive Care Medicine (ESICM). The guideline panel included thirteen international clinical experts who authored the 2021 ERC-ESICM guidelines and two methodologists who participated in the evidence review completed on behalf of the International Liaison Committee on Resuscitation (ILCOR) of whom ERC is a member society. We followed the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach to assess the certainty of evidence and grade recommendations. The panel provided suggestions on guideline implementation and identified priorities for future research. The certainty of evidence ranged from moderate to low. In patients who remain comatose after cardiac arrest, we recommend continuous monitoring of core temperature and actively preventing fever (defined as a temperature > 37.7 degrees C) for at least 72 hours. There was insufficient evidence to recommend for or against temperature control at 32-36 degrees C or early cooling after cardiac arrest. We recommend not actively rewarming comatose patients with mild hypothermia after return of spontaneous circulation (ROSC) to achieve normothermia. We recommend not using prehospital cooling with rapid infusion of large volumes of cold intravenous fluids immediately after ROSC.Peer reviewe

A potassium tert-butoxide and hydrosilane system for ultra-deep desulfurization of fuels

Hydrodesulfurization (HDS) is the process by which sulfur-containing impurities are removed from petroleum streams, typically using a heterogeneous, sulfided transition metal catalyst under high H_2 pressures and temperatures. Although generally effective, a major obstacle that remains is the desulfurization of highly refractory sulfur-containing heterocycles, such as 4,6-dimethyldibenzothiophene (4,6-Me_2DBT), which are naturally occurring in fossil fuels. Homogeneous HDS strategies using well-defined molecular catalysts have been designed to target these recalcitrant S-heterocycles; however, the formation of stable transition metal sulfide complexes following C–S bond activation has largely prevented catalytic turnover. Here we show that a robust potassium (K) alkoxide (O)/hydrosilane (Si)-based (‘KOSi’) system efficiently desulfurizes refractory sulfur heterocycles. Subjecting sulfur-rich diesel (that is, [S] ∼ 10,000 ppm) to KOSi conditions results in a fuel with [S] ∼ 2 ppm, surpassing ambitious future governmental regulatory goals set for fuel sulfur content in all countries. Fossil fuels contain naturally occurring organosulfur impurities, with quantities varying depending on the type of feedstock. These sulfur-containing organic small molecules poison catalytic converters and generate polluting sulfur dioxides when combusted. Hydrodesulfurization (HDS) is the industrial process by which sulfur impurities are removed from petroleum fractions prior to their use as fuels. Currently, HDS is performed by treating petroleum with H_2 at high pressures and temperatures (that is, 150–2,250 psi and 400 °C) over heterogeneous catalysts such as cobalt-doped molybdenum sulfide supported on alumina (that is, CoMoS_x∕γ-Al_2O_3; Fig. 1a). However, certain organosulfur species, in particular dibenzothiophenes alkylated at positions 4 and 6, are not efficiently removed. Homogeneous strategies employing sophisticated, well-defined transition metal complexes—including those based on platinum, nickel, tungsten, molybdenum, palladium, ruthenium, rhodium, iron, cobalt, and others—have been extensively investigated. While these studies have provided valuable mechanistic insights, several fundamental issues, such as the formation of stable organometallic S–M species upon C–S bond activation by the metal centre (Fig. 1b), generally restrict industrial implementation of such methods. Rare examples of desulfurization of dibenzothiophenes alkylated at the 4 and 6 positions by homogeneous transition metal catalysis utilized either Ni compounds in combination with superstoichiometric alkyl Grignard reagents or Ni or Co phosphoranimide complexes in the presence of superstoichiometric KH. These issues pose a formidable challenge for the development of new HDS methods. Moreover, increasingly strict governmental regulations require limiting the sulfur content in diesel fuel and gasoline (in the US: typically <15 and <30 ppm, respectively) as well as other fuels, rendering the development of new powerful HDS methods a primary global concern. In 2013, Grubbs and co-workers reported the KO^tBu mediated cleavage of aryl C–O bonds in lignin models in the absence of transition metals using hydrosilanes. Careful inductively coupled plasma mass spectrometry (ICP-MS) analyses of the reagents and reaction mixtures ruled out catalysis with transition metals. We thus became interested in extending this method to sulfur heterocycles of relevance in oil and gas refining applications. Herein, we report that the robust KOtBu/silane-based (that is, KOSi) system is a powerful and effective homogeneous HDS method, which desulfurizes HDS-resistant dibenzothiophenes in good yield and reduces the sulfur content in diesel fuel to remarkably low levels (Fig. 1c)

Review of the Commission Decision 2010/477/EU concerning MSFD criteria for assessing Good Environmental Status, Descriptor 7

This report represents the result of the scientific and technical review of Commission Decision 2010/477/EU in relation to Descriptor 7. The review has been carried out by the EC JRC together with experts nominated by EU Member States, and has considered contributions from the GES Working Group in accordance with the roadmap set out in the MSFD implementation strategy (agreed on at the 11th CIS MSCG meeting). The report is one of a series of reports (review manuals) including Descriptor 1, 2, 5, 7, 8, 9, 10 that conclude phase 1 of the review process and, as agreed within the MSFD Common Implementation Strategy, are the basis for review phase 2, towards an eventual revision of the Commission Decision 2010/477/EU. The report presents the state of the technical discussions as of 30 April 2015 (document version 7.0: ComDecRev_D7_V7.0_FINAL.docx), as some discussions are ongoing, it does not contain agreed conclusions on all issues. The document does not represent an official, formal position of any of the Member States and the views expressed in the document are not to be taken as representing the views of the European Commission.JRC.H.1-Water Resource

Variants in the GPR146 Gene Are Associated With a Favorable Cardiometabolic Risk Profile

BACKGROUND: In mice, GPR146 (G-protein-coupled receptor 146) deficiency reduces plasma lipids and protects against atherosclerosis. Whether these findings translate to humans is unknown. METHODS: Common and rare genetic variants in the GPR146 gene locus were used as research instruments in the UK-Biobank. The Lifelines, and The Copenhagen-City Heart Study, and a cohort of individuals with familial hypobetalipoproteinemia were used to find and study rare GPR146 variants. RESULTS: In the UK-Biobank, carriers of the common rs2362529-C allele present with lower low-density lipoprotein cholesterol, apo (apolipoprotein) B, high-density lipoprotein cholesterol, apoAI, CRP (C-reactive protein), and plasma liver enzymes compared with noncarriers. Carriers of the common rs1997243-G allele, associated with higher GPR146 expression, present with the exact opposite phenotype. The associations with plasma lipids of the above alleles are allele dose-dependent. Heterozygote carriers of a rare coding variant (p.Pro62Leu; n=2615), predicted to be damaging, show a stronger reductions in the above parameters compared with carriers of the common rs2362529-C allele. The p.Pro62Leu variant is furthermore shown to segregate with low low-density lipoprotein cholesterol in a family with familial hypobetalipoproteinemia. Compared with controls, carriers of the common rs2362529-C allele show a marginally reduced risk of coronary artery disease (P=0.03) concomitant with a small effect size on low-density lipoprotein cholesterol (average decrease of 2.24 mg/dL in homozygotes) of this variant. Finally, mendelian randomization analyses suggest a causal relationship between GPR146 gene expression and plasma lipid and liver enzyme levels. CONCLUSIONS: This study shows that carriers of new genetic GPR146 variants have a beneficial cardiometabolic risk profile, but it remains to be shown whether genetic or pharmaceutical inhibition of GPR146 protects against atherosclerosis in humans

Atomic parity violation in a single trapped radium ion

Atomic parity violation (APV) experiments are sensitive probes of the electroweak interaction at low energy. These experiments are competitive with and complementary to high-energy collider experiments. The APV signal is strongly enhanced in heavy atoms and it is measurable by exciting suppressed (M1, E2) transitions. The status of APV experiments and theory are reviewed as well as the prospects of an APV experiment using one single trapped Ra+ ion. The predicted enhancement factor of the APV effect in Ra+ is about 50 times larger than in Cs atoms. However, certain spectroscopic information on Ra+ needed to constrain the required atomic many-body theory, was lacking. Using the AGOR cyclotron and the TRIμP facility at KVI in Groningen, short-lived 212 - 214Ra+ ions were produced and trapped. First ever excited-state laser spectroscopy was performed on the trapped ions. These measurements provide a benchmark for the atomic theory required to extract the electroweak mixing angle to sub-1% accuracy and are an important step towards an APV experiment in a single trapped Ra+ ion