Cinnamon Use in Type 2 Diabetes: An Updated Systematic Review and Meta-Analysis

PURPOSE Cinnamon has been studied in randomized controlled trials (RCTs) for its glycemic-lowering effects, but studies have been small and show conflicting results. A prior meta-analysis did not show significant results, but several RCTs have been published since then. We conducted an updated systematic review and meta-analysis of RCTs evaluating cinnamon’s effect on glycemia and lipid levels. METHODS MEDLINE, Embase, and Cochrane Central Register of Controlled Trials (CENTRAL) were searched through February 2012. Included RCTs evaluated cinnamon compared with control in patients with type 2 diabetes and reported at least one of the following: glycated hemoglobin (A1c), fasting plasma glucose, total cholesterol, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), or triglycerides. Weighted mean differences (with 95% confidence intervals) for endpoints were calculated using random-effects models. RESULTS In a meta-analysis of 10 RCTs (n = 543 patients), cinnamon doses of 120 mg/d to 6 g/d for 4 to 18 weeks reduced levels of fasting plasma glucose (−24.59 mg/dL; 95% CI, −40.52 to −8.67 mg/dL), total cholesterol (−15.60 mg/dL; 95% CI, −29.76 to −1.44 mg/dL), LDL-C (−9.42 mg/dL; 95% CI, −17.21 to −1.63 mg/dL), and triglycerides (−29.59 mg/dL; 95% CI, −48.27 to −10.91 mg/dL). Cinnamon also increased levels of HDL-C (1.66 mg/dL; 95% CI, 1.09 to 2.24 mg/dL). No significant effect on hemoglobin A1c levels (−0.16%; 95%, CI −0.39% to 0.02%) was seen. High degrees of heterogeneity were present for all analyses except HDL-C (I2 ranging from 66.5% to 94.72%). CONCLUSIONS The consumption of cinnamon is associated with a statistically significant decrease in levels of fasting plasma glucose, total cholesterol, LDL-C, and triglyceride levels, and an increase in HDL-C levels; however, no significant effect on hemoglobin A1c was found. The high degree of heterogeneity may limit the ability to apply these results to patient care, because the preferred dose and duration of therapy are unclear

WHAT IS THE MODE OF DEATH AMONG HEART FAILURE PATIENTS WITH HYPONATREMIA AND IMPLANTABLE CARDIOVERTER DEFIBRILLATORS?

Report submitted by IWMI Nile Basin and East Africa Sub-Regional Office, Addis Ababa, Ethiopia, to International Development Research Centre (IDRC). Project No.10344

Lower Mortality with Andexanet Alfa vs 4-Factor Prothrombin Complex Concentrate for Factor Xa Inhibitor-Related Major Bleeding in a U.S. Hospital-Based Observational Study

BACKGROUND: Well-designed studies with sufficient sample size comparing andexanet alfa vs 4-factor prothrombin complex concentrate (4F-PCC) in routine clinical practice to evaluate clinical outcomes are limited. OBJECTIVES: To compare in-hospital mortality in patients hospitalized with rivaroxaban- or apixaban-related major bleeding who were treated with andexanet alfa or 4F-PCC. METHODS: An observational cohort study (ClinicalTrials.gov identifier: NCT05548777) was conducted using electronic health records between May 2018 and September 2022 from 354 U.S. hospitals. Inclusion criteria were age ≥18 years, inpatient admission with diagnosis code D68.32 (bleeding due to extrinsic anticoagulation), a record of use of the factor Xa inhibitors rivaroxaban or apixaban, andexanet alfa or 4F-PCC treatment during index hospitalization, and a documented discharge disposition. Multivariable logistic regression on in-hospital mortality with andexanet alfa vs 4F-PCC was performed. The robustness of the results was assessed via a supportive propensity score-weighted logistic regression. RESULTS: The analysis included 4395 patients (andexanet alfa, CONCLUSION: In this large observational study, treatment with andexanet alfa in patients hospitalized with rivaroxaban- or apixaban-related major bleeds was associated with 50% lower odds of in-hospital mortality than 4F-PCC. The magnitude of the risk reduction was similar in ICH and GI bleeds

Patterns in Age-Seroprevalence Consistent with Acquired Immunity against Trypanosoma brucei in Serengeti Lions

Trypanosomes cause disease in humans and livestock throughout sub-Saharan Africa. Although various species show evidence of clinical tolerance to trypanosomes, until now there has been no evidence of acquired immunity to natural infections. We discovered a distinct peak and decrease in age prevalence of T. brucei s.l. infection in wild African lions that is consistent with being driven by an exposure-dependent increase in cross-immunity following infections with the more genetically diverse species, T. congolense sensu latu. The causative agent of human sleeping sickness, T. brucei rhodesiense, disappears by 6 years of age apparently in response to cross-immunity from other trypanosomes, including the non-pathogenic subspecies, T. brucei brucei. These findings may suggest novel pathways for vaccinations against trypanosomiasis despite the notoriously complex antigenic surface proteins in these parasites

A microscopic theory of gauge mediation

We construct models of indirect gauge mediation where the dynamics responsible for breaking supersymmetry simultaneously generates a weakly coupled subsector of messengers. This provides a microscopic realization of messenger gauge mediation where the messenger and hidden sector fields are unified into a single sector. The UV theory is SQCD with massless and massive quarks plus singlets, and at low energies it flows to a weakly coupled quiver gauge theory. One node provides the primary source of supersymmetry breaking, which is then transmitted to the node giving rise to the messenger fields. These models break R-symmetry spontaneously, produce realistic gaugino and sfermion masses, and give a heavy gravitino.Comment: 24 pages, 2 figures, accepted to JHEP for publicatio

Gravitational Waves from Mesoscopic Dynamics of the Extra Dimensions

Recent models which describe our world as a brane embedded in a higher dimensional space introduce new geometrical degrees of freedom: the shape and/or size of the extra dimensions, and the position of the brane. These modes can be coherently excited by symmetry breaking in the early universe even on ``mesoscopic'' scales as large as 1 mm, leading to detectable gravitational radiation. Two sources are described: relativistic turbulence caused by a first-order transition of a radion potential, and Kibble excitation of Nambu-Goldstone modes of brane displacement. Characteristic scales and spectral properties are estimated and the prospects for observation by LISA are discussed. Extra dimensions with scale between 10 \AA and 1 mm, which enter the 3+1-D era at cosmic temperatures between 1 and 1000 TeV, produce backgrounds with energy peaked at observed frequencies in the LISA band, between $10^{-1}$ and $10^{-4}$ Hz. The background is detectable above instrument and astrophysical foregrounds if initial metric perturbations are excited to a fractional amplitude of $10^{-3}$ or more, a likely outcome for the Nambu-Goldstone excitations.Comment: Latex, 5 pages, plus one figure, final version to appear in Phys. Rev. Let

UV Completions of Composite Higgs Models with Partial Compositeness

We construct UV completions of bottom-up models with a pseudo Nambu- Goldstone Boson (NGB) composite Higgs and partial compositeness, admitting a weakly coupled description of the composite sector. This is identified as the low energy description of an SO(N) supersymmetric gauge theory with matter fields in the fundamental of the group. The Higgs is a NGB associated to an SO(5)/SO(4) coset of a global symmetry group and is identified with certain components of matter fields in a Seiberg dual description of the theory. The Standard Model (SM) gauge fields are obtained by gauging a subgroup of the global group. The mass mixing between elementary SM and composite fermion fields advocated in partial compositeness arise from the flow in the IR of certain trilinear Yukawa couplings defined in the UV theory. We explicitly construct two models of this kind. Most qualitative properties of the bottom-up constructions are derived. The masses of gauge and fermion resonances in the composite sector are governed by different couplings and can naturally be separated. Accommodating all SM fermion masses within the partial compositeness paradigm remains the main open problem, since the SM gauge couplings develop Landau poles at unacceptably low energies. \ua9 2013 SISSA