Effect of sitagliptin on cardiovascular outcomes in type 2 diabetes

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

Wytrzymałościowa ocena stopnia zużycia lin stalowych mechanizmów zwodzenia organów urabiających koparek kołowych w świetle kryteriów odkładania

W artykule przedstawiono problematykę związaną z odkładaniem lin stalowych stosowanych w układach wciągarek głównych koparek wielonaczyniowych górnictwa odkrywkowego. Autorzy przedstawiają wyniki badań wytrzymałościowych odcinków tych lin, pobranych z różnych miejsc systemu olinowania koparki typu SchRs 4600.30. Odcinki do badań z tych miejsc pobrano, uwzględniając stopień ich zużycia, określony na podstawie oględzin wizualnych oraz częstości przeginania cięgien na krążkach. Zużycie poszczególnych fragmentów lin, rozumiane jako spadek zmierzonej sumarycznej siły zrywającej i spadek liczby jednokierunkowych skręceń drutów, odnoszono do odcinka referencyjnego.The article presents the problems connected with removing wire ropes from main hoists' bucket-wheel excavators of open pit machines. The authors present the results of strength tests of rope segments, gathered from different parts of SchRs 4600.30 excavator rigging system. Segments for tests were gathered taking into consideration their wear level, determined on the basis of visual inspection and the frequency of bending the rope on a pulley. The wear of particular rope fragments is understood as the decrease in the measured total breaking force and the decrease in the number of single wire torsion, were related to the reference segment

Loss of Metallic Area in Winder Ropes Subject to External Wear

The paper presents investigations related to quantification of wear in head ropes of mine drum winders. The loss of metallic area (LMA) of a worn-out rope is determined based on the geometry of the wear and on loss of wire mass. It is then related to the loss of corresponding breaking strength of the rope (LBS). The relation between the two is used to quantify the reliability of various rope condition assessment methods. (C) 2000 Elsevier Science Ltd. All rights reserved.The paper presents investigations related to quantification of wear in head ropes of mine drum winders. The loss of metallic area (LMA) of a worn-out rope is determined based on the geometry of the wear and on loss of wire mass. It is then related to the loss of corresponding breaking strength of the rope (LBS). The relation between the two is used to quantify the reliability of various rope condition assessment methods