Baltimore Supersite: Highly time- and size-resolved concentrations of urban PM2.5 and its constituents for resolution of sources and immune responses

Protection of public health from the effects of air particulate matter (PM) requires measurements and methods that assess the PM chemical constituents, physical properties, and their sources. Sampling was conducted at three sites in the Baltimore area: a source-oriented (industrial) area in south Baltimore (FMC site), and two receptor area sites (Clifton Park and Ponca Street). FMC measurements were made for the initial 1-month of the project; Clifton measurements lasted for about 2 months, while measurements at Ponca Street lasted for about 9.5 months. Pollutant samples were collected at intervals ranging from 5 min to 1 h using semi-continuous monitors for PM2.5 mass, sulfate, nitrate, elemental and organic carbon, particle number size distributions (10–20,000 nm), CO, NOx, O3, 11 metals, and mass spectra of individual particles, throughout the project. In addition to standard meteorological measurements, a 3D-sonic anemometer and a LIDAR system were operated during selected periods as were a rotating drum impactor with 3- to 6-h resolution and a filter/PUF sampler for 3-h measurements of organic compounds. Standard speciation and FRM mass measurements were also made. This report describes the types of measurements that were made at the various sites of the Baltimore Supersite program as well as presents the summary statistics for some of the PM measurements that have been made. The measurements of aerosol mass, major components, and size distribution data for the three sites are compared. Results show comparable PM concentrations at Ponca Street and Clifton Park. Increased variability was observed at Ponca Street

Glycemia Reduction in Type 2 Diabetes - Glycemic Outcomes

BACKGROUND The comparative effectiveness of glucose-lowering medications for use with metformin to maintain target glycated hemoglobin levels in persons with type 2 diabetes is uncertain. METHODS In this trial involving participants with type 2 diabetes of less than 10 years' duration who were receiving metformin and had glycated hemoglobin levels of 6.8 to 8.5%, we compared the effectiveness of four commonly used glucose-lowering medications. We randomly assigned participants to receive insulin glargine U-100 (hereafter, glargine), the sulfonylurea glimepiride, the glucagon-like peptide-1 receptor agonist liraglutide, or sitagliptin, a dipeptidyl peptidase 4 inhibitor. The primary metabolic outcome was a glycated hemoglobin level, measured quarterly, of 7.0% or higher that was subsequently confirmed, and the secondary metabolic outcome was a confirmed glycated hemoglobin level greater than 7.5%. RESULTS A total of 5047 participants (19.8% Black and 18.6% Hispanic or Latinx) who had received metformin for type 2 diabetes were followed for a mean of 5.0 years. The cumulative incidence of a glycated hemoglobin level of 7.0% or higher (the primary metabolic outcome) differed significantly among the four groups (P<0.001 for a global test of differences across groups); the rates with glargine (26.5 per 100 participant-years) and liraglutide (26.1) were similar and lower than those with glimepiride (30.4) and sitagliptin (38.1). The differences among the groups with respect to a glycated hemoglobin level greater than 7.5% (the secondary outcome) paralleled those of the primary outcome. There were no material differences with respect to the primary outcome across prespecified subgroups defined according to sex, age, or race or ethnic group; however, among participants with higher baseline glycated hemoglobin levels there appeared to be an even greater benefit with glargine, liraglutide, and glimepiride than with sitagliptin. Severe hypoglycemia was rare but significantly more frequent with glimepiride (in 2.2% of the participants) than with glargine (1.3%), liraglutide (1.0%), or sitagliptin (0.7%). Participants who received liraglutide reported more frequent gastrointestinal side effects and lost more weight than those in the other treatment groups. CONCLUSIONS All four medications, when added to metformin, decreased glycated hemoglobin levels. However, glargine and liraglutide were significantly, albeit modestly, more effective in achieving and maintaining target glycated hemoglobin levels

Glycemia Reduction in Type 2 Diabetes - Microvascular and Cardiovascular Outcomes

BACKGROUND Data are lacking on the comparative effectiveness of commonly used glucose-lowering medications, when added to metformin, with respect to microvascular and cardiovascular disease outcomes in persons with type 2 diabetes. METHODS We assessed the comparative effectiveness of four commonly used glucose-lowering medications, added to metformin, in achieving and maintaining a glycated hemoglobin level of less than 7.0% in participants with type 2 diabetes. The randomly assigned therapies were insulin glargine U-100 (hereafter, glargine), glimepiride, liraglutide, and sitagliptin. Prespecified secondary outcomes with respect to microvascular and cardiovascular disease included hypertension and dyslipidemia, confirmed moderately or severely increased albuminuria or an estimated glomerular filtration rate of less than 60 ml per minute per 1.73 m2 of body-surface area, diabetic peripheral neuropathy assessed with the Michigan Neuropathy Screening Instrument, cardiovascular events (major adverse cardiovascular events [MACE], hospitalization for heart failure, or an aggregate outcome of any cardiovascular event), and death. Hazard ratios are presented with 95% confidence limits that are not adjusted for multiple comparisons. RESULTS During a mean 5.0 years of follow-up in 5047 participants, there were no material differences among the interventions with respect to the development of hypertension or dyslipidemia or with respect to microvascular outcomes; the mean overall rate (i.e., events per 100 participant-years) of moderately increased albuminuria levels was 2.6, of severely increased albuminuria levels 1.1, of renal impairment 2.9, and of diabetic peripheral neuropathy 16.7. The treatment groups did not differ with respect to MACE (overall rate, 1.0), hospitalization for heart failure (0.4), death from cardiovascular causes (0.3), or all deaths (0.6). There were small differences with respect to rates of any cardiovascular disease, with 1.9, 1.9, 1.4, and 2.0 in the glargine, glimepiride, liraglutide, and sitagliptin groups, respectively. When one treatment was compared with the combined results of the other three treatments, the hazard ratios for any cardiovascular disease were 1.1 (95% confidence interval [CI], 0.9 to 1.3) in the glargine group, 1.1 (95% CI, 0.9 to 1.4) in the glimepiride group, 0.7 (95% CI, 0.6 to 0.9) in the liraglutide group, and 1.2 (95% CI, 1.0 to 1.5) in the sitagliptin group. CONCLUSIONS In participants with type 2 diabetes, the incidences of microvascular complications and death were not materially different among the four treatment groups. The findings indicated possible differences among the groups in the incidence of any cardiovascular disease

Analytical approach to bit-string models of language evolution

A formulation of bit-string models of language evolution, based on differential equations for the population speaking each language, is introduced and preliminarily studied. Connections with replicator dynamics and diffusion processes are pointed out. The stability of the dominance state, where most of the population speaks a single language, is analyzed within a mean-field-like approximation, while the homogeneous state, where the population is evenly distributed among languages, can be exactly studied. This analysis discloses the existence of a bistability region, where dominance coexists with homogeneity as possible asymptotic states. Numerical resolution of the differential system validates these findings.Comment: To appear in Int. J. Mod. Phys.