Insight into the Use and Outcomes of Anti-Platelet Agents in Patients with Acute Coronary Syndrome

In patients who have received percutaneous coronary intervention (PCI) for the treatment of acute coronary syndrome (ACS), three anti-platelet agents were similarly used to reduce further cardiovascular complications. Of them the newer agents, prasugrel and ticagrelor, showed better efficacy profiles in a controlled setting compared to clopidogrel. With regard to the real-world practice in the anti-platelet agent use, however, there has been limited evidence. This research project was designed to fill in the research gap using an insurance claims database. During the period between 2009 and 2013, clopidogrel use remained a dominant option in commercially insured ACS-PCI patients, especially in patients with risk factors of further complication. After being launched, ticagrelor did not take up the US market share of clopidogrel, but instead replaced prasugrel. Clopidogrel use was significantly associated with the presence of comorbid conditions or risks of future complications and mortality. The odds of using ticagrelor vs. prasugrel increased with a history of cerebrovascular events. Selection of anti-platelet agent was not associated with a significant difference in total medical expenditure. Treatment effects on economic outcomes were separately measured in patients who enrolled in the health plan over a 6-month post ACS discharge period and in those who maintained their initial treatment over the 6 months. Regression analyses found that the use of newer agents vs. clopidogrel increased medication cost over the 6-month period, which is mainly attributed to the increase in the expenditure on the cardiovascular medication. However, when we looked at the total medical cost, the estimated difference between the costs in the newer agent users and in the clopidogrel users was insignificant. The analysis of resource utilization demonstrated that there was a significant decrease in the rate of hospital admission with the use of newer agents, which explained how the increase in the medication cost could be cancelled out. Between prasugrel and ticagrelor, there was not a statistically significant difference in the hazard rates of all-cause and MI related hospitalization from 30-day to 365-day post ACS-PCI discharge periods. The hazard ratios were corresponding to the effect of drug selection on healthcare utilization estimates. In general, association measures did not consistently favor one over the other. Although the results and conclusions were accompanied by the general limitations of retrospective analysis and suffered from sample size issues, the study helped to fill a gap which have not been and could not be investigated in a controlled setting

sj-sav-2-alh-10.1177_14697874241229422 – Research Data for Effects of team-building on group cohesion, group efficacy, and individual academic performance in virtual learning environment

Research Data, sj-sav-2-alh-10.1177_14697874241229422 for Effects of team-building on group cohesion, group efficacy, and individual academic performance in virtual learning environment by Pilhyoun Yoon, Sangsun Han and Kibum Kim in Active Learning in Higher Education</p

sj-sav-1-alh-10.1177_14697874241229422 – Research Data for Effects of team-building on group cohesion, group efficacy, and individual academic performance in virtual learning environment

Research Data, sj-sav-1-alh-10.1177_14697874241229422 for Effects of team-building on group cohesion, group efficacy, and individual academic performance in virtual learning environment by Pilhyoun Yoon, Sangsun Han and Kibum Kim in Active Learning in Higher Education</p

Electrochemical Performance of Chemically Integrated N‑Doped Carbon Dots/Bi₂MoO₆ Nanocomposites for Symmetric Supercapacitors

Mixed transition-metal oxides (MTMOs) are attracting tremendous attention as a battery-type electrode due to their high electrical conductivity and structural stability. However, utilizing these electrodes in practical applications is hindered by capacity degradation, especially during the long-term cycle. These limitations could be overcome by constructing electrodes by introducing the carbonaceous material into the MTMO matrix. Accordingly, in this work, a facile hydrothermal method is employed to develop nitrogen-doped carbon dots (NCDs)-integrated bismuth molybdenum oxide (Bi2MoO6; BMO) (NCD/BMO) composites, where the concentration of NCDs is varied, such as 2, 5, 10, and 15 wt %. The structural and chemical state analyses of the samples confirm the formation of the orthorhombic BMO system and the chemically integrated NCD/BMO composites. The morphology analysis revealed a brick-like structure for bare-BMO with an average size of ∼100 nm and a rod-like morphology for the NCD/BMO composites, which is attributed to the interaction of NCDs with growing BMO particles leading to the rod-like formation of the resultant composites. The electrochemical performance of the developed materials is studied in a three-electrode and symmetric assembly system. Among the composites, the 10 wt % NCD/BMO (BMO–C10) composite exhibited an enhanced specific capacity of 561 C g–1 (155.8 mA h g–1) at a current density of 1 A g–1 in 6 M KOH electrolyte. Besides, the assembled symmetric device achieved an energy density and a power density of 44.2 W h kg–1 and 720 W kg–1, respectively, at a current density of 1 A g–1. In addition, the assembled symmetric device maintained excellent cyclic stability of ∼87.3% up to 10,000 cycles at 20 A g–1 current density. The obtained results demonstrate that the NCD/BMO composite could be an efficient battery-type electrode material for promising supercapacitor applications

Pregabalin Does Not Increase Risk of Heart Failure Exacerbation in Patients With Pre-existing Heart Failure

BACKGROUND: Through actions of calcium channel trafficking inhibition and sodium/water retention, pregabalin may increase the risk of acute heart failure (AHF). OBJECTIVE: The objective of this study was to determine the prevalence of heart failure (HF) acute exacerbations, measured by a composite of emergency department (ED) visits, per-patient per-year (PPPY) hospitalizations, time-to first ED admission, and time-to hospitalizations in pre-existing HF patients taking pregabalin compared with those who were pregabalin-naive. METHODS: A retrospective cohort study of pregabalin users with HF were propensity score-matched to pregabalin-naïve patients with HF to evaluate the composite of ED admissions or PPPY hospitalizations, time-to first ED admission, and time-to hospitalizations during the 365 days post-index. Doubly robust generalized linear regression and Cox-proportional hazard regression modeling were undertaken for analysis of differences between groups. RESULTS: The matched cohort of 385 pregabalin users and 3460 pregabalin nonusers were principally middle-aged, equally gender distributed, and primary Caucasian. Most patients were on guideline-directed HF medical therapy. The estimated cumulative incidence of the primary outcome was a hazard ratio of 1.099 (95% CI: 0.789-1.530; P = 0.58). CONCLUSION AND RELEVANCE: This large, single-center, cohort study shows pregabalin is not associated with an increased risk of AHF events in patients with pre-existing HF

Riluzole Mitigates The Risk Of Heart Failure Admissions

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Effect of treatment intensification on glycemic control in patients with subcontrolled type 2 diabetes who failed on two oral antidiabetic agents

Aims: Treatment intensification (TI) may help patients with type 2 diabetes mellitus (T2DM) achieve target hemoglobin A1c (A1c) < 7.0%. This study aimed to measure the influence of TI on A1c outcome in patients who insufficiently responded to two classes of oral antidiabetic drugs (2OADs).</p

Epidemiology of Diabetic Kidney Disease among US Veterans

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Effect of food on systemic exposure to niflumic acid following postprandial administration of talniflumate

PURPOSE: Talniflumate was designed as a prodrug of niflumic acid, a potent analgesic and anti-inflammatory drug, which is widely prescribed for treating rheumatoid diseases. The prandial effect on talniflumate absorption remains unclear; therefore, this study investigated the effect of food on the systemic exposure to niflumic acid in healthy volunteers. METHODS: Volunteers received a single 740-mg dose of talniflumate 30 min after consuming a high-fat breakfast, a low-fat breakfast, or no food (fasting condition). Plasma concentrations of both talniflumate and niflumic acid were measured using validated high-performance liquid chromatography coupled to tandem mass spectrometry. RESULTS: The maximum concentration of niflumic acid was 224 +/- 193 ng/ml at approximately 2.7 h in the fasted condition compared with 886 +/- 417 ng/ml (p < 0.05) at 1.8 h and 1,159 +/- 508 ng/ml (p < 0.01) at 2.2 h with the low- and high-fat meals, respectively. The mean area under the curve from zero to infinity (AUC(inf)) values after the low- and high-fat meals were four- and fivefold, respectively, the value while fasting (p < 0.05). CONCLUSIONS: It is strongly recommended that talniflumate be taken after a meal to increase systemic exposure to its active metabolite. Our results suggest a reduction in the daily dosage of talniflumate when taken with food

Stable and Selective Humidity Sensing Using Stacked Black Phosphorus Flakes

Black phosphorus (BP) atomic layers are known to undergo chemical degradation in humid air. Yet in more robust configurations such as films, composites, and embedded structures, BP can potentially be utilized in a large number of practical applications. In this study, we explored the sensing characteristics of BP films and observed an ultrasensitive and selective response toward humid air with a trace-level detection capability and a very minor drift over time. Our experiments show that the drain current of the BP sensor increases by ∼4 orders of magnitude as the relative humidity (RH) varies from 10% to 85%, which ranks it among the highest ever reported values for humidity detection. The mechanistic studies indicate that the operation principle of the BP film sensors is based on the modulation in the leakage ionic current caused by autoionization of water molecules and ionic solvation of the phosphorus oxoacids produced on moist BP surfaces. Our stability tests reveal that the response of the BP film sensors remains nearly unchanged after prolonged exposures (up to 3 months) to ambient conditions. This study opens up the route for utilizing BP stacked films in many potential applications such as energy generation/storage systems, electrocatalysis, and chemical/biosensing