Wpływ długotrwałego stosowania rozyglitazonu na zdarzenia sercowo-naczyniowe — przegląd systematyczny i metaanaliza

Rosiglitazone has been proposed as a treatment strategy for type 2 diabetes mellitus (T2DM), and it could provide robust glucose-lowering capability with risk of cardiovascular events. We thus performed a systematic review and meta-analysis of controlled trials to assess the effect of this treatment on glycaemic control and cardiovascular events in patients with T2DM. We systematically search PubMed, Embase, and the Cochrane Central Register of Controlled Trials comparing rosiglitazone to other anti-diabetic treatments. These studies included randomised controlled trials (RCTs), cohort studies, and case-control studies that had treatment with at least six months of follow-up in patients with T2DM. We aimed to evaluate the long-term effect on cardiovascular risk of rosiglitazone compared with a basal insulin drug. The main outcomes included myocardial infarction, heart failure, stroke, cardiovascular mortality, and all-cause mortality. We included 11RCTs and four observational studies involving 20,079 individuals with T2DM allocated to rosiglitazone and a similar number to comparison groups of which only five compared rosiglitazone with placebo and collected data on cardiovascular outcomes. Among patients with T2DM, rosiglitazone is associated with a significantly increased risk of heart failure, with little increased risk of myocardial infarction, without a significantly increased risk of stroke, cardiovascular mortality, and all-cause mortality compared with placebo or active controls. Alternative methods to reduce the uncertainty in long-term pragmatic evaluations, inclusion of rosiglitazone in factorial trials, publication of cardiovascular outcome data from adverse event reporting in trials of rosiglitazone and a cardiovascular endpoint trial of rosiglitazone among people without diabetes.   Rozyglitazon został zaproponowany jako strategia leczenia cukrzycy typu 2 (type 2 diabetes mellitus; T2DM). Ma on zdolność do silnego obniżenia stężenia glukozy z jednoczesnym ryzykiem wystąpienia zdarzeń sercowo-naczyniowych. Autorzy przeprowadzili przegląd systematyczny i metaanalizę kontrolowanych badań, aby ocenić wpływ leczenia rozyglitazonem na kontrolę glikemii i zdarzenia sercowo­-naczyniowe u pacjentów z cukrzycą typu 2. Systematycznie przeszukano bazy PubMed, Embase oraz Centralny Rejestr Badań z Grupą Kontrolną im. Cochrane’a (Cochrane Central Register of Controlled Trials), porównując rozyglitazon z innymi terapiami przeciwcukrzycowymi. Badania te obejmowały randomizowane badania kontrolowane, badania kohortowe oraz badania kliniczno-kontrolne, które obejmowały leczenie z co najmniej 6-miesięcznym okresem badań kontrolnych u pacjentów z cukrzycą typu 2. Celem była ocena długoterminowego wpływu rozyglitazonu na ryzyko sercowo-naczyniowe w porównaniu z podstawowym lekiem przeciwcukrzycowym. Główne zdarzenia obejmowały zawał serca, niewydolność serca, udar, śmiertelność z powodu chorób sercowo-naczyniowych oraz śmiertelność niezależ­nie od przyczyny. Uwzględniono 11 randomizowanych badań kontrolowanych i 4 badania obserwacyjne obejmujące 20 079 pacjentów z cukrzycą typu 2 przypisanych do rozyglitazonu i podobną liczbę w grupach porównawczych, w których tylko 5 badań porównywało rozyglitazon z placebo i gromadziło dane dotyczące zdarzeń sercowo-naczyniowych. Wśród pacjentów z cukrzycą typu 2 rozyglitazon jest powiązany ze znacznie zwiększonym ryzykiem niewydolności serca, z nieznacznie zwiększonym ryzykiem zawału serca, bez istotnie zwiększonego ryzyka udaru, śmiertelności z powodu chorób sercowo-naczyniowych i śmiertelności niezależnie od przyczyny w porównaniu z placebo lub aktywną grupą kontrolną. Alternatywne metody zmniejszania niepewności w długoterminowych ocenach pragmatycznych, włączanie rozyglitazonu do badań czynnikowych, publikacja danych dotyczących zdarzeń sercowo-naczyniowych z doniesień o zdarzeniach niepożądanych w badaniach dotyczących rozyglitazonu i próba z udziałem rozyglitazonu w kierunku zdarzeń sercowo-naczyniowych wśród osób bez cukrzycy

Palmistry

A review of "On Intelligence", a book exploring brain function by entrepreneur Jeff Hawkins and science writer Sandra Blakesle

Self-supervised Trajectory Representation Learning with Temporal Regularities and Travel Semantics

Trajectory Representation Learning (TRL) is a powerful tool for spatial-temporal data analysis and management. TRL aims to convert complicated raw trajectories into low-dimensional representation vectors, which can be applied to various downstream tasks, such as trajectory classification, clustering, and similarity computation. Existing TRL works usually treat trajectories as ordinary sequence data, while some important spatial-temporal characteristics, such as temporal regularities and travel semantics, are not fully exploited. To fill this gap, we propose a novel Self-supervised trajectory representation learning framework with TemporAl Regularities and Travel semantics, namely START. The proposed method consists of two stages. The first stage is a Trajectory Pattern-Enhanced Graph Attention Network (TPE-GAT), which converts the road network features and travel semantics into representation vectors of road segments. The second stage is a Time-Aware Trajectory Encoder (TAT-Enc), which encodes representation vectors of road segments in the same trajectory as a trajectory representation vector, meanwhile incorporating temporal regularities with the trajectory representation. Moreover, we also design two self-supervised tasks, i.e., span-masked trajectory recovery and trajectory contrastive learning, to introduce spatial-temporal characteristics of trajectories into the training process of our START framework. The effectiveness of the proposed method is verified by extensive experiments on two large-scale real-world datasets for three downstream tasks. The experiments also demonstrate that our method can be transferred across different cities to adapt heterogeneous trajectory datasets.Comment: 13 pages, 10 figures, Accepted by ICDE 202

Landmarks in Existing Tissue at Wounds Are Utilized to Generate Pattern in Regenerating Tissue

Regeneration in many organisms involves the formation of a blastema, which differentiates and organizes into the appropriate missing tissues. How blastema pattern is generated and integrated with pre-existing tissues is a central question in the field of regeneration. Planarians are free-living flatworms capable of rapidly regenerating from small body fragments [1]. A cell cluster at the anterior tip of planarian head blastemas (the anterior pole) is required for anterior-posterior (AP) and medial-lateral (ML) blastema patterning [2–4]. Transplantation of the head tip into tails induced host tissues to grow patterned head-like outgrowths containing a midline. Given the important patterning role of the anterior pole, understanding how it becomes localized during regeneration would help explain how wounds establish pattern in new tissue. Anterior pole progenitors were specified at the pre-existing midline of regenerating fragments, even when this location deviated from the ML median plane of the wound face. Anterior pole progenitors were specified broadly on the dorsal-ventral (DV) axis and subsequently formed a cluster at the DV boundary of the animal. We propose that three landmarks of pre-existing tissue at wounds set the location of anterior pole formation: a polarized AP axis, the pre-existing midline, and the dorsal-ventral median plane. Subsequently, blastema pattern is organized around the anterior pole. This process, utilizing positional information in existing tissue at unpredictably shaped wounds, can influence the patterning of new tissue in a manner that facilitates integration with pre-existing tissue in regeneration.National Institute of General Medical Sciences (U.S.) (Award T32GM007753)National Institutes of Health (U.S.) (Grant R01GM080639

Case report: Thoughts on two cases of total anomalous pulmonary venous connection complicated with pulmonary artery hypertension

The two primary pathological alterations of total anomalous pulmonary venous connection (TAPVC), a rare cyanotic congenital heart disease (CHD), are right heart failure and pulmonary artery hypertension (PAH). The timing and prognosis of surgery depend on the level of pulmonary hypertension. Surgery will not be an option after Eisenmenger syndrome appears. In light of this, it is crucial to assess patients’ PAH. In order to aid in the following treatment of related types of diseases, this article studied and compared the echocardiographic features and disease development of one adult and one child TAPVC patients complicated with PAH

Dynamical Autler-Townes control of a phase qubit

Routers, switches, and repeaters are essential components of modern information-processing systems. Similar devices will be needed in future superconducting quantum computers. In this work we investigate experimentally the time evolution of Autler-Townes splitting in a superconducting phase qubit under the application of a control tone resonantly coupled to the second transition. A three-level model that includes independently determined parameters for relaxation and dephasing gives excellent agreement with the experiment. The results demonstrate that the qubit can be used as a ON/OFF switch with 100 ns operating time-scale for the reflection/transmission of photons coming from an applied probe microwave tone. The ON state is realized when the control tone is sufficiently strong to generate an Autler-Townes doublet, suppressing the absorption of the probe tone photons and resulting in a maximum of transmission.Comment: 8 pages, 8 figure

First order statistical properties of simulated speckle fields

Publikation entstand im Rahmen der Veranstaltung: Photonics Ireland 2011, 7th – 9th September 2011, Malahide, Dublin

Playground equipment-related extremity fractures in children presenting to US emergency departments, 2006–2016

Background Despite updated playground equipment and improved industry standards, playgrounds remain a common source of childhood injury. Fractures account for 35% of all playground injuries presenting to emergency departments (EDs). We aimed to examine the time trends and epidemiologic patterns of playground equipment-related extremity fractures in children in the United States. Methods We analyzed data from the National Electronic Injury Surveillance System. Children ≤14 years presenting to US emergency departments from 2006 to 2016 with playground equipment-related injuries were included. We used weighted complex survey analysis to describe the epidemiologic patterns and severity of playground equipment-related extremity fractures and Joinpoint linear weighted regression analysis to determine trends in extremity fractures. Results An annual average of 72,889 children were treated in US EDs for playground equipment-related extremity fractures, yielding a national annual incidence rate of 119.2 per 100,000 children. Playground equipment-related extremity fractures accounted for 33.9% of ED presentations and 78.7% of hospitalizations for playground equipment-related injuries. Of patients with playground equipment-related extremity fractures, 11.2% had severe fractures requiring hospitalization. The annual rate of ED visits due to playground equipment-related extremity fractures remained stable (annual rate of change = 0.74, p = 0.14) from 2006 to 2016. Adjusted for age, injuries on monkey bars or climbing gyms were associated with significantly increased odds of extremity fractures in comparison to injuries from other playground equipment (adjusted odds ratio [aOR]: 2.0; 95% CI: 1.9–2.1). Overall, 49.8% of extremity fractures and 54.7% of severe extremity fractures (i.e. those requiring hospitalization) occurred on monkey bars or climbing gyms. Conclusions Despite enhanced playground safety standards, national rates of playground equipment-related extremity fractures have remained stable in the US. Extremity fractures remain the most common type of playground injury presenting to EDs and most commonly occur on monkey bars and climbing gyms

Observable Gravity Waves From Supersymmetric Hybrid Inflation

We identify models of supersymmetric hybrid inflation in which the tensor-to-scalar ratio, a canonical measure of gravity waves produced during inflation, can be as large as 0.03 or so, which will be tested by the Planck satellite experiment. The scalar spectral index lies within the WMAP one sigma bounds, while $|d n_s / d\ln k| \lesssim 0.01$.Comment: (v1) 19 pages, 1 table, 3 figures. (v2) 20 pages; updated figures, included additional discussion, footnotes, and referenc