iGlarLixi reduces residual hyperglycemia in Japanese patients with type 2 diabetes uncontrolled on basal insulin: A post‐hoc analysis of the LixiLan JP‐L trial

IntroductionTreatments for type 2 diabetes targeting baseline glucose levels but not postprandial glucose can result in normalized fasting blood glucose but suboptimal overall glycemic control (high glycated hemoglobin): residual hyperglycemia. In Japanese patients with type 2 diabetes the predominant pathophysiology is a lower insulin secretory capacity, and residual hyperglycemia is common with basal insulin treatment. Single-injection, fixed-ratio combinations of glucagon-like peptide-1 receptor agonists and basal insulin have been developed. iGlarLixi (insulin glargine 100 units/mL [iGlar]: lixisenatide ratio of 1 unit:1 µg) is for specific use in Japan. Post-hoc analysis of the LixiLan JP-L trial (NCT02752412) compared the effect of iGlarLixi with iGlar on this specific subpopulation with residual hyperglycemia.Materials and MethodsOutcomes at week 26 (based on the last observation carried forward) were assessed in patients in the modified intent-to-treat population with baseline residual hyperglycemia.ResultsOverall, 83 (32.5%) patients in the iGlarLixi group and 79 (30.7%) patients in the iGlar group had baseline residual hyperglycemia. The proportion of patients with residual hyperglycemia at week 26 decreased to 15.7% in the iGlarLixi group, and increased to 36.9% in the iGlar group. Patients in the iGlarLixi group had significantly greater reductions in glycated hemoglobin compared with the iGlar group (−0.72% difference between groups; P < 0.0001).ConclusionsNew data from this post-hoc analysis of the JP-L trial show that treatment with the fixed-ratio combination iGlarLixi reduced the proportion of Japanese patients with residual hyperglycemia from baseline to week 26 and significantly reduced glycated hemoglobin vs similar doses of iGlar alone

Rapid development of spiral garnets during subduction zone metamorphism revealed from high-resolution Sm-Nd garnet geochronology

Multiple studies have applied zoned garnet geochronology to place temporal constraints on the rates of metamorphism and deformation during orogenesis. We report new high-resolution isotope dilution–thermal ionization mass spectrometry Sm-Nd isochron ages on concentric growth zones from microstructurally and thermodynamically characterized garnets from the Betic Cordillera, southern Spain. Our ages for the garnet core (13.64 ± 0.31 Ma), mantle (13.41 ± 0.37 Ma), and rim (13.34 ± 0.45 Ma) indicate rapid garnet growth and are consistent with published garnet ages interpreted to reflect high-pressure metamorphism in the region. Thermodynamic analysis indicates garnets grew during subduction at ∼1.5–2.0 GPa and 570–600 °C. The core to rim duration of spiral garnet growth was just a few hundred thousand years. While other zoned garnet studies have shown similar rapid growth in subduction zone settings, this is the first documentation of such rapid growth of a spiral garnet. Combining this garnet growth duration with the magnitude of spiral inclusion trail curvature, we compute a strain rate of ∼10−13 s−1, an order of magnitude faster than all previous spiral garnet studies. We interpret that these spiral garnets recorded a rapid pulse of deformation and strain during the final stages of subduction and incipient exhumation.Spanish grants CGL2015–65602-R (AEI-FEDER), P18-RT-3275, and B-RNM-301-UGR18 (Junta de Andaucía/FEDER)U.S. National Science Foundation grants PIRE-1545903 and EAR-194665

Need for information in a representative sample of outpatients with schizophrenia disorders

Background: providing adequate information and involving patients in treatment has become an essential component of mental health care. Despite this, research regarding the extent to which this need has been met in clinical services is still scarce. Aims: To investigate the need for information about psychiatric condition and treatment among outpatients with schizophrenia disorders and how this need is associated with service use, adjusting for sociodemographic and clinical characteristics. Methods: Need for information for information about condition and treatment was assessed using the corresponding domain in the Camberwell Assessment of Need (CAN), in a representative sample of 401 schizophrenia outpatients in Santos, Brazil. Hierarchical logistic regression was used to investigate the association of information as a reported need and as an unmet need with service use variables, adjusting for sociodemographic and clinical characteristics. Results: Need for information was reported by 214 (53.4%) patients, being met in 101 (25.2%) and unmet in 113 (28.2%). Hierarchical regression indicated a significant association of a reported need with higher age of onset, family monitoring medication use last year and lower education level, which was the only associated with an unmet need. Conclusion: Information was a commonly reported need and which was often unmet, showing no significant association with service use. Greater attention should be given by mental health services to information provision

Options for managing alkaline steel slag leachate: A life cycle assessment

Management of steel slag (a major by-product of the steel industry) includes the treatment of highly alkaline leachate (pH > 11.5) from rainwater infiltration of slag deposits to prevent adverse impact upon surface or ground waters. This study aims to compare different treatment options for steel slag leachate through a life cycle assessment (LCA). Five options were compared: active treatment by acid dosing (A-H2SO4), active treatment by carbon dioxide dosing (A-CO2), active treatment by calcium chloride dosing (A-CaCl2), passive treatment by cascade and reedbeds with pumping (P-P), and passive treatment by cascade and reedbeds in a gravity-driven configuration (P-G). The functional unit was 1 m3 of treated leachate with pH < 9, considering 24 h and 365 days of operating, maintenance operations every year, and service life of 20 years. Inventory data were obtained from project designers, commercial suppliers, laboratory data and field tests. The environmental impacts were calculated in OpenLCA using the ELCD database and ILCD 2011 method, covering twelve impact categories. The A-CaCl2 option scored worse than all other treatments for all considered environmental impact categories. Regarding human toxicity, A-CaCl2 impact was 1260 times higher than the lowest impact option (A-CO2) for carcinogenics and 53 times higher for non-carcinogenics (A-H2SO4). For climate change, the lowest impact was calculated for P-G < P-P < A-H2SO4 < A-CO2 < A-CaCl2, while for particulate matter/respiratory inorganics, the options ranked as follows P-G < P-P < A-CO2 < A-H2SO4 < A-CaCl2. The major contributor to these impact categories was the Solvay process to produce CaCl2. Higher uncertainty was associated with the categories particulate matter formation, climate change and human toxicity, as they are driven by indirect emissions from electricity and chemicals production. Both passive treatment options had better environmental performance than the active treatment options. Potential design measures to enhance environmental performance of the treatments regarding metal removal and recovery are discussed and could inform operational management at active and legacy steel slag disposal sites

NOx Control Options and Integration for US Coal Fired Boilers Quarterly Report

This is the eleventh Quarterly Technical Report for DOE Cooperative Agreement No: DE-FC26-00NT40753. The goal of the project is to develop cost effective analysis tools and techniques for demonstrating and evaluating low NO{sub x} control strategies and their possible impact on boiler performance for boilers firing US coals. The Electric Power Research Institute (EPRI) is providing co-funding for this program. This program contains multiple tasks and good progress is being made on all fronts. During this quarter, FTIR experiments for SCR catalyst sulfation were finished at BYU and indicated no vanadium/vanadyl sulfate formation at reactor conditions. Poisoned catalysts were prepared and tested in the CCS. Poisoning with sodium produced a noticeable drop in activity, which was larger at higher space velocity. A computer code was written at BYU to predict conversion along a cylindrical monolithic reactor. This code may be useful for monolith samples that will be tested in the laboratory. Shakedown of the slipstream reactor was completed at AEP's Rockport plant. Ammonia was connected to the reactor. The measurement of O{sub 2} and NO{sub x} made by the CEMs corresponded to values measured by the plant at the economizer outlet. Excellent NO{sub x} reduction was observed in preliminary tests of the reactor. Some operational problems were noted and these will be addressed next quarter

A transition between the hot and the ultra-hot Jupiter atmospheres

[Abridged] A key hypothesis in the field of exoplanet atmospheres is the trend of atmospheric thermal structure with planetary equilibrium temperature. We explore this trend and report here the first statistical detection of a transition in the near-infrared (NIR) atmospheric emission between hot and ultra-hot Jupiters. We measure this transition using secondary eclipse observations and interpret this phenomenon as changes in atmospheric properties, and more specifically in terms of transition from non-inverted to inverted thermal profiles. We examine a sample of 78 hot Jupiters with secondary eclipse measurements at 3.6 {\mu}m and 4.5 {\mu}m measured with Spitzer Infrared Array Camera (IRAC). We measure the deviation of the data from the blackbody, which we define as the difference between the observed 4.5 {\mu}m eclipse depth and that expected at this wavelength based on the brightness temperature measured at 3.6 {\mu}m. We study how the deviation between 3.6 and 4.5 {\mu}m changes with theoretical predictions with equilibrium temperature and incoming stellar irradiation. We reveal a clear transition in the observed emission spectra of the hot Jupiter population at 1660 +/- 100 K in the zero albedo, full redistribution equilibrium temperature. We find the hotter exoplanets have even hotter daysides at 4.5 {\mu}m compared to 3.6 {\mu}m, which manifests as an exponential increase in the emitted power of the planets with stellar insolation. We propose that the measured transition is a result of seeing carbon monoxide in emission due to the formation of temperature inversions in the atmospheres of the hottest planets. These thermal inversions could be caused by the presence of atomic and molecular species with high opacities in the optical and/or the lack of cooling species. We find that the population of hot Jupiters statistically disfavors high C/O planets (C/O>= 0.85).Comment: Accepted 11th May 202

Subjective distress in a representative sample of outpatients with psychotic disorders

The affective burden of psychotic disorder has been increasingly recognised. However, subjective… reports of distress and its covariates, especially those related to service use, remain under-investigated in patients with psychosis. This study investigated subjective distress and its covariates in a representative sample of 401 outpatients with a confirmed diagnosis of psychotic disorders in Brazil. Distress was assessed using the corresponding domain of a standardised measure of need - the Camberwell Assessment of Need. Distress was reported as a need by 165 (41%) patients, being met in 78 (20%) and unmet in 87 (22%). Hierarchical logistic regression showed that the presence of distress as a need was predicted by attendance at psychotherapy (OR=3.49, CI=1.62-7.53), presence of suicidal ideation (OR=2.89, CI=1.75-4.79), non-attendance at psychosocial rehabilitation (OR=2.84, CI=1.31-6.19), and higher psychopathology (OR=1.09, CI=1.06-1.12). An unmet need was predicted by family not accompanying patients to treatment (OR=2.60, CI=1.05-6.44) and higher psychopathology (OR=1.05, CI=1.02-1.09). The use of a cross-sectional design and a single questionnaire domain to evaluate distress are the main limitations. Subjective distress is a common unmet need in psychosis, and can be treated. The main clinical implication is that subjective distress in psychosis may be impacted on by family engagement and psychosocial intervention