Metformin modifies the exercise training effects on risk factors for cardiovascular disease in impaired glucose tolerant adults

Impaired glucose tolerant (IGT) adults are at elevated risk for cardiovascular disease (CVD). Exercise or metformin reduce CVD risk, but the efficacy of combining treatments is unclear. To determine the effects of exercise training plus metformin, compared to each treatment alone, on CVD risk factors in IGT adults. Subjects were assigned to: placebo (P), metformin (M), exercise plus placebo (EP), or exercise plus metformin (EM) (8/group). In a double-blind design, P or 2000mg/d of M were administered for 12 weeks and half performed aerobic and resistance training 3 days/week for approximately 60 minutes/day at 70% pre-training heart rate peak. Outcomes included: adiposity, blood pressure (BP), lipids and high sensitivity C-reactive protein (hs-CRP). Z-scores were calculated to determine metabolic syndrome severity. M and EM, but not EP, decreased body weight compared to P (p \u3c0.05). M and EP lowered systolic BP by 6% (p \u3c 0.05), diastolic BP by 6% (p \u3c 0.05), and hs-CRP by 20% (M: trend p = 0.06; EP: p \u3c 0.05) compared to P. Treatments raised HDL-cholesterol (p \u3c 0.05; EM: trend p = 0.06) compared to P and lowered triacyglycerol (p \u3c 0.05) and metabolic syndrome Z-score compared to baseline (EP; trend p = 0.07 and EM or M; p \u3c 0.05). Although exercise and/or metformin improve some CVD risk factors, only training or metformin alone lowered hs-CRP and BP. Thus, metformin may attenuate the effects of training on some CVD risk factors and metabolic syndrome severity in IGT adults

Adaptation interventions and their effect on vulnerability in developing countries: Help, hindrance or irrelevance?

This paper critically reviews the outcomes of internationally-funded interventions aimed at climate change adaptation and vulnerability reduction. It highlights how some interventions inadvertently reinforce, redistribute or create new sources of vulnerability. Four mechanisms drive these maladaptive outcomes: (i) shallow understanding of the vulnerability context; (ii) inequitable stakeholder participation in both design and implementation; (iii) a retrofitting of adaptation into existing development agendas; and (iv) a lack of critical engagement with how ‘adaptation success’ is defined. Emerging literature shows potential avenues for overcoming the current failure of adaptation interventions to reduce vulnerability: first, shifting the terms of engagement between adaptation practitioners and the local populations participating in adaptation interventions; and second, expanding the understanding of ‘local’ vulnerability to encompass global contexts and drivers of vulnerability. An important lesson from past adaptation interventions is that within current adaptation cum development paradigms, inequitable terms of engagement with ‘vulnerable’ populations are reproduced and the multi-scalar processes driving vulnerability remain largely ignored. In particular, instead of designing projects to change the practices of marginalised populations, learning processes within organisations and with marginalised populations must be placed at the centre of adaptation objectives. We pose the question of whether scholarship and practice need to take a post-adaptation turn akin to post-development, by seeking a pluralism of ideas about adaptation while critically interrogating how these ideas form part of the politics of adaptation and potentially the processes (re)producing vulnerability. We caution that unless the politics of framing and of scale are explicitly tackled, transformational interventions risk having even more adverse effects on marginalised populations than current adaptation

Clinical Significance of Myocardial Injury in Patients Hospitalized for COVID-19: A Prospective, Multicenter, Cohort Study

\ua9 2024 The AuthorsBackground: Hospitalized COVID-19 patients with troponin elevation have a higher prevalence of cardiac abnormalities than control individuals. However, the progression and impact of myocardial injury on COVID-19 survivors remain unclear. Objectives: This study sought to evaluate myocardial injury in COVID-19 survivors with troponin elevation with baseline and follow-up imaging and to assess medium-term outcomes. Methods: This was a prospective, longitudinal cohort study in 25 United Kingdom centers (June 2020 to March 2021). Hospitalized COVID-19 patients with myocardial injury underwent cardiac magnetic resonance (CMR) scans within 28 days and 6 months postdischarge. Outcomes were tracked for 12 months, with quality of life surveys (EuroQol-5 Dimension and 36-Item Short Form surveys) taken at discharge and 6 months. Results: Of 342 participants (median age: 61.3 years; 71.1% male) with baseline CMR, 338 had a 12-month follow-up, 235 had a 6-month CMR, and 215 has baseline and follow-up quality of life surveys. Of 338 participants, within 12 months, 1.2% died; 1.8% had new myocardial infarction, acute coronary syndrome, or coronary revascularization; 0.8% had new myopericarditis; and 3.3% had other cardiovascular events requiring hospitalization. At 6 months, there was a minor improvement in left ventricular ejection fraction (1.8% \ub1 1.0%; P < 0.001), stable right ventricular ejection fraction (0.4% \ub1 0.8%; P = 0.50), no change in myocardial scar pattern or volume (P = 0.26), and no imaging evidence of continued myocardial inflammation. All pericardial effusions (26 of 26) resolved, and most pneumonitis resolved (95 of 101). EuroQol-5 Dimension scores indicated an overall improvement in quality of life (P < 0.001). Conclusions: Myocardial injury in severe hospitalized COVID-19 survivors is nonprogressive. Medium-term outcomes show a low incidence of major adverse cardiovascular events and improved quality of life. (COVID-19 Effects on the Heart; ISRCTN58667920

The 2022 symposium on dementia and brain aging in low‐ and middle‐income countries: Highlights on research, diagnosis, care, and impact

Two of every three persons living with dementia reside in low‐ and middle‐income countries (LMICs). The projected increase in global dementia rates is expected to affect LMICs disproportionately. However, the majority of global dementia care costs occur in high‐income countries (HICs), with dementia research predominantly focusing on HICs. This imbalance necessitates LMIC‐focused research to ensure that characterization of dementia accurately reflects the involvement and specificities of diverse populations. Development of effective preventive, diagnostic, and therapeutic approaches for dementia in LMICs requires targeted, personalized, and harmonized efforts. Our article represents timely discussions at the 2022 Symposium on Dementia and Brain Aging in LMICs that identified the foremost opportunities to advance dementia research, differential diagnosis, use of neuropsychometric tools, awareness, and treatment options. We highlight key topics discussed at the meeting and provide future recommendations to foster a more equitable landscape for dementia prevention, diagnosis, care, policy, and management in LMICs. Highlights: Two‐thirds of persons with dementia live in LMICs, yet research and costs are skewed toward HICs. LMICs expect dementia prevalence to more than double, accompanied by socioeconomic disparities. The 2022 Symposium on Dementia in LMICs addressed advances in research, diagnosis, prevention, and policy. The Nairobi Declaration urges global action to enhance dementia outcomes in LMICs

Efficient Point-spread Function Modeling with ShOpt.jl: A Point-spread Function Benchmarking Study with JWST NIRCam Imaging

With their high angular resolutions of 30–100 mas, large fields of view, and complex optical systems, imagers on next-generation optical/near-infrared space observatories, such as the Near-Infrared Camera (NIRCam) on the James Webb Space Telescope, present new opportunities for science and also new challenges for empirical point-spread function (PSF) characterization. In this context, we introduce ShOpt, a new PSF fitting tool developed in Julia and designed to bridge the advanced features of PSFs in the full field of view (PIFF) with the computational efficiency of PSF Extractor (PSFEx). Along with ShOpt, we propose a suite of nonparametric statistics suitable for evaluating PSF fit quality in space-based imaging. Our study benchmarks ShOpt against the established PSF fitters PSFEx and PIFF using real and simulated COSMOS-Web Survey imaging. We assess their respective PSF model fidelity with our proposed diagnostic statistics and investigate their computational efficiencies, focusing on their processing speed relative to the complexity and size of the PSF models. We find that ShOpt can already achieve PSF model fidelity comparable to PSFEx and PIFF while maintaining competitive processing speeds, constructing PSF models for large NIRCam mosaics within minutes

COSMOS-Web: An Overview of the JWST Cosmic Origins Survey

We present the survey design, implementation, and outlook for COSMOS-Web, a 255 hour treasury program conducted by the James Webb Space Telescope in its first cycle of observations. COSMOS-Web is a contiguous 0.54 deg$^2$ NIRCam imaging survey in four filters (F115W, F150W, F277W, and F444W) that will reach 5$\sigma$ point source depths ranging $\sim$27.5-28.2 magnitudes. In parallel, we will obtain 0.19 deg$^2$ of MIRI imaging in one filter (F770W). COSMOS-Web will build on the rich heritage of multiwavelength observations and data products available in the COSMOS field. The design of COSMOS-Web is motivated by three primary science goals: (1) to discover thousands of galaxies in the Epoch of Reionization ($64$ and place constraints on the formation of the Universe's most massive galaxies ($M_\star>10^{10}$ M$_\odot$), and (3) directly measure the evolution of the stellar mass to halo mass relation using weak gravitational lensing out to $z\sim2.5$ and measure its variance with galaxies' star formation histories and morphologies. In addition, we anticipate COSMOS-Web's legacy value to reach far beyond these scientific goals, touching many other areas of astrophysics, such as the identification of the first direct collapse black hole candidates, ultracool sub-dwarf stars in the Galactic halo, and possibly the identification of $z>10$ pair-instability supernovae. In this paper we provide an overview of the survey's key measurements, specifications, goals, and prospects for new discovery