An operational information decomposition via synergistic disclosure

Abstract: Multivariate information decompositions hold promise to yield insight into complex systems, and stand out for their ability to identify synergistic phenomena. However, the adoption of these approaches has been hindered by there being multiple possible decompositions, and no precise guidance for preferring one over the others. At the heart of this disagreement lies the absence of a clear operational interpretation of what synergistic information is. Here we fill this gap by proposing a new information decomposition based on a novel operationalisation of informational synergy, which leverages recent developments in the literature of data privacy. Our decomposition is defined for any number of information sources, and its atoms can be calculated using elementary optimisation techniques. The decomposition provides a natural coarse-graining that scales gracefully with the system’s size, and is applicable in a wide range of scenarios of practical interest

Effect of sitagliptin on cardiovascular outcomes in type 2 diabetes

BACKGROUND: Data are lacking on the long-term effect on cardiovascular events of adding sitagliptin, a dipeptidyl peptidase 4 inhibitor, to usual care in patients with type 2 diabetes and cardiovascular disease. METHODS: In this randomized, double-blind study, we assigned 14,671 patients to add either sitagliptin or placebo to their existing therapy. Open-label use of antihyperglycemic therapy was encouraged as required, aimed at reaching individually appropriate glycemic targets in all patients. To determine whether sitagliptin was noninferior to placebo, we used a relative risk of 1.3 as the marginal upper boundary. The primary cardiovascular outcome was a composite of cardiovascular death, nonfatal myocardial infarction, nonfatal stroke, or hospitalization for unstable angina. RESULTS: During a median follow-up of 3.0 years, there was a small difference in glycated hemoglobin levels (least-squares mean difference for sitagliptin vs. placebo, -0.29 percentage points; 95% confidence interval [CI], -0.32 to -0.27). Overall, the primary outcome occurred in 839 patients in the sitagliptin group (11.4%; 4.06 per 100 person-years) and 851 patients in the placebo group (11.6%; 4.17 per 100 person-years). Sitagliptin was noninferior to placebo for the primary composite cardiovascular outcome (hazard ratio, 0.98; 95% CI, 0.88 to 1.09; P<0.001). Rates of hospitalization for heart failure did not differ between the two groups (hazard ratio, 1.00; 95% CI, 0.83 to 1.20; P = 0.98). There were no significant between-group differences in rates of acute pancreatitis (P = 0.07) or pancreatic cancer (P = 0.32). CONCLUSIONS: Among patients with type 2 diabetes and established cardiovascular disease, adding sitagliptin to usual care did not appear to increase the risk of major adverse cardiovascular events, hospitalization for heart failure, or other adverse events

Effects of Once-Weekly Exenatide on Cardiovascular Outcomes in Type 2 Diabetes.

Abstract BACKGROUND: The cardiovascular effects of adding once-weekly treatment with exenatide to usual care in patients with type 2 diabetes are unknown. METHODS: We randomly assigned patients with type 2 diabetes, with or without previous cardiovascular disease, to receive subcutaneous injections of extended-release exenatide at a dose of 2 mg or matching placebo once weekly. The primary composite outcome was the first occurrence of death from cardiovascular causes, nonfatal myocardial infarction, or nonfatal stroke. The coprimary hypotheses were that exenatide, administered once weekly, would be noninferior to placebo with respect to safety and superior to placebo with respect to efficacy. RESULTS: In all, 14,752 patients (of whom 10,782 [73.1%] had previous cardiovascular disease) were followed for a median of 3.2 years (interquartile range, 2.2 to 4.4). A primary composite outcome event occurred in 839 of 7356 patients (11.4%; 3.7 events per 100 person-years) in the exenatide group and in 905 of 7396 patients (12.2%; 4.0 events per 100 person-years) in the placebo group (hazard ratio, 0.91; 95% confidence interval [CI], 0.83 to 1.00), with the intention-to-treat analysis indicating that exenatide, administered once weekly, was noninferior to placebo with respect to safety (P<0.001 for noninferiority) but was not superior to placebo with respect to efficacy (P=0.06 for superiority). The rates of death from cardiovascular causes, fatal or nonfatal myocardial infarction, fatal or nonfatal stroke, hospitalization for heart failure, and hospitalization for acute coronary syndrome, and the incidence of acute pancreatitis, pancreatic cancer, medullary thyroid carcinoma, and serious adverse events did not differ significantly between the two groups. CONCLUSIONS: Among patients with type 2 diabetes with or without previous cardiovascular disease, the incidence of major adverse cardiovascular events did not differ significantly between patients who received exenatide and those who received placebo. (Funded by Amylin Pharmaceuticals; EXSCEL ClinicalTrials.gov number, NCT01144338 .)

An operational information decomposition via synergistic disclosure

Abstract: Multivariate information decompositions hold promise to yield insight into complex systems, and stand out for their ability to identify synergistic phenomena. However, the adoption of these approaches has been hindered by there being multiple possible decompositions, and no precise guidance for preferring one over the others. At the heart of this disagreement lies the absence of a clear operational interpretation of what synergistic information is. Here we fill this gap by proposing a new information decomposition based on a novel operationalisation of informational synergy, which leverages recent developments in the literature of data privacy. Our decomposition is defined for any number of information sources, and its atoms can be calculated using elementary optimisation techniques. The decomposition provides a natural coarse-graining that scales gracefully with the system’s size, and is applicable in a wide range of scenarios of practical interest

Effect of Eight-Week Endurance Exercise on Resistin Gene Expression in Visceral Adipose Tissues in Obese Rats

Introduction: Obesity causes accumulation of proinflammatory factors in adipose tissue and it is regarded as a risk factor for diabetes and cardiovascular diseases. Aerobic exercise increases insulin sensitivityand reduces fat accumulation and proinflammatory factors. The present study aimed to investigate the effect of endurance exercise on resistin gene expression as one of the proinfammatory agents in visceral adipose tissues in diet-induced obese male rats. Methods: In an experimental study, &nbsp;20 Wistar male rats divided into 3 groups: control (standard diet), fat (high-fat diet) and endurance exercise groups (high-fat diet and endurance exercise). Endurance training protocol included 60 minutes exercise per day using an animal treadmill at a speed of 22 meters per minute with 70% of VO2 max, 5 days a week, and for 8 weeks. Changes in body weights of rats were measured and the resistin gene expression in tissue samples analyzed using real-time polymerase chain reaction. Results: High-fat diet increased significantly the weight of rats in the fat group (P<0.01). Resistin gene expression in visceral adipose tissues of rats in the fat group increased 2 times in comparison to those of the control group, but this increase was not statistically significant. Endurance exercise reduced resistin gene expression about 4 times in comparison to those of the fat group, but this reduction was not statistically significant, too. Conclusion: It can be concluded that obesity could increase and endurance training could reduce the resistin gene expression in visceral adipose tissue in rats. Although the present study suggests the beneficial effects of exercise, more studies are needed in this field

Reaching for the stars : Iranian nurses\u27 perceptions of career success

Aim: The aim was to explore nurses\u27 perceptions of career success.Introduction: Career success is a concept which leads to improving professional behaviours. Research that focused on conceptualizing career success found it to be a complex, value-driven construct likely to be perceived differently across work and cultural contexts. It is not yet clear what constitutes career success, and how it is perceived by nurses in Iran. More comprehensive exploration of this concept in nursing is needed, so research and policymaking can advance in informed, data-driven manner.Method: This is a qualitative descriptive study. The setting was teaching hospitals of Iran. Twenty-seven nurses participated in face-to-face interviews, and six field notes were collected. Data were analysed using conventional content analysis.Findings: Analyses identified five themes of career success: providing high-quality care, being exemplary employee, embarking on career growth, having positive personal attributes and being internally satisfied.Conclusion: Findings confirmed that career success in Iranian nurses was a multidimensional concept that represented five internally and externally driven dimensions set within its cultural and religious context. Policymakers and clinical educators can now plan interventions aimed at fostering career success in nursing staff.Implications: Future nurses could use these finding to reflect on their developed attributes throughout their studies and clinical placements and adjust their career preparation and learning to bridge any identified gaps. Organizational values and intervention for nursing staff could also be redesigned to align with the aspects of career success