Management of diabetes by a healthcare team in a cardiology unit: a randomized controlled trial

OBJECTIVE: To assess the effectiveness of healthcare team guidance in the implementation of a glycemic control protocol in the non-intensive care unit of a cardiology hospital. METHODS: This was a randomized clinical trial comparing 9 months of intensive guidance by a healthcare team on a protocol for diabetes care (Intervention Group, n = 95) with 9 months of standard care (Control Group, n = 87). Clinicaltrials.gov: NCT01154413. RESULTS: The mean age of the patients was 61.7±10 years, and the mean glycated hemoglobin level was 71±23 mmol/mol (8.7±2.1%). The mean capillary glycemia during hospitalization was similar between the groups (9.8±2.9 and 9.1±2.4 mmol/l for the Intervention Group and Control Group, respectively, p = 0.078). The number of hypoglycemic episodes (p = 0.77), hyperglycemic episodes (47 vs. 50 in the Intervention Group and Control Group, p = 0.35, respectively), and the length of stay in the hospital were similar between the groups (p = 0.64). The amount of regular insulin administered was 0 (0-10) IU in the Intervention Group and 28 (7-56) IU in the Control Group (

Feições geomorfológicas e solos nos locais em que foram construídos os geoglifos no Estado do Acre.

Distribuição dos Geoglifos na Amazônia Ocidental. Relações Ambientais dos Geoglifos no Município de Plácido de Castro. Localização dos Geoglifos em Relação Às Feições Geomorfológicas. Localização dos Geoglifos em Relação às Classes e Características dos Solos. Ocorrência de Geoglifos em Argissolos. Ocorrência de Geoglifos em Latossolos. Ocorrência de Geoglifos em Plintossolos. Características dos Solos nos Geoglifos. Falta de Evidências de Sítios de Habitação no Interior dos Geoglifos

CMB-S4 Science Book, First Edition

This book lays out the scientific goals to be addressed by the next-generation ground-based cosmic microwave background experiment, CMB-S4, envisioned to consist of dedicated telescopes at the South Pole, the high Chilean Atacama plateau and possibly a northern hemisphere site, all equipped with new superconducting cameras. CMB-S4 will dramatically advance cosmological studies by crossing critical thresholds in the search for the B-mode polarization signature of primordial gravitational waves, in the determination of the number and masses of the neutrinos, in the search for evidence of new light relics, in constraining the nature of dark energy, and in testing general relativity on large scales

Pre-Columbian land use in the ring-ditch region of the Bolivian Amazon

The nature and extent of pre-Columbian (pre-1492 AD) human impact in Amazonia is a contentious issue. The Bolivian Amazon has yielded some of the most impressive evidence for large and complex pre-Columbian societies in the Amazon basin, yet there remains relatively little data concerning the land use of these societies over time. Palaeoecology, when integrated with archaeological data, has the potential to fill these gaps in our knowledge. We present a 6,000-year record of anthropogenic burning, agriculture and vegetation change, from an oxbow lake located adjacent to a pre-Columbian ring-ditch in north-east Bolivia (13°15’44” S, 63°42’37” W). Human occupation around the lake site is inferred from pollen and phytoliths of maize (Zea mays L.) and macroscopic charcoal evidence of anthropogenic burning. First occupation around the lake was radiocarbon dated to ~2500 years BP. The persistence of maize in the record from ~1850 BP suggests that it was an important crop grown in the ringditch region in pre-Columbian times, and abundant macroscopic charcoal suggests that pre-Columbian land management entailed more extensive burning of the landscape than the slash-and-burn agriculture practised around the site today. The site was occupied continuously until near-modern times, although there is evidence for a decline in agricultural intensity or change in land use strategy, and possible population decline, from ~600-500 BP. The long and continuous occupation, which predates the establishment of rainforest in the region, suggests that pre-Columbian land use may have had a significant influence on ecosystem development at this site over the last ~2000 years

The Atacama Cosmology Telescope: Two-Season ACTPol Spectra and Parameters

We present the temperature and polarization angular power spectra measured by the Atacama Cosmology Telescope Polarimeter (ACTPol). We analyze night-time data collected during 2013-14 using two detector arrays at 149 GHz, from 548 deg$^2$ of sky on the celestial equator. We use these spectra, and the spectra measured with the MBAC camera on ACT from 2008-10, in combination with Planck and WMAP data to estimate cosmological parameters from the temperature, polarization, and temperature-polarization cross-correlations. We find the new ACTPol data to be consistent with the LCDM model. The ACTPol temperature-polarization cross-spectrum now provides stronger constraints on multiple parameters than the ACTPol temperature spectrum, including the baryon density, the acoustic peak angular scale, and the derived Hubble constant. Adding the new data to planck temperature data tightens the limits on damping tail parameters, for example reducing the joint uncertainty on the number of neutrino species and the primordial helium fraction by 20%.Comment: 23 pages, 25 figure

T cell immunosenescence after early life adversity: association with cytomegalovirus infection.

Early life adversity (ELA) increases the risk for multiple age-related diseases, such as diabetes type 2 and cardiovascular disease. As prevalence is high, ELA poses a major and global public health problem. Immunosenescence, or aging of the immune system, has been proposed to underlie the association between ELA and long-term health consequences. However, it is unclear what drives ELA-associated immunosenescence and which cells are primarily affected. We investigated different biomarkers of immunosenescence in a healthy subset of the EpiPath cohort. Participants were either parent-reared (Ctrl, n = 59) or had experienced separation from their parents in early childhood and were subsequently adopted (ELA, n = 18). No difference was observed in telomere length or in methylation levels of age-related CpGs in whole blood, containing a heterogeneous mixture of immune cells. However, when specifically investigating T cells, we found a higher expression of senescence markers (CD57) in ELA. In addition, senescent T cells (CD57+) in ELA had an increased cytolytic potential compared to senescent cells in controls. With a mediation analysis we demonstrated that cytomegalovirus (CMV) infection, which is an important driving force of immunosenescence, largely accounted for elevated CD57 expression observed in ELA. Leukocyte telomere length may obscure cell-specific immunosenescence; here, we demonstrated that the use of cell surface markers of senescence can be more informative. Our data suggest that ELA may increase the risk of CMV infection in early childhood, thereby mediating the effect of ELA on T cell-specific immunosenescence. Thus, future studies should include CMV as a confounder or selectively investigate CMV seronegative cohorts

'Correction:' Serum transforming growth factor beta-1 (TGF-beta-1) levels in diabetic patients are not associated with pre-existent coronary artery disease

<p>Abstract</p> <p>Background</p> <p>The association between TGF-β1 levels and long-term major adverse cardiovascular events (MACE) in patients with coronary artery disease (CAD) is controversial. No study specifically addressed patients with CAD and diabetes mellitus (DM). The association between TGF-β1 levels and long-term major adverse cardiovascular events (MACE) in patients with coronary artery disease (CAD) is controversial. No study specifically addressed patients with CAD and diabetes mellitus (DM).</p> <p>Methods</p> <p>Patients (n = 135, 30–80 years) referred for coronary angiography were submitted to clinical and laboratory evaluation, and the coronary angiograms were evaluated by two operators blinded to clinical characteristics. CAD was defined as the presence of a 70% stenosis in one major coronary artery, and DM was characterized as a fasting glycemia > 126 mg/dl or known diabetics (personal history of diabetes or previous use of anti-hyperglycemic drugs or insulin). Based on these criteria, study patients were classified into four groups: no DM and no CAD (controls, C n = 61), DM without CAD (D n = 23), CAD without DM (C-CAD n = 28), and CAD with DM (D-CAD n = 23). Baseline differences between the 4 groups were evaluated by the χ²test for trend (categorical variables) and by ANOVA (continuous variables, post-hoc Tukey). Patients were then followed-up during two years for the occurrence of MACE (cardiac death, stroke, myocardial infarction or myocardial revascularization). The association of candidate variables with the occurrence of 2-year MACE was assessed by univariate analysis.</p> <p>Results</p> <p>The mean age was 58.2 ± 0.9 years, and 51% were men. Patients with CAD had a higher mean age (p = 0.011) and a higher percentage were male (p = 0.040). There were no significant baseline differences between the 4 groups regarding hypertension, smoking status, blood pressure levels, lipid levels or inflammatory markers. TGF-β1 was similar between patients with or without CAD or DM (35.1 ×/÷ 1.3, 33.6 ×/÷ 1.6, 33.9 ×/÷ 1.4 and 31.8 ×/÷ 1.4 ng/ml in C, D, C-CAD and D-CAD, respectively, p = 0.547). In the 2-year follow-ip, independent predictors of 2-year MACE were age (p = 0.007), C-reactive protein (p = 0.048) and systolic blood pressure (p = 0.008), but not TGF-β1.</p> <p>Conclusion</p> <p>Serum TGF-β1 was not associated with CAD or MACE occurrence in patients with or without DM.</p

The Atacama Cosmology Telescope: Microwave Intensity and Polarization Maps of the Galactic Center

We present arcminute-resolution intensity and polarization maps of the Galactic center made with the Atacama Cosmology Telescope (ACT). The maps cover a 32 deg$^2$ field at 98, 150, and 224 GHz with $\vert l\vert\le4^\circ$, $\vert b\vert\le2^\circ$. We combine these data with Planck observations at similar frequencies to create coadded maps with increased sensitivity at large angular scales. With the coadded maps, we are able to resolve many known features of the Central Molecular Zone (CMZ) in both total intensity and polarization. We map the orientation of the plane-of-sky component of the Galactic magnetic field inferred from the polarization angle in the CMZ, finding significant changes in morphology in the three frequency bands as the underlying dominant emission mechanism changes from synchrotron to dust emission. Selected Galactic center sources, including Sgr A*, the Brick molecular cloud (G0.253+0.016), the Mouse pulsar wind nebula (G359.23-0.82), and the Tornado supernova remnant candidate (G357.7-0.1), are examined in detail. These data illustrate the potential for leveraging ground-based Cosmic Microwave Background polarization experiments for Galactic science.Comment: 26 pages, 14 figures, accepted for publication in Ap

Strong detection of the CMB lensingxgalaxy weak lensingcross-correlation from ACT-DR4,PlanckLegacy and KiDS-1000

We measure the cross-correlation between galaxy weak lensing data from the Kilo Degree Survey (KiDS-1000, DR4) and cosmic microwave background (CMB) lensing data from the Atacama Cosmology Telescope (ACT, DR4) and the Planck Legacy survey. We use two samples of source galaxies, selected with photometric redshifts, $(0.1<z_{\rm B}<1.2)$ and $(1.2<z_{\rm B}<2)$, which produce a combined detection significance of the CMB lensing/weak galaxy lensing cross-spectrum of $7.7\sigma$. With the lower redshift galaxy sample, for which the cross-correlation is detected at a significance of $5.3\sigma$, we present joint cosmological constraints on the matter density parameter, $\Omega_{\rm m}$, and the matter fluctuation amplitude parameter, $\sigma_8$, marginalising over three nuisance parameters that model our uncertainty in the redshift and shear calibration, and the intrinsic alignment of galaxies. We find our measurement to be consistent with the best-fitting flat $\Lambda$CDM cosmological models from both Planck and KiDS-1000. We demonstrate the capacity of CMB-weak lensing cross-correlations to set constraints on either the redshift or shear calibration, by analysing a previously unused high-redshift KiDS galaxy sample $(1.2<z_{\rm B}<2)$, with the cross-correlation detected at a significance of $7\sigma$. This analysis provides an independent assessment for the accuracy of redshift measurements in a regime that is challenging to calibrate directly owing to known incompleteness in spectroscopic surveys.Comment: 13 pages, 9 figures, 1 tables, submitted to A&