Doenças autoimunes e manifestações na cavidade oral

As doenças autoimunes são consideradas como doenças inflamatórias crónicas sendo usualmente associadas a lesões orais dolorosas. As manifestações orais podem ser consideradas como os primeiros sinais/sintomas de diversas patologias autoimunes como a Artrite Reumatóide, o Pênfigo, entre outras. Em termos imunopatológicos podemos classificar as lesões orais, maioritariamente, associadas a doenças autoimunes reumáticas, ulcerosas e bolhosas. É de vital importância uma intervenção precoce, muitas vezes associada a um diagnóstico preciso, com uma boa comunicação entre uma equipa médica multidisciplinar incluindo o médico dentista. Estas patologias necessitam, para além do diagnóstico correto, a familiarização com as terapêuticas existentes de forma a definir um melhor plano de tratamento para o individuo, a reduzir a morbilidade destas patologias e melhorar assim a qualidade de vida do paciente.Autoimmune diseases are considered chronic inflammatory diseases being usually associated with painful oral lesions . Oral manifestations may be considered as early signs/symptoms of several autoimmune diseases like Rheumatoid Arthritis (RA), Pemphigus, between others. As immunopathological conditions we can classify the oral lesions, as mainly associated, with Rheumatic, ulcerous and bullous autoimmune diseases. It's vitally important an early intervention, in several cases associated with a precise diagnostic, and a good communication between a multidisciplinary medical team including the medical dentist. These pathologies need, beyond the correct diagnostic a familiarization with the existing therapies, to define the better treatment plan for the individual thereby reducing the morbidity and improving the quality life of the patient

Doenças autoimunes e manifestações na cavidade oral

As doenças autoimunes são consideradas como doenças inflamatórias crónicas sendo usualmente associadas a lesões orais dolorosas. As manifestações orais podem ser consideradas como os primeiros sinais/sintomas de diversas patologias autoimunes como a Artrite Reumatóide, o Pênfigo, entre outras. Em termos imunopatológicos podemos classificar as lesões orais, maioritariamente, associadas a doenças autoimunes reumáticas, ulcerosas e bolhosas. É de vital importância uma intervenção precoce, muitas vezes associada a um diagnóstico preciso, com uma boa comunicação entre uma equipa médica multidisciplinar incluindo o médico dentista. Estas patologias necessitam, para além do diagnóstico correto, a familiarização com as terapêuticas existentes de forma a definir um melhor plano de tratamento para o individuo, a reduzir a morbilidade destas patologias e melhorar assim a qualidade de vida do paciente.Autoimmune diseases are considered chronic inflammatory diseases being usually associated with painful oral lesions . Oral manifestations may be considered as early signs/symptoms of several autoimmune diseases like Rheumatoid Arthritis (RA), Pemphigus, between others. As immunopathological conditions we can classify the oral lesions, as mainly associated, with Rheumatic, ulcerous and bullous autoimmune diseases. It's vitally important an early intervention, in several cases associated with a precise diagnostic, and a good communication between a multidisciplinary medical team including the medical dentist. These pathologies need, beyond the correct diagnostic a familiarization with the existing therapies, to define the better treatment plan for the individual thereby reducing the morbidity and improving the quality life of the patient

USO DE PRF ASSOCIADO A CIRURGIAS DE IMPLANTES DENTÁRIOS

The physical changes that occur in the alveolus during the period of bone resorption bring with them the need for a specific surgical approach to patients who will undergo prosthetic rehabilitation through dental implants. Therefore, it is extremely important that the implant dentist is able to perform procedures that will lead to future treatment success, both aesthetic and functional. Aiming to carry out a procedure in an integral manner and maintaining the quality of soft tissues, incorporating preventive actions for the patient's periodontium and bone framework into surgical practice. As usual choices in treatment, conjunctival grafts, free gingiva and biological membranes are used to cover the surgical bed. Therefore, the purpose of this monograph is to evaluate the effectiveness of PRF (Platelet Rich Fibrin), as an alternative membrane to cover and protect the surgical bed, thus avoiding the presence of infection at the site, and maintaining its tissue aesthetics, especially in the anterior region. Most procedures showed the restoration of peri-implant health, bone regeneration resulting from the use of bone graft and improvement in the quality, modulation and appearance of soft tissue. Therefore, the fibrin-rich plasma membrane appears to be a good alternative to replace biological membranes. It is an accessible, low-cost, non-invasive technique and its use in this literature review was effective.  As mudanças físicas que ocorrem no alvéolo no período de reabsorção óssea trazem consigo a necessidade de abordagem cirúrgica específica à pacientes que serão submetidos a reabilitação protética através de implantes dentários. Sendo assim, é de extrema importância que o implantodontista esteja apto a realizar procedimentos que vão levar um futuro sucesso do tratamento, tanto estético quanto funcional. Visando efetuar um procedimento de forma íntegra e mantendo a qualidade dos tecidos moles, incorporando na prática cirúrgica, ações preventivas para o periodonto do paciente e arcabouço ósseo. Como escolhas habituais, no    tratamento, são utilizados enxertos de conjuntivo, gengivais livres e membranas biológicas a fim de recobrir o leito cirúrgico. Desta maneira, a proposta dessa monografia é avaliar a efetividade do PRF (Fibrina Rica em Plaquetas), como uma alternativa de membrana para recobrir e proteger o leito cirúrgico, evitando assim a presença de infecção no local, e mantendo sua estética tecidual, principalmente na região anterior. A maioria dos procedimentos mostraram o restabelecimento da saúde peri-implantar, regeneração óssea presente decorrente da utilização do enxerto ósseo e melhora na qualidade, modulação e aspecto do tecido moles. Desta maneira, a membrana de plasma rico em fibrina parece ser uma boa alternativa para substituir as membranas biológicas. É uma técnica acessível, de baixo custo, não invasiva e foi efetiva sua utilização nessa revisão de literatura

Hexapoda Yearbook (Arthropoda: Mandibulata: Pancrustacea) Brazil 2020: the first annual production survey of new Brazilian species

This paper provided a list of all new Brazilian Hexapoda species described in 2020. Furthermore, based on the information extracted by this list, we tackled additional questions regarding the taxa, the specialists involved in the species descriptions as well as the journals in which those papers have been published. We recorded a total of 680 new Brazilian species of Hexapoda described in 2020, classified in 245 genera, 112 families and 18 orders. These 680 species were published in a total of 219 articles comprising 423 different authors residing in 27 countries. Only 30% of these authors are women, which demonstrates an inequality regarding sexes. In relation to the number of authors by species, the majority of the new species had two authors and the maximum of authors by species was five. We also found inequalities in the production of described species regarding the regions of Brazil, with Southeast and South leading. The top 10 institutions regarding productions of new species have four in the Southeast, two at South and with one ate North Region being the outlier of this pattern. Out of the total 219 published articles, Zootaxa dominated with 322 described species in 95 articles. The average impact factor was of 1.4 with only seven articles being published in Impact Factors above 3, indicating a hardship on publishing taxonomic articles in high-impact journals.The highlight of this paper is that it is unprecedent, as no annual record of Hexapoda species described was ever made in previous years to Brazil.Fil: Silva Neto, Alberto Moreira. Ministério da Ciência, Tecnologia, Inovações. Instituto Nacional de Pesquisas da Amazônia; BrasilFil: Lopes Falaschi, Rafaela. Universidade Estadual do Ponta Grossa; BrasilFil: Zacca, Thamara. Universidade Federal Do Rio de Janeiro. Museu Nacional; BrasilFil: Hipólito, Juliana. Universidade Federal da Bahia; BrasilFil: Costa Lima Pequeno, Pedro Aurélio. Universidade Federal de Roraima; BrasilFil: Alves Oliveira, João Rafael. Ministério da Ciência, Tecnologia, Inovações. Instituto Nacional de Pesquisas da Amazônia; BrasilFil: Oliveira Dos Santos, Roberto. Ministério da Ciência, Tecnologia, Inovações. Instituto Nacional de Pesquisas da Amazônia; BrasilFil: Heleodoro, Raphael Aquino. Ministério da Ciência, Tecnologia, Inovações. Instituto Nacional de Pesquisas da Amazônia; BrasilFil: Jacobina, Adaiane Catarina Marcondes. Universidade Federal do Paraná; BrasilFil: Somavilla, Alexandre. Ministério da Ciência, Tecnologia, Inovações. Instituto Nacional de Pesquisas da Amazônia; BrasilFil: Camargo, Alexssandro. Ministério da Ciência, Tecnologia, Inovações. Instituto Nacional de Pesquisas da Amazônia; BrasilFil: de Oliveira Lira, Aline. Universidad Federal Rural Pernambuco; BrasilFil: Sampaio, Aline Amanda. Ministério da Ciência, Tecnologia, Inovações. Instituto Nacional de Pesquisas da Amazônia; BrasilFil: da Silva Ferreira, André. Universidad Federal Rural Pernambuco; BrasilFil: Martins, André Luis. Universidade Federal do Paraná; BrasilFil: Figueiredo de Oliveira, Andressa. Universidade Federal do Mato Grosso do Sul; BrasilFil: Gonçalves da Silva Wengrat , Ana Paula. Universidade do Sao Paulo. Escola Superior de Agricultura Luiz de Queiroz; BrasilFil: Batista Rosa, Augusto Henrique. Universidade Estadual de Campinas; BrasilFil: Dias Corrêa, Caio Cezar. Universidade Federal Do Rio de Janeiro. Museu Nacional; BrasilFil: Costa De-Souza, Caroline. Museu Paraense Emilio Goeldi; BrasilFil: Anjos Dos Santos, Danielle. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Patagonia Norte. Centro de Investigación Esquel de Montaña y Estepa Patagónica. Universidad Nacional de la Patagonia "San Juan Bosco". Centro de Investigación Esquel de Montaña y Estepa Patagónica; ArgentinaFil: Pacheco Cordeiro, Danilo. Instituto Nacional Da Mata Atlantica; BrasilFil: Silva Nogueira, David. Ministério da Ciência, Tecnologia, Inovações. Instituto Nacional de Pesquisas da Amazônia; BrasilFil: Almeida Marques, Dayse Willkenia. Ministério da Ciência, Tecnologia, Inovações. Instituto Nacional de Pesquisas da Amazônia; BrasilFil: Nunes Barbosa, Diego. Universidade Federal do Paraná; BrasilFil: Mello Mendes, Diego Matheus. Instituto de Desenvolvimento Sustentável Mamirauá; BrasilFil: Galvão de Pádua, Diego. Ministério da Ciência, Tecnologia, Inovações. Instituto Nacional de Pesquisas da Amazônia; BrasilFil: Silva Vilela, Diogo. Universidade Estadual Paulista Julio de Mesquita Filho; BrasilFil: Gomes Viegas, Eduarda Fernanda. Ministério da Ciência, Tecnologia, Inovações. Instituto Nacional de Pesquisas da Amazônia; BrasilFil: Carneiro dos Santos, Eduardo. Universidade Federal do Paraná; BrasilFil: Rodrigues Fernandes, Daniell Rodrigo. Ministério da Ciência, Tecnologia, Inovações. Instituto Nacional de Pesquisas da Amazônia; Brasi

ATLANTIC ‐ PRIMATES : a dataset of communities and occurrences of primates in the Atlantic Forests of South America

Primates play an important role in ecosystem functioning and offer critical insights into human evolution, biology, behavior, and emerging infectious diseases. There are 26 primate species in the Atlantic Forests of South America, 19 of them endemic. We compiled a dataset of 5,472 georeferenced locations of 26 native and 1 introduced primate species, as hybrids in the genera Callithrix and Alouatta. The dataset includes 700 primate communities, 8,121 single species occurrences and 714 estimates of primate population sizes, covering most natural forest types of the tropical and subtropical Atlantic Forest of Brazil, Paraguay and Argentina and some other biomes. On average, primate communities of the Atlantic Forest harbor 2 ± 1 species (range = 1–6). However, about 40% of primate communities contain only one species. Alouatta guariba (N = 2,188 records) and Sapajus nigritus (N = 1,127) were the species with the most records. Callicebus barbarabrownae (N = 35), Leontopithecus caissara (N = 38), and Sapajus libidinosus (N = 41) were the species with the least records. Recorded primate densities varied from 0.004 individuals/km2 (Alouatta guariba at Fragmento do Bugre, Paraná, Brazil) to 400 individuals/km2 (Alouatta caraya in Santiago, Rio Grande do Sul, Brazil). Our dataset reflects disparity between the numerous primate census conducted in the Atlantic Forest, in contrast to the scarcity of estimates of population sizes and densities. With these data, researchers can develop different macroecological and regional level studies, focusing on communities, populations, species co‐occurrence and distribution patterns. Moreover, the data can also be used to assess the consequences of fragmentation, defaunation, and disease outbreaks on different ecological processes, such as trophic cascades, species invasion or extinction, and community dynamics. There are no copyright restrictions. Please cite this Data Paper when the data are used in publications. We also request that researchers and teachers inform us of how they are using the data.Fil: Culot, Laurence. Universidade Estadual Paulista Julio de Mesquita Filho; BrasilFil: Pereira, Lucas Augusto. Universidade Estadual Paulista Julio de Mesquita Filho; BrasilFil: Agostini, Ilaria. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Nordeste. Instituto de Biología Subtropical. Universidad Nacional de Misiones. Instituto de Biología Subtropical; Argentina. Centro de Investigaciones del Bosque Atlántico; ArgentinaFil: de Almeida, Marco Antônio Barreto. Pontificia Universidade Católica do Rio Grande do Sul; BrasilFil: Alves, Rafael Souza Cruz. Universidade Estadual Paulista Julio de Mesquita Filho; BrasilFil: Baldovino, María Celia. Centro de Investigaciones del Bosque Atlántico; Argentina. Universidad Nacional de Tucumán. Facultad de Ciencias Naturales e Instituto Miguel Lillo. Instituto Miguel Lillo; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Tucumán; ArgentinaFil: Di Bitetti, Mario Santiago. Centro de Investigaciones del Bosque Atlántico; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Nordeste. Instituto de Biología Subtropical. Instituto de Biología Subtropical - Nodo Puerto Iguazú | Universidad Nacional de Misiones. Instituto de Biología Subtropical. Instituto de Biología Subtropical - Nodo Puerto Iguazú; ArgentinaFil: Oklander, Luciana Inés. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Nordeste. Instituto de Biología Subtropical. Instituto de Biología Subtropical - Nodo Puerto Iguazú | Universidad Nacional de Misiones. Instituto de Biología Subtropical. Instituto de Biología Subtropical - Nodo Puerto Iguazú; ArgentinaFil: Holzmann, Ingrid. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Salta. Instituto de Bio y Geociencias del NOA. Universidad Nacional de Salta. Facultad de Ciencias Naturales. Museo de Ciencias Naturales. Instituto de Bio y Geociencias del NOA; ArgentinaFil: Dums, Marcos. RUMO S.A. Licenciamento Ambiental; BrasilFil: Lombardi, Pryscilla Moura. RUMO S.A. Licenciamento Ambiental; BrasilFil: Bonikowski, Renata Twardowsky Ramalho. RUMO S.A. Licenciamento Ambiental; BrasilFil: Age, Stéfani Gabrieli. RUMO S.A. Licenciamento Ambiental; BrasilFil: Souza Alves, João Pedro. Universidade Federal de Pernambuco; BrasilFil: Chagas, Renata. Universidade Federal da Paraíba; BrasilFil: da Cunha, Rogério Grassetto Teixeira. Universidade Federal de Alfenas; BrasilFil: Valença Montenegro, Monica Mafra. Centro Nacional de Pesquisa e Conservaçao de Primates Brasileiros; BrasilFil: Ludwig, Gabriela. Centro Nacional de Pesquisa e Conservaçao de Primates Brasileiros; BrasilFil: Jerusalinsky, Leandro. Centro Nacional de Pesquisa e Conservaçao de Primates Brasileiros; BrasilFil: Buss, Gerson. Centro Nacional de Pesquisa e Conservaçao de Primates Brasileiros; BrasilFil: de Azevedo, Renata Bocorny. Centro Nacional de Pesquisa e Conservaçao de Primates Brasileiros; BrasilFil: Filho, Roberio Freire. Universidade Federal de Pernambuco; BrasilFil: Bufalo, Felipe. Universidade Estadual Paulista Julio de Mesquita Filho; BrasilFil: Milhe, Louis. Université D'Avignon et des Pays du Vaucluse; FranciaFil: Santos, Mayara Mulato dos. Universidade Estadual Paulista Julio de Mesquita Filho; BrasilFil: Sepulvida, Raíssa. Universidade Estadual Paulista Julio de Mesquita Filho; BrasilFil: Ferraz, Daniel da Silva. Universidade do Estado de Minas Gerais; BrasilFil: Faria, Michel Barros. Universidade do Estado de Minas Gerais; BrasilFil: Ribeiro, Milton Cezar. Universidade Estadual Paulista Julio de Mesquita Filho; BrasilFil: Galetti, Mauro. Universidade Estadual Paulista Julio de Mesquita Filho; Brasi

Algorithms to predict cerebral malaria in murine models using the SHIRPA protocol

<p>Abstract</p> <p>Background</p> <p><it>Plasmodium berghei </it>ANKA infection in C57Bl/6 mice induces cerebral malaria (CM), which reproduces, to a large extent, the pathological features of human CM. However, experimental CM incidence is variable (50-100%) and the period of incidence may present a range as wide as 6-12 days post-infection. The poor predictability of which and when infected mice will develop CM can make it difficult to determine the causal relationship of early pathological changes and outcome. With the purpose of contributing to solving these problems, algorithms for CM prediction were built.</p> <p>Methods</p> <p>Seventy-eight <it>P. berghei</it>-infected mice were daily evaluated using the primary SHIRPA protocol. Mice were classified as CM+ or CM- according to development of neurological signs on days 6-12 post-infection. Logistic regression was used to build predictive models for CM based on the results of SHIRPA tests and parasitaemia.</p> <p>Results</p> <p>The overall CM incidence was 54% occurring on days 6-10. Some algorithms had a very good performance in predicting CM, with the area under the receiver operator characteristic (_auROC) curve ≥ 80% and positive predictive values (PV+) ≥ 95, and correctly predicted time of death due to CM between 24 and 72 hours before development of the neurological syndrome (_auROC = 77-93%; PV+ = 100% using high cut off values). Inclusion of parasitaemia data slightly improved algorithm performance.</p> <p>Conclusion</p> <p>These algorithms work with data from a simple, inexpensive, reproducible and fast protocol. Most importantly, they can predict CM development very early, estimate time of death, and might be a valuable tool for research using CM murine models.</p

MAMMALS IN PORTUGAL : A data set of terrestrial, volant, and marine mammal occurrences in P ortugal

Mammals are threatened worldwide, with 26% of all species being includedin the IUCN threatened categories. This overall pattern is primarily associatedwith habitat loss or degradation, and human persecution for terrestrial mam-mals, and pollution, open net fishing, climate change, and prey depletion formarine mammals. Mammals play a key role in maintaining ecosystems func-tionality and resilience, and therefore information on their distribution is cru-cial to delineate and support conservation actions. MAMMALS INPORTUGAL is a publicly available data set compiling unpublishedgeoreferenced occurrence records of 92 terrestrial, volant, and marine mam-mals in mainland Portugal and archipelagos of the Azores and Madeira thatincludes 105,026 data entries between 1873 and 2021 (72% of the data occur-ring in 2000 and 2021). The methods used to collect the data were: live obser-vations/captures (43%), sign surveys (35%), camera trapping (16%),bioacoustics surveys (4%) and radiotracking, and inquiries that represent lessthan 1% of the records. The data set includes 13 types of records: (1) burrowsjsoil moundsjtunnel, (2) capture, (3) colony, (4) dead animaljhairjskullsjjaws, (5) genetic confirmation, (6) inquiries, (7) observation of live animal (8),observation in shelters, (9) photo trappingjvideo, (10) predators dietjpelletsjpine cones/nuts, (11) scatjtrackjditch, (12) telemetry and (13) vocalizationjecholocation. The spatial uncertainty of most records ranges between 0 and100 m (76%). Rodentia (n=31,573) has the highest number of records followedby Chiroptera (n=18,857), Carnivora (n=18,594), Lagomorpha (n=17,496),Cetartiodactyla (n=11,568) and Eulipotyphla (n=7008). The data setincludes records of species classified by the IUCN as threatened(e.g.,Oryctolagus cuniculus[n=12,159],Monachus monachus[n=1,512],andLynx pardinus[n=197]). We believe that this data set may stimulate thepublication of other European countries data sets that would certainly contrib-ute to ecology and conservation-related research, and therefore assisting onthe development of more accurate and tailored conservation managementstrategies for each species. There are no copyright restrictions; please cite thisdata paper when the data are used in publications.info:eu-repo/semantics/publishedVersio

Mammals in Portugal: a data set of terrestrial, volant, and marine mammal occurrences in Portugal

Mammals are threatened worldwide, with ~26% of all species being included in the IUCN threatened categories. This overall pattern is primarily associated with habitat loss or degradation, and human persecution for terrestrial mammals, and pollution, open net fishing, climate change, and prey depletion for marine mammals. Mammals play a key role in maintaining ecosystems functionality and resilience, and therefore information on their distribution is crucial to delineate and support conservation actions. MAMMALS IN PORTUGAL is a publicly available data set compiling unpublished georeferenced occurrence records of 92 terrestrial, volant, and marine mammals in mainland Portugal and archipelagos of the Azores and Madeira that includes 105,026 data entries between 1873 and 2021 (72% of the data occurring in 2000 and 2021). The methods used to collect the data were: live observations/captures (43%), sign surveys (35%), camera trapping (16%), bioacoustics surveys (4%) and radiotracking, and inquiries that represent less than 1% of the records. The data set includes 13 types of records: (1) burrows | soil mounds | tunnel, (2) capture, (3) colony, (4) dead animal | hair | skulls | jaws, (5) genetic confirmation, (6) inquiries, (7) observation of live animal (8), observation in shelters, (9) photo trapping | video, (10) predators diet | pellets | pine cones/nuts, (11) scat | track | ditch, (12) telemetry and (13) vocalization | echolocation. The spatial uncertainty of most records ranges between 0 and 100 m (76%). Rodentia (n =31,573) has the highest number of records followed by Chiroptera (n = 18,857), Carnivora (n = 18,594), Lagomorpha (n = 17,496), Cetartiodactyla (n = 11,568) and Eulipotyphla (n = 7008). The data set includes records of species classified by the IUCN as threatened (e.g., Oryctolagus cuniculus [n = 12,159], Monachus monachus [n = 1,512], and Lynx pardinus [n = 197]). We believe that this data set may stimulate the publication of other European countries data sets that would certainly contribute to ecology and conservation-related research, and therefore assisting on the development of more accurate and tailored conservation management strategies for each species. There are no copyright restrictions; please cite this data paper when the data are used in publications

Canagliflozin and renal outcomes in type 2 diabetes and nephropathy

BACKGROUND Type 2 diabetes mellitus is the leading cause of kidney failure worldwide, but few effective long-term treatments are available. In cardiovascular trials of inhibitors of sodium–glucose cotransporter 2 (SGLT2), exploratory results have suggested that such drugs may improve renal outcomes in patients with type 2 diabetes. METHODS In this double-blind, randomized trial, we assigned patients with type 2 diabetes and albuminuric chronic kidney disease to receive canagliflozin, an oral SGLT2 inhibitor, at a dose of 100 mg daily or placebo. All the patients had an estimated glomerular filtration rate (GFR) of 30 to &lt;90 ml per minute per 1.73 m2 of body-surface area and albuminuria (ratio of albumin [mg] to creatinine [g], &gt;300 to 5000) and were treated with renin–angiotensin system blockade. The primary outcome was a composite of end-stage kidney disease (dialysis, transplantation, or a sustained estimated GFR of &lt;15 ml per minute per 1.73 m2), a doubling of the serum creatinine level, or death from renal or cardiovascular causes. Prespecified secondary outcomes were tested hierarchically. RESULTS The trial was stopped early after a planned interim analysis on the recommendation of the data and safety monitoring committee. At that time, 4401 patients had undergone randomization, with a median follow-up of 2.62 years. The relative risk of the primary outcome was 30% lower in the canagliflozin group than in the placebo group, with event rates of 43.2 and 61.2 per 1000 patient-years, respectively (hazard ratio, 0.70; 95% confidence interval [CI], 0.59 to 0.82; P=0.00001). The relative risk of the renal-specific composite of end-stage kidney disease, a doubling of the creatinine level, or death from renal causes was lower by 34% (hazard ratio, 0.66; 95% CI, 0.53 to 0.81; P&lt;0.001), and the relative risk of end-stage kidney disease was lower by 32% (hazard ratio, 0.68; 95% CI, 0.54 to 0.86; P=0.002). The canagliflozin group also had a lower risk of cardiovascular death, myocardial infarction, or stroke (hazard ratio, 0.80; 95% CI, 0.67 to 0.95; P=0.01) and hospitalization for heart failure (hazard ratio, 0.61; 95% CI, 0.47 to 0.80; P&lt;0.001). There were no significant differences in rates of amputation or fracture. CONCLUSIONS In patients with type 2 diabetes and kidney disease, the risk of kidney failure and cardiovascular events was lower in the canagliflozin group than in the placebo group at a median follow-up of 2.62 years

Search for new particles in events with energetic jets and large missing transverse momentum in proton-proton collisions at root s=13 TeV

A search is presented for new particles produced at the LHC in proton-proton collisions at root s = 13 TeV, using events with energetic jets and large missing transverse momentum. The analysis is based on a data sample corresponding to an integrated luminosity of 101 fb(-1), collected in 2017-2018 with the CMS detector. Machine learning techniques are used to define separate categories for events with narrow jets from initial-state radiation and events with large-radius jets consistent with a hadronic decay of a W or Z boson. A statistical combination is made with an earlier search based on a data sample of 36 fb(-1), collected in 2016. No significant excess of events is observed with respect to the standard model background expectation determined from control samples in data. The results are interpreted in terms of limits on the branching fraction of an invisible decay of the Higgs boson, as well as constraints on simplified models of dark matter, on first-generation scalar leptoquarks decaying to quarks and neutrinos, and on models with large extra dimensions. Several of the new limits, specifically for spin-1 dark matter mediators, pseudoscalar mediators, colored mediators, and leptoquarks, are the most restrictive to date.Peer reviewe