Impact of Fenofibrate on Type 2 Diabetes Patients with Features of the Metabolic Syndrome: Subgroup Analysis From FIELD

Given evidence of increasing prevalence in developed and developing countries, as a result of obesity trends and sedentary lifestyles, the metabolic syndrome represents an increasing burden on healthcare systems. Management guidelines for dyslipidaemia have primarily focused on LDL-C reduction; however, this approach fails to sufficiently address other lipid abnormalities associated with the metabolic syndrome. Atherogenic dyslipidaemia (characterized by elevated triglycerides and low HDL-C) is strongly associated with insulin-resistant states, such as type 2 diabetes and the metabolic syndrome, and is also a common finding among patients receiving treatment for dyslipidaemia. Intervening against atherogenic dyslipidaemia may address a substantial modifiable fraction of residual cardiovascular risk that remains after treatment with a statin. Recent findings from the Fenofibrate Intervention and Event Lowering in Diabetes (FIELD) study support this view. Fenofibrate treatment was shown to be especially effective in treating marked atherogenic dyslipidaemia, with a significant 27% relative risk reduction for cardiovascular events (P=0.0005, vs. 11%, P=0.035 for all patients) relative to placebo. These data, together with the earlier demonstration of significant microvascular benefits associated with this treatment, suggest a role for fenofibrate, in addition to statin therapy and lifestyle intervention, for reducing global vascular risk in type 2 diabetes patients and for impacting atherogenic dyslipidaemia associated with the metabolic syndrome

Improving Bayesian Evidential Learning 1D imaging (BEL1D) accuracy through iterative prior resampling

Bayesian Evidential Learning 1D Imaging (BEL1D) has been recently introduced as a new computationally efficient tool for the interpretation of 1D geophysical datasets in a Bayesian framework. Applications have already been demonstrated for Surface Nuclear Magnetic Resonance (SNMR) data and surface waves dispersion curves. The case of SNMR is particularly relevant in hydrogeophysics, as it directly sounds the water content of the subsurface. BEL1D relies on the constitution of statistical relationships in a reduced dimension space between model parameters and simulated data using prior model samples that replicate the field experiment. In BEL1D, this relationship is deduced through Canonical Correlation Analysis (CCA). When using large prior distributions, CCA may lead to numerous poorly correlated distributions for higher dimensions. Those poorly correlated distributions are resulting in a low reduction of uncertainty on some parameters, even if the experiment is supposed to be sensitive to them. This phenomenon is related to the aggregation of multiple parameters in the same dimension, hence the possible aggregation of sensitive and insensitive parameters. However, arbitrarily reducing the extent of the prior will lead to biased estimations. To overcome this impediment, we introduce an iterative procedure, using the posterior model space of the previous iteration as prior model of the current iteration. This approach frequently reveals higher correlations between the datasets and the model parameters, while still using large unbiased priors. It enables BEL1D to produce better estimations of the posterior probability density functions of the model parameters. Nonetheless, iterating on BEL1D presents several challenges related to the presence of insensitive parameters, that will always mitigate the capacity to reduce at once the uncertainty on the whole set of parameters describing the models. On noise-free synthetic datasets, this method leads to near-exact estimation of the sensitive parameters after few (two to three) iterations. On noisy datasets, the resulting distributions bear some uncertainty, arising directly from the presence of noise, but to a lesser extent than the non-iterative approach.. The procedure remains more computationally efficient than McMC

log(TG)/HDL-C is related to both residual cardiometabolic risk and β-cell function loss in type 2 diabetes males

<p>Abstract</p> <p>Background</p> <p>T2DM is associated with atherogenic dyslipidemia (AD), defined as decreased HDL-C plus raised triglycerides (TG). AD confers increased risk for CAD, even when LDL-C is at target. AD is rarely assessed due to lack of screening methods consensus.</p> <p>Aim</p> <p>To establish the prevalence and severity of AD from <it>log</it>(TG)/HDL-C in T2DM males, and to determine how it relates to cardiometabolic phenotype, glucose homeostasis, micro- and macrovascular complications, and 10-year <it>UKPDS </it>CV risk.</p> <p>Methods</p> <p>585 T2DM males divided according to quintiles (Q) of <it>log</it>(TG)/HDL-C. AD prevalence defined as HDL-C <40 mg.dL^-1plus TG ≥150 mg.dL^-1. β-cell function assessed with HOMA.</p> <p>Results</p> <p>Mean HDL-C and TG were 44 (13) and 204 (155) mg.dL^-1. AD prevalence was 35%. AD correlated with lower β-cell function, with accelerated loss of insulin secretion, and with poorer HbA_1clevels. AD was related to a high prevalence of CAD, and also to 10-year absolute CAD risk.</p> <p>Conclusions</p> <p><it>log</it>(TG)/HDL-C is a simple means to estimate AD and the residual CV risk it confers in T2DM. AD closely associates with major cardiometabolic and glucose homeostasis determinants and poorer metabolic control. The ratio also relates to macroangiopathy prevalence and ranks future CAD risk, and is well-suited to capture non-LDL-related macrovascular residual risk and major glycemic determinants.</p

Geophysical investigation of the Pb-Zn deposit of Lontzen-Poppelsberg, Belgium

The drillhole information from the Lontzen-Poppelsberg site has demonstrated three orebodies and has allowed the estimation of the extension of the lodes, their dip, and the location at the ground surface. The localisation of the lodes makes them excellent targets for further exploration with geophysics. This deposit is classified as a Mississippi Valley Type (MVT) deposit. It consists mainly of Pb-Zn-Fe sulphides that display contrasting values in resistivity, chargeability, density, and magnetic susceptibility, with regards to the sedimentary host rocks. The dipole-dipole direct current (DC) resistivity and induce polarization (IP) profiles have been collected and inverted to successfully delineate the Pb-Zn mineralization and the geological structures. Short-spacing EM34 electromagnetic conductivity data were collected mainly on the top of Poppelsberg East lode and have revealed a conductive body matching with the geologically modelled mineralization. Gravity profiles have been carried out perpendicularly to the lode orientation; they show a strong structural anomaly. High resolution ground magnetic data were collected over the study area, but they showed no anomaly over the ore deposits. The geophysical inversion results are complementary to the model based on drill information, and allow us to refine the delineation of the mineralization. The identification of the geophysical signatures of this deposit permits targeting new possible mineralization in the area

Improving the accuracy of 1D SNMR surveys using the multi-central-loop configuration

Temeljna svrha i cilj ovoga rada bilo je ispitati koliko su potrošači skloni dijeljenju svojih turističkih iskustva s drugima te putem kojih medija. Osim navedenog, drugi cilj provedenog istraživanja bilo je utvrditi koliko su potrošačima važna iskustva i komentari drugih posjetitelja u procesu donošenja odluke o kupnji. Istraživanje je provedeno metodom ispitivanja, a kao instrument korišten je anketni upitnik sastavljen od 22 pitanja. Utvrđivanjem problema istraživanja, postavljene su tri hipoteze. Od tri hipoteze, u potpunosti je dokazana samo prva koja pretpostavlja da su potrošačima tuđa iskustva i komentari od velike važnosti kod planiranja i odabira putovanja. Druga hipoteza je djelomično potvrđena, tj. potvrđeno je da su potrošači skloni dijeliti svoja iskustva s drugima u situaciji kada su jako zadovoljni dok s druge strane nije potvrđeno kako su potrošači skloni dijeliti svoja iskustva u situaciji kada su nezadovoljni uslugom ili proizvodom. Na kraju, potvrđena je i treća hipoteza koja pretpostavlja kako su potrošači skloni dijeljenju vlastitog turističkog iskustva putem više društvenih medija, iako je utvrđeno kako najveći broj ispitanika ne dijeli svoja turistička iskustva. Istraživano je i mišljenje ispitanika o turističkoj destinaciji iz snova, a iznenađujuće, najveći broj ispitanika je navelo hrvatske destinacije kao svoje destinacije iz snova kao i one koje su im dosada pružile najnezaboravnije turističko iskustvo. Potrebno je provesti detaljnija istraživanja kako bi se detaljnije istražilo novije društvene medije koji su dostupni potrošačima za dijeljenje svog iskustva

Improving the accuracy of 1D SNMR surveys using the multi-central-loop configuration

A multi-central loop configuration has been studied through forward and inverse modelling of synthetics and real data. This set-up takes advantage of the multichannel features of the NMR device and consists of using several (2 to 3) additional receiver loops displayed concentrically with the main transmitter/receiver loop, which all record the NMR signal simultaneously within a single acquisition. If the loop diameters are chosen appropriately, the kernel sensitivity distributions for each receiver loop can show complementary features. Inverting simultaneously the data sets obtained through each different receiver loop can then enhance the accuracy of the final model. To do so, a 1D QT inversion scheme in the frequency domain dedicated to the inversion of multiple data sets is being used. One challenging feature is to adapt the regularization of the inverse process so as to handle correctly the noise originating from different data sets. The efficiency of this multi-central loop acquisition set-up and procedure is being assessed through the forward and inverse modelling of several scenarios implying varying aquifer characteristics. Finally a field case is being presented that was conducted on a low noise level site located in Germany, where conditions were favourable to the implementation and testing of circular multi-central loop configurations.We also introduce a new method for determining NMR parameters, named the prediction-focused-approach (PFA), that is based on statistical analysis of a large number of simple models. We observe, using synthetic examples, that the effciency of the method benefits from the use of the multi-central-loop configurations