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Comparative efficacy of sodium glucose cotransporter-2 inhibitors in the management of type 2 diabetes mellitus:A real-world experience

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World Journal of Diabetes 2024年第3期15卷 463-474页

作者： Lubna Islam Dhanya Jose Mohammed Alkhalifah Dania Blaibel Vishnu Chandrabalan Joseph M Pappachan Department of Endocrinology and Metabolism Lancashire Teaching Hospitals NHS TrustPreston PR29HTUnited Kingdom Department of Community Medicine Goa Medical CollegeGoa 403202India Department of Family Medicine King Faisal Specialist HospitalRiyadh 11564Saudi Arabia Department of Data Science Lancashire Teaching Hospitals NHS TrustPreston PR29HTUnited Kingdom Faculty of Science Manchester Metropolitan UniversityAll Saints BuildingManchester M156BHUnited Kingdom Faculty of Biology Medicine and HealthThe University of ManchesterManchester M139PLUnited Kingdom

BACKGROUND Sodium glucose cotransporter-2 inhibitors(SGLT-2i)are a class of drugs with modest antidiabetic efficacy,weight loss effect,and cardiovascular benefits as proven by multiple randomised controlled trials(RCTs).However,real-world data on the comparative efficacy and safety of individual SGLT-2i medications is *** To study the comparative efficacy and safety of SGLT-2i using real-world clinical *** We evaluated the comparative efficacy data of 3 SGLT-2i drugs(dapagliflozin,canagliflozin,and empagliflozin)used for treating patients with type 2 diabetes *** on the reduction of glycated hemoglobin(HbA1c),body weight,blood pressure(BP),urine albumin creatinine ratio(ACR),and adverse effects were recorded *** Data from 467 patients with a median age of 64(14.8)years,294(62.96%)males and 375(80.5%)Caucasians were *** diabetes duration was 16.0(9.0)years,and the duration of SGLT-2i use was 3.6(2.1)***-2i molecules used were dapagliflozin 10 mg(n=227;48.6%),canagliflozin 300 mg(n=160;34.3%),and empagliflozin 25 mg(n=80;17.1).Baseline median(interquartile range)HbA1c in mmol/mol were:dapagliflozin-78.0(25.3),canagliflozin-80.0(25.5),and empagliflozin-75.0(23.5)*** respective median HbA1c reduction at 12 months and the latest review(just prior to the study)were:66.5(22.8)&69.0(24.0),67.0(16.3)&66.0(28.0),and 67.0(22.5)&66.5(25.8)respectively(P<0.001 for all comparisons from baseline).Significant improvements in body weight(in kilograms)from baseline to study end were noticed with dapagliflozin-101(29.5)to 92.2(25.6),and canagliflozin 100(28.3)to 95.3(27.5)*** reductions in median systolic and diastolic BP,from 144(21)mmHg to 139(23)mmHg;(P=0.015),and from 82(16)mmHg to 78(19)mmHg;(P<0.001)respectively were also observed.A significant reduction of microalbuminuria was observed with canagliflozin only[ACR 14.6(42.6)at baseline to 8.9(23.7)at the study end;P=0.043].Adverse effects

关键词： Sodium glucose cotransporter-2 inhibitors Empagliflozin Canagliflozin Dapagliflozin Type 2 diabetes mellitus Cardiovascular disease Albumin creatinine ratio Diabesity

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Toward a Security Community in Asia? The Limits of Constructivism, Developmental Statism, Liberalism, and Realism

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International Relations and Diplomacy 2022年第1期10卷 1-24页

作者： Sorpong Peou toronto metropolitan university TorontoCanada

This article asks whether a regional security community has emerged in Asia with the potential to grow mature and seeks to make a contribution to the ongoing debate on this controversial *** advances the argument that states in this broad region are far from being able to develop a security community for reasons different from those provided by political realists,developmental statists,liberals,and constructivists(social,discursive,and emancipationist).The role of Association of Southeast Asia(ASEAN)and that of China provide excellent test cases for the theoretical proposition that the building of a successful regional security community requires at least two necessary conditions:liberal democracy and regional democratic leadership,which remain absent in Asia.

关键词： regional security community Asia ASEAN China European Union North America constructivism liberalism political realism liberal democracy regional democratic leadership

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The skeletal muscle fiber periphery:A nexus of mTOR-related anabolism

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运动医学与健康科学(英文) 2023年第1期5卷 10-19页

作者： Cassidy T.Tinline-Goodfellow Matthew J.Lees Nathan Hodson Faculty of Kinesiology and Physical Education University of TorontoCanada Institute of Sport Manchester Metropolitan UniversityManchesterUnited Kingdom Department of Sport and Exercise Sciences Manchester Metropolitan UniversityManchesterUnited Kingdom

Skeletal muscle anabolism is driven by numerous stimuli such as growth factors,nutrients(i.e.,amino acids,glucose),and mechanical *** stimuli are integrated by the mechanistic target of rapamycin(mTOR)complex 1(mTORC1)signal transduction *** recent years,work from our laboratory and elsewhere has sought to unravel the molecular mechanisms underpinning the mTOR-related activation of muscle protein synthesis(MPS),as well as the spatial regulation of these mechanisms within the skeletal muscle *** studies have suggested that the skeletal muscle fiber periphery is a region of central importance in anabolism(i.e.,growth/MPS).Indeed,the fiber periphery is replete with the substrates,molecular machinery,and translational apparatus necessary to facilitate *** review provides a summary of the mechanisms underpinning the mTOR-associated activation of MPS from cell,rodent,and human *** also presents an overview of the spatial regulation of mTORC1 in response to anabolic stimuli and outlines the factors that distinguish the periphery of the cell as a highly notable region of skeletal muscle for the induction of *** research should seek to further explore the nutrient-induced activation of mTORC1 at the periphery of skeletal muscle fibers.

关键词： Skeletal muscle mTOR Periphery Muscle protein synthesis Hypertrophy Translation

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Sodium glucose cotransporter-2 inhibitors and heart disease:Current perspectives

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World Journal of Cardiology 2024年第5期16卷 240-259页

作者： Sunetra Mondal Subhodip Pramanik Vibhu Ranjan Khare Cornelius James Fernandez Joseph M Pappachan Department of Endocrinology NRS Medical CollegeKolkata 700020West BengalIndia Department of Endocrinology Neotia Getwel Multispecialty HospitalsSiliguri 734010West BengalIndia Department of Endocrinology and Metabolism Pilgrim HospitalUnited Lincolnshire Hospitals NHS TrustBoston PE219QSUnited Kingdom Department of Endocrinology and Metabolism Lancashire Teaching Hospitals NHS TrustPreston PR29HTUnited Kingdom Faculty of Science Manchester Metropolitan UniversityManchester M156BHUnited Kingdom Faculty of Biology Medicine&HealthThe University of ManchesterManchester M139PLUnited Kingdom

Sodium glucose cotransporter-2 inhibitors(SGLT-2i)are antidiabetic medications with remarkable cardiovascular(CV)benefits proven by multiple randomised controlled trials and real-world *** drugs are also useful in the prevention of CV disease(CVD)in patients with diabetes mellitus(DM).Although DM as such is a huge risk factor for CVD,the CV benefits of SGLT-2i are not just because of antidiabetic *** molecules have proven beneficial roles in prevention and management of nondiabetic CVD and renal disease as *** are various molecular mechanisms for the organ protective effects of SGLT-2i which are still being *** understanding of the role of SGLT-2i in prevention and management of CVD is important not only for the cardiologists but also for other specialists caring for various illnesses which can directly or indirectly impact care of heart *** clinical review compiles the current evidence on the rational use of SGLT-2i in clinical practice.

关键词： SGLT2 inhibitors SGLT2i Cardiovascular disease Heart failure Atherosclerotic cardiovascular disease Diabetic kidney disease

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Management of male obesity-related secondary hypogonadism:A clinical update

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World Journal of Experimental Medicine 2024年第2期14卷 11-28页

作者： Mohan T Shenoy Sunetra Mondal Cornelius James Fernandez Joseph M Pappachan Department of Endocrinology Sree Gokulam Medical Collegeand Research FoundationTrivandrum 695607KeralaIndia Department of Endocrinology NRS Medical College and HospitalKolkata 700014West BengalIndia Department of Endocrinology&Metabolism Pilgrim HospitalUnited Lincolnshire Hospitals NHS TrustBoston PE219QSUnited Kingdom Department of Endocrinology and Metabolism Lancashire Teaching Hospitals NHS TrustPreston PR29HTUnited Kingdom Faculty of Science Manchester Metropolitan UniversityManchester M156BHUnited Kingdom Faculty of Biology Medicine&HealthThe University of ManchesterManchester M139PLUnited Kingdom

The global obesity pandemic has resulted in a rise in the prevalence of male obesity-related secondary hypogonadism(MOSH)with emerging evidence on the role of testosterone *** aim to provide an updated and practical approach towards its *** did a comprehensive literature search across MEDLINE(via PubMed),Scopus,and Google Scholar databases using the keywords“MOSH”OR“Obesity-related hypogonadism”OR“Testosterone replacement therapy”OR“Selective estrogen receptor modulator”OR“SERM”OR“Guidelines on male hypogonadism”as well as a manual search of references within the articles.A narrative review based on available evidence,recommendations and their practical implications was *** weight loss is the ideal therapeutic strategy for patients with MOSH,achievement of significant weight reduction is usually difficult with lifestyle changes alone in real-world ***,androgen administration is often necessary in the management of hypogonadism in patients with MOSH which also improves many other comorbidities related to ***,there is conflicting evidence for the appropriate use of testosterone replacement therapy(TRT),and it can also be associated with *** evidence-based review updates the available evidence including the very recently published results of the TRAVERSE trial and provides comprehensive clinical practice pearls for the management of patients with *** starting testosterone replacement in functional hypogonadism of obesity,it would be desirable to initiate lifestyle modification to ensure weight *** should be coupled with the management of other comorbidities related to obesity in MOSH *** the risks and benefits of TRT should be considered in every patient before and during longterm management.

关键词： Male obesity-related secondary hypogonadism Androgen therapy Testosterone replacement therapy Obesity Cardiovascular benefits

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Exploring spatiotemporal patterns of geosocial media data for urban functional zone identification

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International Journal of Digital Earth 2022年第1期15卷 1305-1325页

作者： Aleta Mawuenyegah Songnian Li Shishuo Xu Department of Civil Engineering Toronto Metropolitan UniversityTorontoCanada School of Geomatics and Urban Spatial Informatics Beijing University of Civil Engineering and ArchitectureBeijingPeople’s Republic of China Key Laboratory of Urban Spatial Informatics Ministry of Natural Resources of the People’s Republic of ChinaBeijingPeople’s Republic of China

Urban Functional Zones(UFZs)can be identified by measuring the spatiotemporal patterns of activities that occur within *** media data possesses abundant spatial and temporal information for activity *** UFZs from geosocial media data aids urban planning,infrastructure,resource allocation,and transportation modernization in the complex urban *** this work,we proposed an integrated approach by combining the spatiotemporal clustering method with a machine learning *** spatiotemporal clustering method was used to mine the spatiotemporal patterns of activities,of which the distinctive features were extracted as inputs into a machine learning classifier for UFZ *** results show that more than 80%of the UFZs can be correctly identified by our proposed *** reveals that this work serves as a functional groundwork for future studies,facilitating the understanding of urban systems as well as promoting sustainable urban development.

关键词： Urban functional zones geosocial media twitter spatiotemporal clustering random forest

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Achieving superior strength-ductility synergy in a heterostructured magnesium alloy via low-temperature extrusion and low-temperature annealing

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Journal of Materials Science & Technology 2023年第32期163卷 32-44页

作者： H.Wang D.T.Zhang C.Qiu W.W.Zhang D.L.Chen Guangdong Key Laboratory for Advanced Metallic Materials Processing and Forming National Engineering Research Center of Near-net-shape Forming for Metallic MaterialsSouth China University of TechnologyGuangzhou 510640China Department of Mechanical and Industrial Engineering Toronto Metropolitan University(formerly Ryerson University)350 Victoria StreetTorontoON M5B 2K3Canada

A low-alloyed Mg-1.2Zn-0.1Ca(wt.%)alloy was fabricated via low-temperature extrusion and annealing at 250℃for different times(10,30,and 90 min)to attain heterostructures with different fine-grained fractions,focusing on the effect of heterostructure on the mechanical *** dynamic recrystallization(RX)occurred during extrusion at 150℃,and a lamellar structure consisting of fine RX grains and coarse unRX grains was *** subsequent annealing promoted static RX in the as-extruded alloy,leading to an increased fine-grained fraction from 67%to 95%.Meanwhile,the co-segregation of Zn and Ca atoms impeded the migration of grain boundaries,thus achieving a fine grain size of 0.8–1.6μ*** sample annealed for 10 min with a fine-grained fraction of 73%and an average RX grain size of 0.9μm exhibited a superior combination of high yield strength(305 MPa)and good ductility(20%).In comparison,an excellent elongation of 30%was achieved in the alloy with a nearly fully-RXed microstructure and an average grain size of 1.6μm after 90 min annealing,despite a lower yield strength of 228 *** unRX grains,the hard orientation with(01–10)parallel to the extrusion direction and high-density dislocations made it more difficult to deform compared with the RX grains,thus producing hetero-deformation induced(HDI)*** fine grains and high-density dislocations,HDI strengthening is the key to achieving the superior mechanical properties of the low-alloyed Mg alloy.

关键词： Low-alloyed magnesium alloy Low-temperature extrusion Annealing Heterostructure Mechanical properties

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Identifying urban functional zones by capturing multi-spatial distribution patterns of points of interest

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International Journal of Digital Earth 2022年第1期15卷 2468-2494页

作者： Quan Qin Shishuo Xu Mingyi Du Songnian Li School of Geomatics and Urban Spatial Informatics Beijing University of Civil Engineering and ArchitectureBeijingPeople’s Republic of China Key Laboratory of Urban Spatial Informatics Ministry of Natural Resources of the People’s Republic of ChinaBeijingPeople’s Republic of China Department of Civil Engineering Toronto Metropolitan UniversityTorontoCanada

Urban Functional Zone(UFZ)identification is vital for urban planning,renewal,and *** of Interest(POI),as one of the most popular data in UFZ studies,is transformed into a geo-corpus under specific sampling strategies,which can be used with Natural Language Processing(NLP)technology to extract geo-semantic features and identify ***,existing studies only capture a single spatial distribution pattern of POIs,while ignoring the other spatial distribution *** this paper,we developed an integrated geo-corpus construction approach to capture multi-spatial distribution patterns of POIs that were represented by different modal POI ***,random forest model was leveraged to classify UFZs based on those embeddings.A set of combination experiments were designed for performance *** results show that our proposed method can effectively identify UFZs with an accuracy of 72.9%,with an improvement of 8.5%compared to the baseline *** outcome of this study will help urban planners to better understand UFZs through investigating the integrated spatial distribution patterns of POIs embedded in UFZs.

关键词： Urban functional zone point of interest spatial distribution pattern natural language processing word2vec

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A preliminary study on rectal dose reduction associated with hyaluronic acid implantation in brachytherapy for prostate cancer

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Asian Journal of Urology 2024年第2期11卷 286-293页

作者： Tairo Kashihara Yuka Urago Hiroyuki Okamoto Mihiro Takemori Hiroki Nakayama Shohei Mikasa Tetsu Nakaichi Kotaro Iijima Takahito Chiba Junichi Kuwahara Satoshi Nakamura Weishan Chang Yoshiyuki Matsui Hiroshi Igaki Department of Radiation Oncology National Cancer Center Hospital5-1-1 TsukijiChuo-kuTokyoJapan Radiation Safety and Quality Assurance Division National Cancer Center Hospital5-1-1 TsukijiChuo-kuTokyoJapan Department of Radiological Sciences Graduate School of Human Health SciencesTokyo Metropolitan University7-2-10 Higashi-OguArakawa-kuTokyoJapan Department of Radiological Technology National Cancer Center Hospital5-1-1 TsukijiChuo-kuTokyoJapan Department of Urological Oncology National Cancer Center Hospital5-1-1 TsukijiChuo-kuTokyoJapan

Objectives: Hydrogel spacer (HS) was developed to reduce rectal toxicities caused by radiotherapy, but has been reported to cause major adverse events. Our institute has attempted to introduce a hyaluronic acid (HA) as an alternative spacer. This study aimed to compare rectal doses and geometric distributions between the HS and HA implantation in prostate ***: HS and HA were inserted in 20 and 18 patients undergoing high-dose brachytherapy, respectively. The rectum spacer volumes injected were 10 mL and 22 mL, respectively. In the treatment planning system, 13.5 Gy was administered with common catheter positions. The rectal dose indices were assessed between the spacer groups for dosimetry evaluation. Distances between the prostate and rectum and configurations of the spacers were ***: The mean doses irradiated to 0.1 and 2 mL of the rectum were 10.45 Gy and 6.71 Gy for HS, and 6.73 Gy and 4.90 Gy for HA (p<0.001). The mean minimum distances between the prostate and rectum were 1.23 cm and 1.79 cm for HS and HA, respectively (p<0.05). Geometrical configuration comparisons revealed that HA has a higher ability to expand the space than ***: The rectal dose reduction ability of HA is significantly greater than that of HS, suggesting its potential as a new spacer.

关键词： Brachytherapy Hyaluronicacid Hydrogel Prostaticneoplasm Radiotherapy

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Interdepartmental miscommunication regarding radiology:Addressing chronic challenges and exploring solutions

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World Journal of Radiology 2024年第5期16卷 109-114页

作者： Nikolaos-Achilleas Arkoudis Emmanouil Karofylakis Ornella Moschovaki-Zeiger Spyridon Prountzos Evgenia Efthymiou George Samonis Christos Koutserimpas Research Unit of Radiology and Medical Imaging National and Kapodistrian University of AthensAthens 11528Greece The Second Department of Radiology General University Hospital“Attikon”National and Kapodistrian University of AthensChaidari 12462Greece Addenbrooke’s Hospital Cambridge University Hospitals NHS Foundation TrustCambridge CB20QQUnited Kingdom Department of Medicine University of CreteHeraklionCrete 71500Greece The First Department of Oncology Metropolitan HospitalNeon FalironAthens 18547Greece Orthopaedics Surgery and Sports Medicine Department FIFA Medical Centre of ExcellenceCroix-Rousse HospitalLyon University HospitalLyon 69004France Department of Anatomy National and Kapodistrian University of AthensAthens 11527Greece

Effective communication and collaboration among healthcare professionals are crucial for delivering high-quality patient *** miscommunication poses a significant challenge to healthcare systems,potentially undermining the quality of healthcare services *** the same manner,communication barriers between referring physicians and radiologists can specifically affect radiology services and patient *** article attempts to put the spotlight on the ever-present chronic challenges of this issue and prompt readers to recognize the relevant potential pitfalls in their daily clinical *** solutions are explored and proposed,which should be tailored to the specific needs and issues that each individual institution may face.

关键词： Radiology Miscommunication Collaboration Barriers Solutions Patient care Healthcare services Referring physician Challenges Medical

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