Empagliflozin lowers serum uric acid in chronic kidney disease: exploratory analyses from the EMPA-KIDNEY trial.

Background And Hypothesis: Hyperuricaemia and gout are common in chronic kidney disease (CKD). We aimed to assess the effects of sodium-glucose co-transporter-2 (SGLT2) inhibition on uric acid (urate) and gout in patients with CKD.

Methods: The EMPA-KIDNEY trial randomised 6609 patients with CKD (estimated glomerular filtration rate [eGFR] ≥20 and <90 mL/min/1.

Towards an understanding of the ethics of electronic consent in clinical trials.

There are good practical reasons to use electronic consent (e-consent) in randomised trials, especially when conducting large-scale clinical trials to answer population-level health research questions. However, determining ethical reasons for e-consent is not so clear and depends on a proper understanding of what e-consent means when used in clinical trials and its ethical significance. Here we focus on four features of ethical significance which give rise to a range of ethical considerations relating to e-consent and merit further focused ethics research.

Frailty, multimorbidity and polypharmacy: exploratory analyses of the effects of empagliflozin from the EMPA-KIDNEY trial.

Background: Sodium-glucose co-transporter-2 (SGLT2) inhibitors are recommended treatment for adults with chronic kidney disease (CKD), but uncertainty exists regarding their use in patients with frailty and/or multimorbidity, among whom polypharmacy is common. We derived a multivariable logistic regression model to predict hospitalization (reflecting frailty) and assessed empagliflozin's risk-benefit profile in a post-hoc analysis of the double-blind, placebo-controlled EMPA-KIDNEY trial.

Methods: The EMPA-KIDNEY trial randomized 6609 patients with CKD (estimated glomerular filtration rate [eGFR] ≥20<45 mL/min/1.

Effect of Fenofibrate on Progression of Diabetic Retinopathy.

Background: Findings from cardiovascular outcome trials suggest that fenofibrate therapy may reduce the progression of diabetic retinopathy.

Methods: We recruited and followed adults with nonreferable diabetic retinopathy or maculopathy using the national Diabetic Eye Screening (DES) program in Scotland. We randomly assigned participants to receive 145-mg fenofibrate tablets or placebo (taken daily or, in those with impaired renal function, on alternate days).

Diabetic Retinopathy and Quality of Life: A Systematic Review and Meta-Analysis.

Importance: The association between diabetic retinopathy (DR) and quality of life (QoL) has not been thoroughly investigated.

Objective: To investigate the association between DR and both vision-related QoL (VRQoL) and general health-related QoL (HRQoL).

Data Sources: MEDLINE, EBSCO, Embase, and Web of Science were searched from their inception to April 2022.

Effects of Empagliflozin on Fluid Overload, Weight, and Blood Pressure in CKD.

Significance Statement: SGLT2 inhibitors reduce risk of kidney progression, AKI, and cardiovascular disease, but the mechanisms of benefit are incompletely understood. Bioimpedance spectroscopy can estimate body water and fat mass. One quarter of the EMPA-KIDNEY bioimpedance substudy CKD population had clinically significant levels of bioimpedance-derived "Fluid Overload" at recruitment.

Intima-media thickness at the near or far wall of the common carotid artery in cardiovascular risk assessment.

Aims: Current guidelines recommend measuring carotid intima-media thickness (IMT) at the far wall of the common carotid artery (CCA). We aimed to precisely quantify associations of near vs. far wall CCA-IMT with the risk for atherosclerotic cardiovascular disease (CVD, defined as coronary heart disease or stroke) and their added predictive values.

Quality of care for secondary cardiovascular disease prevention in 2009-2017: population-wide cohort study of antiplatelet therapy use in Scotland.

Background: Antiplatelet therapy (APT) can substantially reduce the risk of further vascular events in individuals with established atherosclerotic cardiovascular disease (ASCVD). However, knowledge regarding the extent and determinants of APT use is limited.

Objectives: Estimate the extent and identify patient groups at risk of suboptimal APT use at different stages of the treatment pathway.

High aspect ratio diamond nanosecond laser machining.

Unlabelled: Laser processing of diamond has become an important technique for fabricating next generation microelectronic and quantum devices. However, the realization of low taper, high aspect ratio structures in diamond remains a challenge. We demonstrate the effects of pulse energy, pulse number and irradiation profile on the achievable aspect ratio with 532 nm nanosecond laser machining.

Diamond rotors.

The resolution of magic angle spinning (MAS) nuclear magnetic resonance (NMR) spectra remains bounded by the spinning frequency, which is limited by the material strength of MAS rotors. Since diamond is capable of withstanding 1.5-2.

Metabolic profiling of MRI-measured liver fat in the UK Biobank.

Objective: Liver fat associates with obesity-related metabolic disturbances and may precede incident diseases. Metabolomic profiles of liver fat in the UK Biobank were investigated.

Methods: Regression models assessed the associations between 180 metabolites and proton density liver fat fraction (PDFF) measured 5 years later through magnetic resonance imaging, as the difference (in SD units) of each log metabolite measure with 1-SD higher PDFF among those without chronic disease and not taking statins, and by diabetes and cardiovascular diseases.

Perceptions and goals of preoperative planning conversations between anesthesiology residents and attending physicians.

Study Objective: To systematically evaluate anesthesiology resident and attending perceptions of preoperative planning conversations (POPCs) and to generate understanding for improving the educational and clinical value of this practice.

Design: cross-sectional study.

Setting: two large Northeastern US academic residency training programs.

Modular Morphing Lattices for Large-Scale Underwater Continuum Robotic Structures.

In this study, we present a method to construct meter-scale deformable structures for underwater robotic applications by discretely assembling mechanical metamaterials. We address the challenge of scaling up nature-like deformable structures while remaining structurally efficient by combining rigid and compliant facets to form custom unit cells that assemble into lattices. The unit cells generate controlled local anisotropies that architect the global deformation of the robotic structure.

Empagliflozin in Patients with Chronic Kidney Disease.

Background: The effects of empagliflozin in patients with chronic kidney disease who are at risk for disease progression are not well understood. The EMPA-KIDNEY trial was designed to assess the effects of treatment with empagliflozin in a broad range of such patients.

Methods: We enrolled patients with chronic kidney disease who had an estimated glomerular filtration rate (eGFR) of at least 20 but less than 45 ml per minute per 1.

Population-wide cohort study of statin use for the secondary cardiovascular disease prevention in Scotland in 2009-2017.

Objective: To estimate the extent of suboptimal statin use for the secondary prevention of atherosclerotic cardiovascular disease (ASCVD) at different stages of the treatment pathway and identify patient groups at risk of suboptimal treatment.

Methods: National retrospective cohort study using linked National Health Service Scotland administrative data of adults hospitalised for an ASCVD event (n=167 978) from 2009 to 2017. Proportions of patients initiating, adhering to, discontinuing and reinitiating statins were calculated.

Metacognition, Mind Wandering, and Cognitive Flexibility: Understanding Creativity.

The goal of this article is to review work on mind wandering, metacognition and creativity in order to consider their relationship with cognitive flexibility. I introduce a model of the role that mind wandering and metacognition have in the generation and exploration of novel ideas and products in the creative process. I argue that managing the interaction between metacognition and mind wandering is the main role of cognitive flexibility in creativity.

Beyond 10-Year Risk: A Cost-Effectiveness Analysis of Statins for the Primary Prevention of Cardiovascular Disease.

Background: Cholesterol guidelines typically prioritize primary prevention statin therapy on the basis of 10-year risk of cardiovascular disease. The advent of generic pricing may justify expansion of statin eligibility. Moreover, 10-year risk may not be the optimal approach for statin prioritization.

Meta-Intelligence: Understanding, Control, and Interactivity between Creative, Analytical, Practical, and Wisdom-Based Approaches in Problem Solving.

A deeper understanding of the processes leading to problem framing and behind finding solutions to problems should help explain variability in the quality of the solutions to those problems. Using Sternberg's WICS model as the conceptual basis of problem solving, this article discusses the relations between creative, analytical, practical, and wisdom-based approaches as bases for solutions to problems. We use a construct of to encompass understanding, control, and coordination between these constructs.

Costs of Inaccurate Anesthesia Start Time Documentation Within a Health System.

Inaccurate anesthesia start time (AST) documentation can result in lost revenue. Using a retrospective analysis, we estimated lost revenue from inaccurate documentation of the AST within a single health care system, including academic and community-based facilities. We used differences in nursing documentation of "in-room" time and AST to calculate lost billable revenue.

Manifesto for new directions in developmental science.

Although developmental science has always been evolving, these times of fast-paced and profound social and scientific changes easily lead to disorienting fragmentation rather than coherent scientific advances. What directions should developmental science pursue to meaningfully address real-world problems that impact human development throughout the lifespan? What conceptual or policy shifts are needed to steer the field in these directions? The present manifesto is proposed by a group of scholars from various disciplines and perspectives within developmental science to spark conversations and action plans in response to these questions. After highlighting four critical content domains that merit concentrated and often urgent research efforts, two issues regarding "how" we do developmental science and "what for" are outlined.

Personalized Ventilation to Multiple Patients Using a Single Ventilator: Description and Proof of Concept.

Objectives: To design and test a ventilator circuit that can be used for ventilation of two or more patients with a single ventilator, while allowing individualization of tidal volume, fractional concentration of oxygen, and positive end-expiratory pressure to each patient, irrespective of the other patient's respiratory system mechanics.

Design: Description and proof of concept studies.

Settings: Respiratory therapy laboratory.