-
The New England Journal of Medicine Jun 2024Obstructive sleep apnea is characterized by disordered breathing during sleep and is associated with major cardiovascular complications; excess adiposity is an etiologic...
BACKGROUND
Obstructive sleep apnea is characterized by disordered breathing during sleep and is associated with major cardiovascular complications; excess adiposity is an etiologic risk factor. Tirzepatide may be a potential treatment.
METHODS
We conducted two phase 3, double-blind, randomized, controlled trials involving adults with moderate-to-severe obstructive sleep apnea and obesity. Participants who were not receiving treatment with positive airway pressure (PAP) at baseline were enrolled in trial 1, and those who were receiving PAP therapy at baseline were enrolled in trial 2. The participants were assigned in a 1:1 ratio to receive either the maximum tolerated dose of tirzepatide (10 mg or 15 mg) or placebo for 52 weeks. The primary end point was the change in the apnea-hypopnea index (AHI, the number of apneas and hypopneas during an hour of sleep) from baseline. Key multiplicity-controlled secondary end points included the percent change in AHI and body weight and changes in hypoxic burden, patient-reported sleep impairment and disturbance, high-sensitivity C-reactive protein (hsCRP) concentration, and systolic blood pressure.
RESULTS
At baseline, the mean AHI was 51.5 events per hour in trial 1 and 49.5 events per hour in trial 2, and the mean body-mass index (BMI, the weight in kilograms divided by the square of the height in meters) was 39.1 and 38.7, respectively. In trial 1, the mean change in AHI at week 52 was -25.3 events per hour (95% confidence interval [CI], -29.3 to -21.2) with tirzepatide and -5.3 events per hour (95% CI, -9.4 to -1.1) with placebo, for an estimated treatment difference of -20.0 events per hour (95% CI, -25.8 to -14.2) (P<0.001). In trial 2, the mean change in AHI at week 52 was -29.3 events per hour (95% CI, -33.2 to -25.4) with tirzepatide and -5.5 events per hour (95% CI, -9.9 to -1.2) with placebo, for an estimated treatment difference of -23.8 events per hour (95% CI, -29.6 to -17.9) (P<0.001). Significant improvements in the measurements for all prespecified key secondary end points were observed with tirzepatide as compared with placebo. The most frequently reported adverse events with tirzepatide were gastrointestinal in nature and mostly mild to moderate in severity.
CONCLUSIONS
Among persons with moderate-to-severe obstructive sleep apnea and obesity, tirzepatide reduced the AHI, body weight, hypoxic burden, hsCRP concentration, and systolic blood pressure and improved sleep-related patient-reported outcomes. (Funded by Eli Lilly; SURMOUNT-OSA ClinicalTrials.gov number, NCT05412004.).
PubMed: 38912654
DOI: 10.1056/NEJMoa2404881 -
Heliyon Jun 2024The discrepancy between the operating and design capacities of solar plants in eastern Uganda is alarming; about 35 % underperformance in solar power generation is...
The discrepancy between the operating and design capacities of solar plants in eastern Uganda is alarming; about 35 % underperformance in solar power generation is observed. The goal of the current study is to minimize this disparity by improving the design models. Considering only cell temperature in the power generation model is responsible for the observed difference in design and operational solar power generated, the present study used a thermocouple to directly measure cell temperature, an anemometer to measure wind speed, and a solar power meter to measure irradiance. These extrinsic factors were used to modify the power generation model based only on cell temperature through the direct correlation of cell temperature, wind speed, and irradiance with solar power generation. Thus, the absence of extrinsic factors (wind speed and irradiance) in the design models is responsible for the colossal drop in solar power generated. Empirically, the missing extrinsic factors were used to transform the implicit solar power model into an explicit model. The development of a solar power generation model, multiple differential models, simulation and experimentation with a pilot solar rig served as alternate model for the prediction of solar power generation. The second-order differential model validated well with empirical solar power generated in Busitema, Mayuge, Soroti, and Tororo study areas based on RMSEs (0.6437, 0.6692, 0.2008, 0.1804, respectively), thus, narrowing the gap between the designed and operational solar power generated. Mayuge and Soroti recorded the highest solar power generation of 9.028 MW compared to Busitema (8.622 MW) and Tororo (8.345 MW), suggesting that it has a conducive site for installing future solar plants. The above results support the use of empirical explicit (triple) and second-order differential models for the design and operation of power plants.
PubMed: 38912472
DOI: 10.1016/j.heliyon.2024.e32353 -
Heliyon Jun 2024In recent years, the use of solar photovoltaic (PV) energy, which is one of the leading renewable energy sources, has become increasingly widespread around the world due...
In recent years, the use of solar photovoltaic (PV) energy, which is one of the leading renewable energy sources, has become increasingly widespread around the world due to its numerous advantages. However, PV-based electricity generation necessitates a large amount of land. Agrivoltaic (AV) systems, an innovative approach to combining agricultural and electricity production in the same area through solar modules positioned several meters above the surface of the ground, are growing rapidly in renewable energy and farming communities. This study explores Turkey's solar power generation and agricultural activities, combining crop cultivation and electricity generation for sustainable development on the same land. Furthermore, the AV potential for the most agriculture ten cities in different climate zones in Turkey is investigated using the PVsyst program. A list of the most commonly grown crops in the ten selected cities and the types of AV systems that can be employed with these crops is provided. The results show that AV systems present a great opportunity for the optimal integration of solar power generation with food production, especially for the cities of Konya, Kayseri, and Manisa, with the most ideal conditions for agricultural and solar power production. By combining the solar power potential of the country with the production capacity of arable lands, the increasing energy needs can be met and more efficient agricultural production can be provided. This study is expected to demonstrate that in specific regions of Turkey, AV farming will be suitable for certain crops.
PubMed: 38912471
DOI: 10.1016/j.heliyon.2024.e32300 -
Frontiers in Plant Science 2024The expanding cannabis production sector faces economic challenges, intensified by freshwater scarcity in the main US production areas. Greenhouse cultivation harnesses...
The expanding cannabis production sector faces economic challenges, intensified by freshwater scarcity in the main US production areas. Greenhouse cultivation harnesses sunlight to reduce production costs, yet the impact of greenhouse light levels on crucial production components, such as plant growth, branching, and water use efficiency (WUE), remains poorly understood. This study aimed to assess the effects of combined sunlight and supplemental lighting on the crop's main production components and leaf gas exchange of 'Suver Haze' in the vegetative stage. Within a greenhouse, LED lighting provided at intensities of ~150, 300, 500, and 700 µmol m s (18-hour photoperiod), combined with solar radiation, resulted in average daily light integrals of 17.9, 29.8, 39.5, and 51.8 mol m d. Increasing light levels linearly increased biomass, leaf area, and the number of branches per plant and square meter, with respective rates of 0.26 g, 32.5 cm, and 0.41 branches per mole of additional light. As anticipated, crop evapotranspiration increased by 1.8-fold with the increase in light intensity yet crop WUE improved by 1.6-fold when comparing the lowest and highest light treatments. Moreover, water requirements per unit of plant biomass decreased from 0.37 to 0.24 liters per gram when lighting increased from ~18 to 52 mol m d, marking a 35% reduction in evapotranspiration. These results were supported by increments in leaf photosynthesis and WUE with light enhancement. Furthermore, our findings indicate that even 52 mol m d of supplemental lighting did not saturate any of the crop responses to light and can be economically viable for cannabis nurseries. In conclusion, light supplementation strongly enhanced photosynthesis and plant growth while increasing WUE. Additionally, a comprehensive discussion highlights the shared physiological mechanisms governing WUE in diverse plant species and their potential for water conservation under enhanced lighting conditions.
PubMed: 38911978
DOI: 10.3389/fpls.2024.1371702 -
ACS Omega Jun 2024Rabies is a zoonotic infection with the potential to infect all mammals and poses a significant threat to mortality. Although enzyme-linked immunosorbent tests and...
Rabies is a zoonotic infection with the potential to infect all mammals and poses a significant threat to mortality. Although enzyme-linked immunosorbent tests and real-time reverse transcription-quantitative polymerase chain reaction (RT-qPCR) have been established for rabies virus (RABV) detection, they require skilled staff. Here, we introduce a personal glucose meter (PGM)-based nucleic acid (NA-PGM) detection method to diagnose RABV. This method ensures sensitive and convenient RABV diagnosis through hybridization of reverse transcription-recombinase aided amplification (RT-RAA) amplicons with probes labeled with sucrose-converting enzymes, reaching a detection level as low as 6.3 copies/μL equivalent to 12.26 copies. NA-PGM allows for the differentiation of RABV from other closely related viruses. In addition, NA-PGM showed excellent performance on 65 clinical samples with a 100% accuracy rate compared with the widely adopted RT-qPCR method. Thus, our developed NA-PGM method stands out as sensitive, semiquantitative, and portable for RABV detection, showcasing promise as a versatile platform for a wide range of pathogens.
PubMed: 38911722
DOI: 10.1021/acsomega.4c01352 -
Journal of Alzheimer's Disease Reports 2024Slower walking is associated with changes in cortical volume and thickness. Computerized cognitive training (CCT) and exercise improve cortical volume and thickness and...
The Effect of Computerized Cognitive Training, with and without Exercise, on Cortical Volume and Thickness and Its Association with Gait Speed in Older Adults: A Secondary Analysis of a Randomized Controlled Trial.
BACKGROUND
Slower walking is associated with changes in cortical volume and thickness. Computerized cognitive training (CCT) and exercise improve cortical volume and thickness and thus, may promote gait speed. Slowing of gait is predictive of Alzheimer's disease.
OBJECTIVE
To examine: 1) the effect of CCT, with or without physical exercise, on cortical volume and thickness and; 2) the association of changes in cortical volume and thickness with changes in gait speed.
METHODS
A subset of 124 adults ( = 53), aged 65-85 years, enrolled in an 8-week randomized controlled trial and completed T1-weighted MRI and 4-meter walk at baseline and 8 weeks. Participants were randomized to: 1) active control (BAT; = 19); 2) CCT ( = 17); or 3) CCT preceded by exercise (Ex-CCT; = 17). Change in cortical volume and thickness were assessed and compared across all groups using Freesurfer.
RESULTS
BAT versus CCT increased left rostral middle frontal gyrus volume ( = 0.027) and superior temporal gyrus thickness ( = 0.039). Ex-CCT versus CCT increased left cuneus thickness ( < 0.001) and right post central gyrus thickness ( = 0.005), and volume ( < 0.001). Ex-CCT versus BAT increased left ( = 0.001) and right ( = 0.020) superior parietal gyri thickness. There were no significant between-group differences in gait speed ( > 0.175). Increased left superior parietal volume ( = 0.036, = 0.340) and thickness ( = 0.002, = 0.348), right post central volume ( = .017, = 0.341) and thickness ( = 0.001, = 0.348), left banks of superior temporal sulcus thickness ( = 0.002, = 0.356), and left precuneus thickness ( < 0.001, = 0.346) were associated with increased gait speed.
CONCLUSIONS
CCT with physical exercise, but not CCT alone, improves cortical volume and thickness in older adults. These changes may contribute to the maintenance of gait speed in aging.
PubMed: 38910947
DOI: 10.3233/ADR-230206 -
Medical Ultrasonography Jun 2024
Topics: Humans; Heart Neoplasms; Myxoma; Neoplasm Recurrence, Local; Female; Male; Middle Aged; Echocardiography
PubMed: 38909370
DOI: 10.11152/mu-4401 -
Nature Communications Jun 2024Soil organic carbon (SOC) persistence is predominantly governed by mineral protection, consequently, soil mineral-associated (MAOC) and particulate organic carbon (POC)...
Soil organic carbon (SOC) persistence is predominantly governed by mineral protection, consequently, soil mineral-associated (MAOC) and particulate organic carbon (POC) turnovers have different impacts on the vulnerability of SOC to climate change. Here, we generate the global MAOC and POC maps using 8341 observations and then infer the turnover times of MAOC and POC by a data-model integration approach. Global MAOC and POC storages are Pg C (mean with 5% and 95% quantiles) and Pg C, while global mean MAOC and POC turnover times are yr and yr in the top meter, respectively. Climate warming-induced acceleration of MAOC and POC decomposition is greater in subsoil than that in topsoil. Overall, the global atlas of MAOC and POC turnover, together with the global distributions of MAOC and POC stocks, provide a benchmark for Earth system models to diagnose SOC-climate change feedback.
PubMed: 38909059
DOI: 10.1038/s41467-024-49743-7 -
Scientific Data Jun 2024In studies of the relief evolution of smaller landforms, up to several dozen meters in width/diameter, digital elevation models (DEMs) freely accessible in different...
In studies of the relief evolution of smaller landforms, up to several dozen meters in width/diameter, digital elevation models (DEMs) freely accessible in different repositories may be insufficient in terms of resolution. Existing geophysical or photogrammetric equipment is not always available due to costs, conditions and regulations, especially for students or young researchers. An alternative may be the handy-held ground-based Structure from Motion technique. It allows us to obtain free high-resolution DEMs (~0.05 m) using open-source software. The method was tested on kettle holes of the glacial flood origin on Skeiðarársandur (S Iceland). The material was collected in 2022 at two outwash levels of different ages and vegetation cover. The dataset is available in the Zenodo repository; the first part is data processed in point clouds and DEMs, and the second includes original videos in MOV format. The data can be used as a reference to assess changes in the kettle hole relief in subsequent research seasons, as a methodological study for other projects, or for didactic purposes.
PubMed: 38906921
DOI: 10.1038/s41597-024-03515-6 -
Respiratory Care Jun 2024This study aimed to describe the use of pressured metered dose inhalers (pMDI) and dry powder inhalers (DPI) in Spanish patients in terms of socio-demographic,...
This study aimed to describe the use of pressured metered dose inhalers (pMDI) and dry powder inhalers (DPI) in Spanish patients in terms of socio-demographic, clinical, and functional characteristics in patients with asthma or COPD on maintenance treatment with inhaled therapy. A retrospective, descriptive, national, multicentre, and observational study using a database with 1.8 million patients from hospitals and primary care centers as a secondary information source. The sample included 24,102 subjects with asthma on maintenance therapy (26.0% with pMDI, 54.9% with DPI, and 19.0% with a combination of DPI + pMDI inhalers) and 12,858 subjects with COPD on maintenance therapy (26.1% with pMDI, 38.7% with DPI and 35.2% with a combination of pMDI + DPI inhalers, mostly extemporary triple therapy). In proportion, subjects ≥ 75 years old use more pMDI than DPI, while younger subjects (40-64 years old) use more DPI. An inhalation chamber was prescribed in 51.0% of asthma subjects and 47.2% of COPD subjects treated with pMDI. The use of an inhalation chamber increases with the degree of airflow limitation by disease and age. In subjects with comorbidities, pMDI inhaler use increased in those ≥75 years old for asthma and COPD subjects. Switching from pMDI to DPI and vice versa was relatively common: 25.5% of asthma subjects and 21.9% of COPD subjects treated with pMDI had switched from DPI in the previous year. On the contrary, 14.1% and 11.7% of asthma and COPD patients treated with DPI had switched from pMDI the last year. The use of pMDI or DPI can vary according to age, both in asthma and COPD. Switching from pMDI to DPI and vice versa is relatively common. Despite the availability of dual and triple therapy inhalers on the market, a considerable number of subjects were treated with multiple devices.
PubMed: 38906702
DOI: 10.4187/respcare.11643