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- Zhou, J. M., et al.
(författare)
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Digoxin is associated with worse outcomes in patients with heart failure with reduced ejection fraction
- 2020
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Ingår i: Esc Heart Failure. - : Wiley. - 2055-5822. ; 7:1, s. 139-147
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Tidskriftsartikel (refereegranskat)abstract
- Aims The aim of this study was to investigate the impact of digoxin use on the outcomes of patients with heart failure with reduced ejection fraction (HFrEF) and its possible interaction with atrial fibrillation or use of currently guideline-recommended treatments in the real world in China. Methods and results Patients hospitalized with HFrEF from 45 hospitals participating in the China National Heart Failure Registration Study (CN-HF) were enrolled to assess the all-cause mortality, HF mortality, all-cause re-hospitalization, and HF re-hospitalization associated with digoxin use. Eight hundred eighty-two eligible HFrEF patients in the CN-HF registry were included: 372 patients with digoxin and 510 patients without digoxin. Among them, 794 (90.0%) patients were followed up for the endpoint events, with a median follow-up of 28.6 months. Kaplan-Meier survival analysis showed that the all-cause mortality (P < 0.001) and all-cause re-hospitalization (P = 0.020) were significantly higher in digoxin group than non-digoxin group, while HF mortality (P = 0.232) and HF re-hospitalization (P = 0.098) were similar between the two groups. The adjusted Cox proportional-hazards regression analysis demonstrated that digoxin use remained as an independent risk factor for increased all-cause mortality [hazard ratio (HR) 1.76; 95% confidence interval (CI) 1.27-2.44; P = 0.001] and all-cause re-hospitalization (HR 1.27; 95% CI 1.03-1.57; P = 0.029) in HFrEF patients and the predictive value of digoxin for all-cause mortality irrespective of rhythm or in combination with other guideline-recommended therapies. Conclusions Digoxin use is independently associated with increased risk of all-cause mortality and all-cause re-hospitalization in HFrEF patients.
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- Bousquet, J, et al.
(författare)
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Nrf2-interacting nutrients and COVID-19: time for research to develop adaptation strategies
- 2020
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Ingår i: Clinical and translational allergy. - : Wiley. - 2045-7022. ; 10:1, s. 58-
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Tidskriftsartikel (refereegranskat)abstract
- There are large between- and within-country variations in COVID-19 death rates. Some very low death rate settings such as Eastern Asia, Central Europe, the Balkans and Africa have a common feature of eating large quantities of fermented foods whose intake is associated with the activation of the Nrf2 (Nuclear factor (erythroid-derived 2)-like 2) anti-oxidant transcription factor. There are many Nrf2-interacting nutrients (berberine, curcumin, epigallocatechin gallate, genistein, quercetin, resveratrol, sulforaphane) that all act similarly to reduce insulin resistance, endothelial damage, lung injury and cytokine storm. They also act on the same mechanisms (mTOR: Mammalian target of rapamycin, PPARγ:Peroxisome proliferator-activated receptor, NFκB: Nuclear factor kappa B, ERK: Extracellular signal-regulated kinases and eIF2α:Elongation initiation factor 2α). They may as a result be important in mitigating the severity of COVID-19, acting through the endoplasmic reticulum stress or ACE-Angiotensin-II-AT1R axis (AT1R) pathway. Many Nrf2-interacting nutrients are also interacting with TRPA1 and/or TRPV1. Interestingly, geographical areas with very low COVID-19 mortality are those with the lowest prevalence of obesity (Sub-Saharan Africa and Asia). It is tempting to propose that Nrf2-interacting foods and nutrients can re-balance insulin resistance and have a significant effect on COVID-19 severity. It is therefore possible that the intake of these foods may restore an optimal natural balance for the Nrf2 pathway and may be of interest in the mitigation of COVID-19 severity.
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- Zhong, Z. H., et al.
(författare)
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Direct Evidence for Electron Acceleration Within Ion-Scale Flux Rope
- 2020
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Ingår i: Geophysical Research Letters. - : AMER GEOPHYSICAL UNION. - 0094-8276 .- 1944-8007. ; 47:1
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Tidskriftsartikel (refereegranskat)abstract
- Energetic electrons have frequently been observed in small-scale flux ropes. However, whether these energetic electrons were energized directly within the flux rope or not is unknown. In this paper, we present concrete evidence provided by the Magnetospheric Multiscale mission that a secondary flux rope provided strong acceleration for electrons expelled by the reconnection X line. We find that the energetic electron fluxes inside the ion-scale flux rope were larger than those outside the flux rope. Electrons were adiabatically accelerated by betatron and Fermi mechanisms inside the flux rope. The highest energy electrons (>100 keV) were produced by betatron acceleration, whereas Fermi acceleration was unable to accelerate the electrons to high energy probably due to the finite distance of the acceleration region along the field-aligned direction. These results confirm the essential role of ion-scale flux ropes in producing energetic electrons.
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- Zhong, Z. H., et al.
(författare)
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Extension of the Electron Diffusion Region in a Guide Field Magnetic Reconnection at Magnetopause
- 2020
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Ingår i: Astrophysical Journal Letters. - : IOP PUBLISHING LTD. - 2041-8205 .- 2041-8213. ; 892:1
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Tidskriftsartikel (refereegranskat)abstract
- The structure of the electron diffusion region (EDR) in different plasma regimes is an outstanding question related to magnetic reconnection. Here we report a long EDR that extended at least 20 ion inertial lengths downstream of an X line at the Earth's magnetopause, which was observed by the Magnetospheric Multiscale mission. This EDR was detected in the exhaust of an asymmetric magnetic reconnection with a moderate guide field, the reconnection rate of which was similar to 0.1. It corresponds to strong positive energy dissipation (J . E' > 0) and enhancement of electron nongyrotropy. The energy dissipation was contributed by the electron jet and non-ideal electric field along the outflow direction, which suggests that the EDR probably plays more important roles in the energy conversion in magnetic reconnection than previously thought. Our result could be a significant step toward fully understanding the structure of the EDR.
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