EXPRESS: Effectiveness of HMG-CoA reductase inhibitors on inflammation and metabolic markers in the US-Mexico border Hispanic population.

HMG-CoA reductase inhibitors (statins) are commonly used for dyslipidemia management to reduce the risk of cardiovascular disease (CVD). High-sensitivity C-reactive protein (hs-CRP) is an emerging systematic low-grade inflammatory marker associated with atherosclerotic CVD development. Despite racial/ethnic disparities in the use and response of statins and the anti-inflammatory effects of statins, the effectiveness of statins on inflammation and metabolic markers is unknown among Hispanics. We performed a retrospective cohort study using 150 adult patients scheduled for an annual physical exam at a family medicine clinic between January 1, 2021, and December 31, 2021. Effect size with a 95% confidence interval (CI) was estimated using adjusted regression analyses. Among 150 patients, 52 (34.67%) received statins. Patients who received statins had significantly reduced median hs-CRP (1.9 vs. 3.2, p=0.007), mean low-density lipoprotein (LDL-C) (101.18 vs. 124.6, p<0.001), and total cholesterol (172.6 vs. 194.5, p<0.001) concentrations compared to those who did not receive statins. In the propensity-scores matched analysis, lower concentrations of log-transformed hs-CRP (regression coefficient [RC], -0.48; 95%CI: -0.89, -0.07), LDL-C (RC, -19.57; 95%CI: -33.04, -6.1), and total cholesterol (RC, -23.47; 95%CI: -38.96, -7.98) were associated with statin use. In addition, hepatic steatosis (adjusted relative risk [aRR]=0.25; 95%CI: 0.08, 0.78, p= 0.017) was significantly lower among patients with the use of statins. Our study suggests that HMG-CoA reductase inhibitors may help reduce inflammation among Hispanic patients with dyslipidemia and hypertension. These findings have useful implications for preventing risk and disparities associated with cardiovascular and other inflammatory-induced diseases among the fastest-growing US Hispanic minorities.

Assessment of rice yield and economic losses caused by ground-level O3 exposure in the Mekong delta region, Vietnam.

The Lower Mekong Delta region (LMD) accounts for 90% of Vietnam's rice exports; however, the air quality in the LMD is remarkably reduced by ground-level ozone (O3) pollution. This study aimed to quantify the relative yield and economic value losses in rice-growing crop seasons affected by ground-level O3 concentrations across the LMD. The results of this study can serve as a basis for extensive assessments for the following years and support environmental managers to propose control measures of O3 precursor emissions (NOx and VOCs) from man-made sectors, as well as build protective solutions for rice farming in LMD. Two ground-level O3 exposure metrics of M7 and AOT40 reflecting ground-level O3 pollution impacts, combined with the model of exposure-relative yield relationship (or surface O3-crop models), were used to assess losses of crop production (CPL) and economic cost losses (ECL) caused by rice crop yield reductions. For the M7 metric of ground-level O3 exposure, the average value was 14.746 ppbV, with levels ranging from 13.959 ppbV to 15.502 ppbV, and the affected area was spread across 1309.39 thousand hectares. The AOT40 exposure metric reached an average value of 11.490 ppbV, with a range of 0.000-31.665 ppbV. The highest exposure level was 17.503-31.653 ppbV, covering an area of 747.01 thousand hectares. The total CPL of the three rice crops over the LMD was 9593.52 tonnes (accounting for 0.039% of the total value of rice production in the region), with a total corresponding EPL of 62.405 billion VND (equivalent to 2761.01 thousand USD). The results are considered a baseline study to serve as a basis for extensive assessments for the following years and support for the environmental managers to propose control measures of O3 precursor emissions (NOx and VOCs) from man-made sectors as well as build protective solutions in rice farming in LMD shortly.

Early Effects of Ticagrelor Versus Clopidogrel on Peripheral Endothelial Function After Non-ST-Elevation Acute Coronary Syndrome and Assessment of Its Relationship With Coronary Microvascular Function.

Peripheral endothelial dysfunction is an independent predictor of adverse long-term prognosis after acute coronary syndrome. Data are lacking on the effects of oral P2Y12-inhibitors on peripheral endothelial function in non-ST-elevation acute coronary syndrome (NSTEACS). Furthermore, the relation between peripheral endothelial function and invasive indexes of coronary microvascular function in NSTEACS is unclear. Between March 2018 and July 2020, hospitalized patients with NSTEACS were randomized (1:1) to ticagrelor or clopidogrel. Peripheral endothelial function was assessed with brachial artery flow-mediated vasodilation (FMD). Invasive indexes of coronary microvascular function were obtained using an intracoronary pressure-temperature sensor-tipped wire. In 70 patients included, mean age was 58.6 years, 78.6% (n = 55) were male and 20% (n = 14) had diabetes mellitus. Compared with clopidogrel, ticagrelor significantly improved FMD (14.2 ± 5.4% vs 8.9 ± 5.3%, p <0.001) after a median treatment time of 41.2 hours. The FMD was significantly correlated with the index of microcirculatory resistance (IMR) measured in the infarct-related artery (r = -0.38, p = 0.001), with a stronger correlation found in those who did not have percutaneous coronary intervention (r = -0.52, p = 0.03). Using receiver operating characteristic curve analysis, an FMD of 8.2% identified an IMR of >34 as the threshold, with 77.6% sensitivity and 52.4% specificity. In patients who did not have a percutaneous coronary intervention, an FMD of 11.49% identified an IMR of >34 with 84.6% sensitivity and 80% specificity. In conclusion, ticagrelor significantly improved peripheral endothelial function compared with clopidogrel in patients with NSTEACS. There was a significant correlation between brachial artery FMD and IMR of the infarct-related artery.

Varied Health Spending Growth Across US States Was Associated With Incomes, Price Levels, And Medicaid Expansion, 2000-19.

Little is known about health care spending variation across the US for recent years. To estimate health spending by state and payer, we combined data from the government's State Health Expenditure Accounts, which have estimates through 2014, with other primary data on spending. In 2019 state-specific per person spending ranged from $7,250 to $14,500. After adjustment for inflation, annualized per person spending growth for each state ranged from 1.0 percent in Washington, D.C., to 4.2 percent in South Dakota between 2013 and 2019. The factors that explained the most variation across states were incomes (25.3 percent) and consumer prices (21.7 percent). Medicaid expansion was associated with increases in total spending per person, although the median of spending in expansion states showed slower growth in out-of-pocket spending than the median in nonexpansion states. Contemporary estimates of state health spending are valuable for tracking divergent expenditure trajectories in the US and assessing the associated factors.

Internet of Things Enabled Financial Crisis Prediction in Enterprises Using Optimal Feature Subset Selection-Based Classification Model.

At present time, an effective tool becomes essential to forecast business failure as well as financial crisis on small- to medium-sized enterprises. This article presents a new optimal feature selection (FS)-based classification model for financial crisis prediction (FCP). The proposed FCP method involves data acquisition, preprocessing, FS, and classification. Initially, the financial data of the enterprises are collected by the use of the internet of things devices, such as smartphones and laptops. Then, the pigeon-inspired optimization (PIO)-based FS technique is applied to choose an optimal set of features. Afterward, the extreme gradient boosting (XGB)-based classification optimized by the Jaya optimization (JO) algorithm called JO-XGB is employed to classify the financial data. The application of the JO algorithm helps to tune the parameters of the XGB model. A detailed experimental validation process takes place to ensure the performance of the presented PIO-JO-XGBoost model. The obtained simulation results verified the effectiveness of the presented model over the compared methods.

Integrated model for methane emission and dispersion assessment from landfills: A case study of Ho Chi Minh City, Vietnam.

Methane is considered to be one of the main causes of global warming. Quantifying methane emissions from landfills is the subject of many studies, especially emphasizing the role of two parameters: methane generation potential capacity (L0), methane generation rate (k). In this study, we propose a system of integrated environmental information and mathematical model named EnLandFill (ENvironmental information - model integrated system for air emission and dispersion estimation from LandFill) that allows calculation L0 from database and experimentally to determine optimal k. To perform experimental calculations, meteorological data were extracted from the WRF model and verified with real measurements. The novelty of this study lies in the inferred database system, the math model bank, especially the dispersion model, taking note account the complex topography, meteorological factors that change by the hour. EnLandFill was applied to Phuoc Hiep Landfill (PHLF) in Ho Chi Minh City as a case study, the results have identified the amount of methane released that is equal to 44,094,697.88 m3/year in 2019, but EnLandFill is designed to be general, applicable to other landfill entities.

Evaluation of a policy of selective drug-eluting stent implantation for patients at high risk of restenosis.

Drug-eluting stent (DES) deployment during percutaneous coronary intervention (PCI) has reduced target-vessel revascularisation rates (TVR). The selective use of DES in patients at highest risk of restenosis may allay concerns about universal compliance of dual antiplatelet therapy for one year, and potentially reduce costs. If this strategy achieved acceptably low TVR rates, such an approach could be attractive. Late clinical outcomes were examined in 2115 consecutive patients (mean age 63±12 years, 75% male, 22% diabetics) who underwent PCI in the first three years from October 2003, after commencing the following selective criteria for DES use: left main stenosis; ostial lesions of major epicardial arteries; proximal LAD lesions; lesions≥20mm in length with vessel diameter≤3.0mm; lesions in vessels≤2.5mm; diabetics with vessel(s)≤3.0mm; and in-stent restenosis. Among patients undergoing PCI, 2075 (98%) patients received stents (29%≥1 DES and 71% bare metal stent [BMS]), and among those who received DES, there was a 92% compliance with these criteria. There were no differences in clinical outcomes between the two stent groups except for definite stent thrombosis, which occurred in 2% after DES, and 0.6% after BMS at one year (p=0.002). With BMS, large coronary arteries (≥3.5mm), intermediate (3-3.49mm) and small arteries (<3mm) in diameter had a TVR rate at one year of 3.6%, 7.2% and 8.2% respectively (p=0.005). It is possible to use selective criteria for DES while maintaining low TVR rates. The TVR rate with BMS was low in those with stent diameters≥3.5mm. The higher DES stent thrombosis rate reflects first generation DES use, though whether routine second generation DES use reduces these rates needs confirmation.

Mandatory helmet legislation and the print media in Viet Nam.

With motorcycle ownership high and rising in Viet Nam, and motorcycle riders vulnerable to both fatal and non-fatal injury, the re-introduction of mandatory helmet legislation in 2007 has been a priority for the Vietnamese government. The paper uses a qualitative analysis of web-based versions of the eight most popular newspapers in Viet Nam to track reporting over four phases of the implementation of the legislation, identifying codes and constructing the dominant themes of the media coverage. The study documents the justification and promotion of the legislation, and the mechanisms for preparing for its implementation at a national and local level, developing solutions and encouraging the replication of successful strategies. It records opposition and obstacles to helmet use, and concerns raised around the quality of helmets purchased. In return, the press notes the response of the market in innovative solutions to these problems. With the successful implementation of the legislation, the functions of the print media in promulgating and promoting the legislation, together with the reporting of ongoing resistance to the process, serve to enable a dialogue between the State and population around expressed concerns. In highlighting quality control of helmets as a key issue, the media have identified a potential ongoing role in monitoring the state's initiative in reducing the road toll from traumatic brain injury in motorcyclists.

The metabolic cost of carrying a single- versus double-strap golf bag.

The purpose of this study was to compare energy expenditure and perceived comfort using two modes of carrying a golf bag. Fifteen men completed 2 trials of walking on a treadmill while carrying a golf bag. During 1 of 2 trials, an extra strap was added to convert a single-strap bag to a double-strap bag. The order was randomized. Oxygen consumption (L x min(-1)), heart rate, perceived exertion, and perceived comfort were measured during the 5-minute walk. Oxygen consumption was significantly lower carrying the double-strap golf bag (L x min(-1), p = 0.0004; ml x kg(-1) x min(-1), p < 0.0003), as were heart rate (p = 0.0013) and rate of perceived exertion (p < 0.005) During the double strap trial, the perceived comfort was higher (p < 0.005). Improvements in metabolic demands and comfort while carrying a double-strap golf bag should increase walking tolerance in golf.