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Blood clots, skin lesions among newly identified possible COVID-19 symptoms

Blood clots, skin rashes and other lesions might be among the symptoms some people experience with COVID-19, according to new research released Thursday.




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Face-aging app increases sunscreen use among teens by 50%, study finds

A face-aging app could encourage young people to protect their skin from harmful UV rays and lessen their risk for skin cancer, a study published Wednesday by JAMA Dermatology has found.




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The Effects of Intensive Glycemic Control on Clinical Outcomes Among Patients With Type 2 Diabetes With Different Levels of Cardiovascular Risk and Hemoglobin A1c in the ADVANCE Trial

OBJECTIVE

To study whether the effects of intensive glycemic control on major vascular outcomes (a composite of major macrovascular and major microvascular events), all-cause mortality, and severe hypoglycemia events differ among participants with different levels of 10-year risk of atherosclerotic cardiovascular disease (ASCVD) and hemoglobin A1c (HbA1c) at baseline.

RESEARCH DESIGN AND METHODS

We studied the effects of more intensive glycemic control in 11,071 patients with type 2 diabetes (T2D), without missing values, in the Action in Diabetes and Vascular Disease: Preterax and Diamicron Modified Release Controlled Evaluation (ADVANCE) trial, using Cox models.

RESULTS

During 5 years’ follow-up, intensive glycemic control reduced major vascular events (hazard ratio [HR] 0.90 [95% CI 0.83–0.98]), with the major driver being a reduction in the development of macroalbuminuria. There was no evidence of differences in the effect, regardless of baseline ASCVD risk or HbA1c level (P for interaction = 0.29 and 0.94, respectively). Similarly, the beneficial effects of intensive glycemic control on all-cause mortality were not significantly different across baseline ASCVD risk (P = 0.15) or HbA1c levels (P = 0.87). The risks of severe hypoglycemic events were higher in the intensive glycemic control group compared with the standard glycemic control group (HR 1.85 [1.41–2.42]), with no significant heterogeneity across subgroups defined by ASCVD risk or HbA1c at baseline (P = 0.09 and 0.18, respectively).

CONCLUSIONS

The major benefits for patients with T2D in ADVANCE did not substantially differ across levels of baseline ASCVD risk and HbA1c.




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Continuous Glucose Monitoring in Pregnancy: Importance of Analysing Temporal Profiles to Understand Clinical Outcomes

OBJECTIVE

To determine if temporal glucose profiles differed between 1) women who were randomized to real-time continuous glucose monitoring (RT-CGM) or self-monitored blood glucose (SMBG), 2) women who used insulin pumps or multiple daily insulin injections (MDIs), and 3) women whose infants were born large for gestational age (LGA) or not, by assessing CGM data obtained from the Continuous Glucose Monitoring in Women With Type 1 Diabetes in Pregnancy Trial (CONCEPTT).

RESEARCH DESIGN AND METHODS

Standard summary metrics and functional data analysis (FDA) were applied to CGM data from the CONCEPTT trial (RT-CGM, n = 100; SMBG, n = 100) taken at baseline and at 24- and 34-weeks gestation. Multivariable regression analysis determined if temporal differences in 24-h glucose profiles occurred between comparators in each of the three groups.

RESULTS

FDA revealed that women using RT-CGM had significantly lower glucose (0.4–0.8 mmol/L [7–14 mg/dL]) for 7 h/day (0800 h–1200 h and 1600 h–1900 h) compared with those with SMBG. Women using pumps had significantly higher glucose (0.4–0.9 mmol/L [7–16 mg/dL]) for 12 h/day (0300 h to 0600 h, 1300 h to 1800 h, and 2030 h to 0030 h) at 24 weeks with no difference at 34 weeks compared with MDI. Women who had an LGA infant ran a significantly higher glucose by 0.4–0.7 mmol/L (7–13 mg/dL) for 4.5 h/day at baseline; by 0.4–0.9 mmol/L (7–16 mg/dL) for 16 h/day at 24 weeks; and by 0.4–0.7 mmol/L (7–13 mg/dL) for 14 h/day at 34 weeks.

CONCLUSIONS

FDA of temporal glucose profiles gives important information about differences in glucose control and its timing, which are undetectable by standard summary metrics. Women using RT-CGM were able to achieve better daytime glucose control, reducing fetal exposure to maternal glucose.




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Hospitalization for Lactic Acidosis Among Patients With Reduced Kidney Function Treated With Metformin or Sulfonylureas

OBJECTIVE

To compare the risk of lactic acidosis hospitalization between patients treated with metformin versus sulfonylureas following development of reduced kidney function.

RESEARCH DESIGN AND METHODS

This retrospective cohort combined data from the National Veterans Health Administration, Medicare, Medicaid, and the National Death Index. New users of metformin or sulfonylureas were followed from development of reduced kidney function (estimated glomerular filtration rate [eGFR] <60 mL/min/1.73 m2 or serum creatinine ≥1.4 mg/dL [female] or 1.5 mg/dL [male]) through hospitalization for lactic acidosis, death, loss to follow-up, or study end. Lactic acidosis hospitalization was defined as a composite of primary discharge diagnosis or laboratory-confirmed lactic acidosis (lactic acid ≥2.5 mmol/L and either arterial blood pH <7.35 or serum bicarbonate ≤19 mmol/L within 24 h of admission). We report the cause-specific hazard of lactic acidosis hospitalization between metformin and sulfonylureas from a propensity score–matched weighted cohort and conduct an additional competing risks analysis to account for treatment change and death.

RESULTS

The weighted cohort included 24,542 metformin and 24,662 sulfonylurea users who developed reduced kidney function (median age 70 years, median eGFR 55.8 mL/min/1.73 m2). There were 4.18 (95% CI 3.63, 4.81) vs. 3.69 (3.19, 4.27) lactic acidosis hospitalizations per 1,000 person-years among metformin and sulfonylurea users, respectively (adjusted hazard ratio [aHR] 1.21 [95% CI 0.99, 1.50]). Results were consistent for both primary discharge diagnosis (aHR 1.11 [0.87, 1.44]) and laboratory-confirmed lactic acidosis (1.25 [0.92, 1.70]).

CONCLUSIONS

Among veterans with diabetes who developed reduced kidney function, occurrence of lactic acidosis hospitalization was uncommon and not statistically different between patients who continued metformin and those patients who continued sulfonylureas.




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Commercially Available Insulin Products Demonstrate Stability Throughout the Cold Supply Chain Across the U.S.

OBJECTIVE

A recent publication questioned the integrity of insulin purchased from U.S. retail pharmacies. We sought to independently validate the method used, isotope dilution solid-phase extraction (SPE) liquid chromatography mass spectrometry (LC-MS), and expand analysis to two U.S. Pharmacopeia (USP) methods (high-performance LC with ultraviolet detection and LC-MS).

RESEARCH DESIGN AND METHODS

Each method was used to evaluate nine insulin formulations, purchased at four pharmacies, within five geographic locations in the U.S.

RESULTS

All human and analog insulins measured by the USP methods (n = 174) contained the expected quantity of active insulin (100 ± 5 units/mL). When using isotope dilution SPE-LC-MS, units-per-milliliter values were well below product labeling due to unequal recovery of the internal standard compared with target insulin.

CONCLUSIONS

Insulin purchased from U.S. pharmacies is consistent with product labeling.




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The Association of Energy and Macronutrient Intake at Dinner Versus Breakfast With Disease-Specific and All-Cause Mortality Among People With Diabetes: The U.S. National Health and Nutrition Examination Survey, 2003-2014

OBJECTIVE

This study aims to evaluate the association of energy and macronutrient intake at dinner versus breakfast with disease-specific and all-cause mortality in people with diabetes.

RESEARCH DESIGN AND METHODS

A total of 4,699 people with diabetes who enrolled in the National Health and Nutrition Examination Survey from 2003 to 2014 were recruited for this study. Energy and macronutrient intake was measured by a 24-h dietary recall. The differences () in energy and macronutrient intake between dinner and breakfast ( = dinner – breakfast) were categorized into quintiles. Death information was obtained from the National Death Index until 2015. Cox proportional hazards regression models were developed to evaluate the survival relationship between and diabetes, cardiovascular disease (CVD), and all-cause mortality.

RESULTS

Among the 4,699 participants, 913 deaths, including 269 deaths due to diabetes and 314 deaths due to CVD, were documented. After adjustment for potential confounders, compared with participants in the lowest quintile of in terms of total energy and protein, participants in the highest quintile were more likely to die due to diabetes (hazard ratio [HR]energy 1.92, 99% CI 1.08–3.42; HRprotein 1.92, 99% CI 1.06–3.49) and CVD (HRenergy 1.69, 99% CI 1.02–2.80; HRprotein 1.96, 99% CI 1.14–3.39). The highest quintile of total fat was related to CVD mortality (HR 1.67, 99% CI 1.01–2.76). Isocalorically replacing 5% of total energy at dinner with breakfast was associated with 4% and 5% lower risk of diabetes (HR 0.96, 95% CI 0.94–0.98) and CVD (HR 0.95, 95% CI 0.93–0.97) mortality, respectively.

CONCLUSIONS

Higher intake of energy, total fat, and protein from dinner than breakfast was associated with greater diabetes, CVD, and all-cause mortality in people with diabetes.




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Pennsylvania, Texas, California among states lifting coronavirus restrictions Friday

California, Iowa, Pennsylvania and Rhode Island are among states that are loosening coronavirus restrictions Friday to gradually revive their economies.




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Halley's Comet will spark Eta Aquarids meteor shower late Monday

Halley's Comet only orbits the sun once every 75 years, but each year in early May, the Earth passes through some of the debris that it left behind.




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USS Montgomery, USNS Cesar Chavez enter South China Sea to support drill ship

The USS Montgomery and the USNS Cesar Chavez sailed into the South China Sea this week in support of the West Capella drill ship, according to U.S. Indo-Pacific Command.




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[ Politics ] Open Question : Is it true many British and American banks and companies(Bank of England,UIC,Prescott Bush,etc) gave money and goods to Hitler secretly?




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Among Taxpayers, Inequality May Equal Cheating

Economists have long known there are two reasons that people cheat on their taxes. One is that they are poor and need the extra cash so badly they are willing to risk getting caught. The other is that they are rich and have lots of "non-matchable" income -- mostly investment income not directly...




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Cracked Foundation, Uncertain Future: Structural Weaknesses in the Common European Asylum System

During the 2015–16 migration crisis, European asylum systems were stretched to a breaking point. Yet many of the structural issues that contributed to failures to register newcomers, insufficient reception capacity, and growing backlogs of asylum cases existed before—and many remain unresolved. This report critically evaluates Common European Asylum System legal and operational shortcomings at a time when reform is on the table.




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Money Wise: Improving How EU Funds Support Migration and Integration Policy Objectives

European policymakers are negotiating the blueprint for the next EU funding cycle—a plan that will determine how much money is available for migration and integration aims, what it can be used for, and who can access it. This policy brief explores some of the limitations of EU funds, as well as strategies that could help them more effectively serve migration and integration policy goals.




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The Costs of Brain Waste among Highly Skilled Immigrants in Select States

Across the United States, nearly 2 million immigrants with college degrees are unemployed or stuck in low-skilled jobs. This skill underutilization, known as “brain waste,” varies significantly by state. These fact sheets offer a profile of these highly skilled immigrants and estimate their forgone earnings and resulting unrealized tax receipts in eight states: California, Florida, Michigan, New York, Ohio, Oregon, Texas, and Washington.




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New Brain Gain: Rising Human Capital among Recent Immigrants to the United States

Nearly half of immigrant adults arriving in the U.S. since 2011 have a college degree—a far higher share than a quarter-century ago, when just 27 percent did. This striking but little noted shift in the composition of recent immigrant flows, driven in part by rising migration from Asia, comes as some policymakers press for a "merit-based" immigration system. This fact sheet examines rising human capital at U.S. and state levels.




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As Brussels seeks fresh ideas to reform the Common European Asylum System, innovative member state responses offer a wealth of lessons–and some caution

Brussels and Gütersloh, 05.03.2020 — Anticipated reform of the Common European Asylum System (CEAS), which was high on the agenda as nearly 2 million asylum seekers arrived at Europe’s door in 2015-16, quickly fell victim to EU Member State competing views on what constitutes equal burden-sharing, domestic politics around migration and the urgency of first addressing overtaxed national asylum systems.




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Bbq barramundi, Jamon, minted peas, Dijon mustard dressing & Danish fetta

Delicious fish dish for a summer night.




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Garden peas, cauliflower, almonds, lemon

This recipe was featured on Foodie Tuesday, a weekly segment with Raf Epstein on Drive, 774 ABC Melbourne, 3:30 PM, courtesy of George Calombaris. George's new book is called "Greek."




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WARM FIGS WITH HONEY, ORANGE & CINNAMON

It's rare for me to cook fresh figs as I think there is little that can better a squishy-ripe, jammy fig eaten just as is. However just sometimes when they are cheap (well, relatively speaking!) and plentiful, I make this dish; it makes a lovely, simple summer dessert. The thing to be mindful of when you're buying figs, is that they're often picked when they're under-ripe as they're easier to handle and store, however if they're like this they're rarely worth eating; look for figs that feel softly squishy when you gently cup them in your hand, and ideally have tiny splits in the tender flesh...your care will pay off in spades.





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Grilled coconut salmon

4X 200G SKINLESS SALMON FILLETS 1 TSP. HIMALAYAN PINK SALT 1 TSP. GROUND WHITE PEPPER 60ML. COCONUT CREAM 1 TSP. GROUND TURMERIC SUNFLOWER OIL FOR BRUSHING TO SERVE: STEAMED RICE AND WILTED ASIAN GREENS




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Lamb kofte with lemon yogurt flatbread

700g minced lamb 30g pine nuts, roughly chopped 1/4 cup flat-leaf parsley, finely chopped 1/2 onion, diced 1 garlic clove, finely chopped 1 tsp cumin 1 tsp ground coriander 1/2 tsp dried chilli flakes (optional) zest of 1/2 lemon pinch of salt and pepper 3 tbsp. oil Lemon Flatbread 1 cup plain flour 1 1/2 tsp baking powder pinch of salt 3/4 cup plain yoghurt zest of 1/2 lemon




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Marinated crispy skinned salmon fillets

4 salmon fillets, skin on (175g per portion) 2 tbs soy sauce 1 tbs rice wine vinegar 1 tbs olive oil 1 clove garlic, minced 1 tbs ginger, mined 1 small red chilli 1 lime, juiced





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Potatoes with Lemon and Oregano

This recipe features on Foodie Tuesday, a weekly segment on 774 Drive with Raf Epstein, 3.30PM, courtesy of Kathy Tsaples.




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Flourless Chocolate Cake (almond meal)

This recipe features on Foodie Tuesday, a weekly segment on 774 Drive with Raf Epstein, 3.30PM, courtesy of Tad Lombardo Director & Head Chocolatier at Cioccolato Lombardo.




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Pumpkin soup with roasted almond pesto

Pumpkin soup on it's own can be rather plain but with interesting garnishes, the ordinary becomes delicious. This variation on a classic pesto, which uses pine nuts, incorporates roasted almonds instead, giving this ubiquitous winter soup a greater depth of flavour and crunch.




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ROASTED GREEN BEANS WITH LEMON AND ANCHOVIES

I nearly didn't write the word 'anchovies' in the name of this dish as I know that many people will pretty much automatically by-pass any recipe that has anchovies in it. It's such a shame, because (as is the case with many dishes that include them) they add a depth of flavour and intriguing background note that is perfectly delicious without being at all fishy. If you're one of my mob, and love them, then do give this recipe a try...it's such a simple dish yet full of flavour (I sometimes add a chopped red chilli at the end to give it a bit more oomph too.) The beans are terrific with any sort of grilled meat or fish.




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Choux puffs, lemon curd and whipped cream

This recipe features on Foodie Tuesday, a weekly segment on 774 Drive with Raf Epstein, 3.30PM, courtesy of Nicky Riemer at Union Dining.




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Luscious lemon slice

Base 180g butter, at room temperature 80g icing sugar 1 tsp vanilla extract 1 egg 225g plain flour Topping 315g castor sugar 4 eggs 2 egg yolks 1 tbs lemon zest 160ml lemon juice 40g plain flour




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Sesame, honey, ginger and soy grilled salmon with lime

Atlantic Salmon is Australia's most popular farmed fish and is a healthy weekly staple for many people. This recipe offers a marinade more commonly thought of for chicken however is simply delicious with salmon. Enjoy with a fresh local limes, which are in season from early April to mid September.




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Greek syrup drenched semolina, yoghurt and almond cake somali

1 1/2 cups fine semolina 1 1/2 cups sugar 1/2 cups Greek yogurt 2 tsps. baking soda 1/2 tsp ground mastic resin, we are substituting ground fennel 3-4 tbsps. butter, melted slivered almonds For the syrup: 2 1/2 cups sugar 1 1/2 cups water 1 lemon, cut in half 1/2 tsp. rose water Dash of vanilla extract 1 cinnamon stick





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Citrus cured salmon, pickled clams, herb emulsion

This recipe features on Foodie Tuesday, a weekly segment on 774 Drive with Raf Epstein, 3.30PM, courtesy of David Hall of Pure South Dining.





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Lemony myrtle delicious pudding

Sometimes these old desserts are just the ticket on a winter's night. We have used a little lemon myrtle powder to add that native home growing touch to this gorgeous pudding.







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Lemon Meringue Pie

For the pastry casing: 200g plain flour 100g butter 50g sugar zest of half a lemon 1g vanilla seed 1/2 egg (beat egg, then halve it - should be about 25g) For the curd: 450ml water 180g sugar 75g cornflour 3ea lemons 45g butter 4 eggs For the Italian meringue: 4 x egg whites 270g caster sugar 1 x drop lemon juice 100ml water




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Chocolate and almond torte with amaretto cream and fresh market raspberries

This is the biscuit base to sprinkle in top of the cake Make enough to accomodate 22 cm round tin 50 g Unsalted Butter 50 g Raw Sugar 50 g Almond Meal 8 g of Coco Powder Pinch of Salt 40 g plain Flour Beat all ingredients together in machine with k beater Roll into oblong wrap in glad and freeze Cake mix 250 g eggs or 5 x large eggs 75 g of local honey 125 g castor sugar beat all ingredients together 75 g Almond Meal 120 g plain Flour 25 g coco powder 8 g Baking powder sieve ingredients Add to egg mix then add 120 ml of double Cream Melt together 70 g 70% best quality chocolate 75 g unsalted butter




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Phillippa's Ginger Almond Shortbread

This recipe features on Foodie Tuesday, a weekly segment on 774 Drive at 3.30PM. It was shared by Phillippa Grogan, adapted from Phillippa's Home Baking written with Richard Cornish.




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Parmesan and Herby Crumbed Pork Loin with raw cabbage salad and lemon

4 x 150 x g of pork loin steaks as your butcher to cut 3 x cup (210 g) Panko Breadcrumbs (Japanese bread crumb) 1/2 cup (80g) Plain flour Chopped flat leaf parsley, thyme, rosemary 2 Eggs, lightly beaten 1/2cup (80g) finely grated Parmesan CABBAGE SLAW 500 grams of Cabbage finely shredded Squeezed of Lemon juice 1/4 cup (60 ml) quality cider vinegar add to taste. May need less. 2 Tablespoon of Macadamia Oil 1 Tablespoon chop parsley Aioli just a little bit to bind Sea salt and cracked pepper 100 ml Macadamia oil for cooking 4 juicy lemon wedges to squeeze over Pork




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Autumn roasted vegetables with lemon thyme and a drizzle of macadamia honey

Nothing beats beautifully roasted vegetables caramelized in their own sugar content to accompany a simple roast dinner or even on their own with a nice salad. The addition of perfumed lemon thyme and macadamia gives a nice touch.




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Preserved lemons

Preserved lemons are exotic, easily prepared at home and impart a flavour and perfume like no other - they are the next best thing to a holiday in Morocco, transforming any dish from the ho-hum to the sublime. When using them cooking, only use the yellow zest, discarding any white pith, pulp and juice. It is best to preserve lemons during autumn and spring when they are in season and have maximum aroma and juice. Any lemon worth its salt can be preserved, although having preserved a number of different varieties I can report most success with the thin-skinned Meyer lemon. I also think organic lemons give the best results. When choosing lemons for preserving, ensure you choose fully ripe, very yellow fragrant fruit with unblemished skin. In the case of store-bought lemons, wash well to remove the wax that is used to make them shiny.




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Myocardial Ischemic Burden and Differences in Prognosis Among Patients With and Without Diabetes: Results From the Multicenter International REFINE SPECT Registry

OBJECTIVE

Prevalence and prognostic impact of cardiovascular disease differ between patients with or without diabetes. We aimed to explore differences in the prevalence and prognosis of myocardial ischemia by automated quantification of total perfusion deficit (TPD) among patients with and without diabetes.

RESEARCH DESIGN AND METHODS

Of 20,418 individuals who underwent single-photon emission computed tomography myocardial perfusion imaging, 2,951 patients with diabetes were matched to 2,951 patients without diabetes based on risk factors using propensity score. TPD was categorized as TPD = 0%, 0% < TPD < 1%, 1% ≤ TPD < 5%, 5% ≤ TPD ≤ 10%, and TPD >10%. Major adverse cardiovascular events (MACE) were defined as a composite of all-cause mortality, myocardial infarction, unstable angina, or late revascularization.

RESULTS

MACE risk was increased in patients with diabetes compared with patients without diabetes at each level of TPD above 0 (P < 0.001 for interaction). In patients with TPD >10%, patients with diabetes had greater than twice the MACE risk compared with patients without diabetes (annualized MACE rate 9.4 [95% CI 6.7–11.6] and 3.9 [95% CI 2.8–5.6], respectively, P < 0.001). Patients with diabetes with even very minimal TPD (0% < TPD < 1%) experienced a higher risk for MACE than those with 0% TPD (hazard ratio 2.05 [95% CI 1.21–3.47], P = 0.007). Patients with diabetes with a TPD of 0.5% had a similar MACE risk as patients without diabetes with a TPD of 8%.

CONCLUSIONS

For every level of TPD >0%, even a very minimal deficit of 0% < TPD < 1%, the MACE risk was higher in the patients with diabetes compared with patients without diabetes. Patients with diabetes with minimal ischemia had comparable MACE risk as patients without diabetes with significant ischemia.




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Mental Health Risks and Resilience among Somali and Bhutanese Refugee Parents

Somali and Bhutanese refugees are two of the largest groups recently resettled in the United States and Canada. This report examines factors that might promote or undermine the mental health and overall well-being of children of these refugees, with regard to factors such as past exposure to trauma, parental mental health, educational attainment, social support, and discrimination.




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A Study of Pregnancy and Birth Outcomes among African-Born Women Living in Utah

Resettled African refugee women may experience particularly acute complications during pregnancy, birth, and the child's early infancy. Yet health care-providers and policymakers may not be aware of the particular challenges that these women and their children face. This report, examining women giving birth in Utah over a seven-year period, compares perinatal complications of the African born and a segment of the U.S. born.




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Mitigating the Effects of Trauma among Young Children of Immigrants and Refugees: The Role of Early Childhood Programs

The first years of a child’s life are a time of immense growth, and exposure to trauma—if left unaddressed—can have significant, lifelong effects. This issue brief examines how young children of refugees and other immigrants may be affected by trauma, and what early childhood education and care programs, health-care providers, and others can do to mitigate its adverse effects.