le with T2DM. This trial was registered at PROSPERO (https//www.crd.york.ac.uk/PROSPERO/#recordDetails) as CRD42019120531.
 When compared with lower intake, increased MAC intake improved glycemic control, blood lipid, body weight, and inflammatory markers for people with T2DM. This trial was registered at PROSPERO (https//www.crd.york.ac.uk/PROSPERO/#recordDetails) as CRD42019120531.
  Atrial fibrillation (AF) is the most common cardiac arrhythmia and can lead to significant comorbidities and mortality. Persistence with oral anticoagulation (OAC) is crucial to prevent stroke but rates of discontinuation are high. This systematic review explored underlying reasons for OAC discontinuation.
 
  A systematic review was undertaken to identify studies that reported factors influencing discontinuation of OAC in AF, in 11 databases, grey literature and backwards citations from eligible studies published between 2000 and 2019. Two reviewers independently screened titles, abstracts and papers against inclusion criteria and extracted data. Study quality was appraised using Gough's weight of evidence framework. Data were synthesised narratively.
 
  Of 6,619 sources identified, 10 full studies and 2 abstracts met the inclusion criteria. Overall, these provided moderate appropriateness to answer the review question. Four reported clinical registry data, six were retrospective reviews of patients' medical poorly understood.
  To describe, in a real-life setting, the direct causes of death in a cohort of consecutive patients with giant cell arteritis (GCA).
 
  We retrospectively analyzed the deaths that occurred in a cohort of 470 consecutive GCA patients from a center of expertise between January 2000 and December 2019. Among the 120 patients who died, we retrieved data from the medical files of 101 patients.
 
  Cardiovascular events were the dominant cause of death (n = 41; 41%) followed by infections (n = 22, 22%), geriatric situations (i.e. falls or senile deterioration; n = 17, 17%) and cancers (n = 15, 15%). Patients in each of these four groups were compared with the other deceased patients pooled together. Patients who died from cardiovascular events were more frequently male (46% vs 27%, p= 0.04) with a past history of coronary artery disease (29% vs 8%, p= 0.006). Patients who died from infections mostly had ongoing glucocorticoid treatment (82% vs 53%, p= 0.02) with higher cumulative doses (13994 mg vs 9150 mg, p= 0.03). Patients who died from geriatric causes more frequently had osteoporosis (56% vs 17%, p= 0.0009) and had mostly discontinued glucocorticoid treatment (76% vs 33%, p= 0.001). The predictive factors of death in multivariate analysis were a history of coronary disease (HR 2.39; 95% CI 1.27-4.21; p= 0.008), strokes at GCA diagnosis (HR 2.54; 95% CI 1.05-5.24; p= 0.04), any infection during follow-up (HR 1.93; 95% CI 1.24-2.98; p= 0.004) and fever at GCA diagnosis (HR 1.99; 95% CI 1.16-3.28; p= 0.01).
 
  Our study provides real-life insight on the cause-specific mortality in GCA patients.
 Our study provides real-life insight on the cause-specific mortality in GCA patients.
  To evaluate the efficacy and safety of SHR4640, a highly selective urate transporter 1 inhibitor in Chinese subjects with hyperuricemia.
 
  This was a randomized double-blind dose-ranging phase II study. Subjects whose serum uric acid levels ≥480 µmol/l with gout, or sUA levels ≥480 µmol/l without gout but with comorbidities, or sUA levels ≥540 µmol/l were enrolled. Subjects were randomly assigned (11111) to receive once daily 2.5 mg/5 mg/10 mg of SHR4640, 50 mg of benzbromarone, and placebo, respectively. The primary end point was the proportion of subjects achieved target sUA level of ≤ 360 µmol/l at week 5.
 
  About 99.5% of subjects (n = 197) were male and 95.9% of subjects had gout history. The proportions of subjects achieved target sUA at week 5 were 32.5%, 72.5% and 61.5% in 5 mg, 10 mg of SHR4640 and benzbromarone groups, respectively, significantly higher than placebo group (0%; p< 0.05 for 5 mg and 10 mg of SHR4640 group). The sUA was reduced by 32.7%, 46.8% and 41.8% at week 5 with 5 mg, 10 mg of SHR4640 and benzbromarone, respectively, vs placebo (5.9%; p< 0.001 for each comparison). The incidences of gout flares requiring intervention were similar among all groups. Occurrences of treatment-emergent adverse events (TEAEs) were comparable across all groups, and serious TEAEs were not reported.
 
  The present study indicated a superior sUA-lowering effect, and well tolerated safety profile after 5-week treatment with once-daily 5 mg/10 mg of SHR4640 as comparing with placebo in Chinese subjects with hyperuricemia.
 
  ClinicalTrials.gov number, NCT03185793.
 ClinicalTrials.gov number, NCT03185793.Patients with acute coronary syndromes (ACS), particularly non-ST-segment elevation ACS, represent a spectrum of patients at variable risk of short- and long-term adverse clinical outcomes. Accurate prognostic assessment in this population requires the simultaneous consideration of multiple clinical and laboratory variables which may be under-recognized by the treating physicians, leading to an observed risk-treatment paradox in the use of invasive and pharmacological therapies. The routine application of established clinical risk scores, such as the Global Registry of Acute Coronary Events risk score, is recommended by major international clinical practice guidelines for structured risk stratification at the time of presentation, but uptake remains inconsistent. This article discusses the methodology of designing, deriving, and validating clinical risk scores, reviews the major validated risk scores for assessing prognosis in ACS, and examines their role in guiding clinical decision-making in ACS management, especially the timing of invasive coronary angiography. We also discuss emerging data on the impact of the routine use of such risk scores on patient management and clinical outcomes, as well as future directions for investigation in this field.Although the need for addressing matching in the analysis of matched case-control studies is well established, debate remains as to the most appropriate analytic method when matching on at least one continuous factor. We compare the bias and efficiency of unadjusted and adjusted conditional logistic regression (CLR) and unconditional logistic regression (ULR) in the setting of both exact and non-exact matching. To demonstrate that case-control matching distorts the association between the matching variables and the outcome in the matched sample relative to the target population, we derive the logit model for the matched case-control sample under exact matching. We conduct simulations to validate our theoretical conclusions and to explore different ways of adjusting for the matching variables in CLR and ULR to reduce biases. When matching is exact, CLR is unbiased in all settings. When matching is not exact, unadjusted CLR tends to be biased and this bias increases with increasing matching caliper size.  https://www.selleckchem.com/products/ly333531.html  Spline smoothing of the matching variables in CLR can alleviate biases.