Classifying “urban” and “rural” environments is a challenge in understanding urban climate, specifically urban heat islands (UHIs). Stewart and Oke developed the “local climate zone” (LCZ) classification system to clarify these distinctions using 17 unique groups. This system has been applied to many areas around the world, but few studies have attempted to utilize them to detect UHI effects in smaller cities. Our aim was to use the LCZ classification system 1) to detect UHI in two small cities in Alabama and 2) to determine whether similar zones experienced similar intensity or magnitude of UHIs. For 1 week, we monitored hourly temperature in two cities, in four zones: compact low-rise, open low-rise, dense forests, and water. We found that urban zones were often warmer for overall, daytime, and nighttime temperatures relative to rural zones (from −0.1° to 2.8°C). In addition, we found that temperatures between cities in similar zones were not very similar, indicating that the LCZ system does not predict UHI intensity equally in places with similar background climates. We found that the LCZ classification system was easy to use, and we recognize its potential as a tool for urban ecologists and urban planners.
BACKGROUNDIn patients with type 2 diabetes, inhibitors of sodium-glucose cotransporter 2 (SGLT2) reduce the risk of a first hospitalization for heart failure, possibly through glucoseindependent mechanisms. More data are needed regarding the effects of SGLT2 inhibitors in patients with established heart failure and a reduced ejection fraction, regardless of the presence or absence of type 2 diabetes. METHODSIn this phase 3, placebo-controlled trial, we randomly assigned 4744 patients with New York Heart Association class II, III, or IV heart failure and an ejection fraction of 40% or less to receive either dapagliflozin (at a dose of 10 mg once daily) or placebo, in addition to recommended therapy. The primary outcome was a composite of worsening heart failure (hospitalization or an urgent visit resulting in intravenous therapy for heart failure) or cardiovascular death. RESULTSOver a median of 18.2 months, the primary outcome occurred in 386 of 2373 patients (16.3%) in the dapagliflozin group and in 502 of 2371 patients (21.2%) in the placebo group (hazard ratio, 0.74; 95% confidence interval [CI], 0.65 to 0.85; P<0.001). A first worsening heart failure event occurred in 237 patients (10.0%) in the dapagliflozin group and in 326 patients (13.7%) in the placebo group (hazard ratio, 0.70; 95% CI, 0.59 to 0.83). Death from cardiovascular causes occurred in 227 patients (9.6%) in the dapagliflozin group and in 273 patients (11.5%) in the placebo group (hazard ratio, 0.82; 95% CI, 0.69 to 0.98); 276 patients (11.6%) and 329 patients (13.9%), respectively, died from any cause (hazard ratio, 0.83; 95% CI, 0.71 to 0.97). Findings in patients with diabetes were similar to those in patients without diabetes. The frequency of adverse events related to volume depletion, renal dysfunction, and hypoglycemia did not differ between treatment groups. CONCLUSIONSAmong patients with heart failure and a reduced ejection fraction, the risk of worsening heart failure or death from cardiovascular causes was lower among those who received dapagliflozin than among those who received placebo, regardless of the presence or absence of diabetes. (Funded by AstraZeneca; DAPA-HF ClinicalTrials .gov number, NCT03036124.
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