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2017

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Effect Of Endophyte-Infected Tall Fescue Toxins On Growth Performance And The Microbial Community In The Rumen And Feces In Pregnant Ewes, Saleh Alrashedi Dec 2017

Effect Of Endophyte-Infected Tall Fescue Toxins On Growth Performance And The Microbial Community In The Rumen And Feces In Pregnant Ewes, Saleh Alrashedi

Graduate Theses and Dissertations

Fifty pregnant Katahdin ewes grazed pastures with high (HE) and moderate (MI) levels of Neotyphodium coenophialum-infected tall fescue between February 1 and May 24 to determine the impacts of tall fescue toxins on body weight (BW), body condition scores, FAMACHA scores, fecal egg counts (FEC), and serum Cu, Zn, prolactin, and non-esterified fatty acids (NEFA). Within those 50 ewes, 15 were selected randomly for fecal and rumen sampling to assess the impacts of HE and MI on the microbiome community. Total bacterial DNA was extracted from rumen and fecal samples, and alpha and beta diversities were used to relate microbiome …


Horizontal Transmission Of Helicoverpa Armigera Nucleopolyhedrovirus (Hearnpv) In Soybean Fields Infested With Helicoverpa Zea (Boddie), Joseph Lee Black Dec 2017

Horizontal Transmission Of Helicoverpa Armigera Nucleopolyhedrovirus (Hearnpv) In Soybean Fields Infested With Helicoverpa Zea (Boddie), Joseph Lee Black

Graduate Theses and Dissertations

Helicoverpa armigera Nucleopolyhedrovirus (HearNPV) is a commercially available viral biopesticide that targets Heliothines, including Helicoverpa zea (Boddie) (Lepidoptera: Noctuidae), the most damaging pest of soybean (Glycine max (L.) Merrill) in the Mid-South. Previous formulations of HearNPV have been well studied; however, no research has been published on current formulations. The first objective of this thesis was to assess the rate of horizontal transmission of HearNPV in a soybean field infested with H. zea when HearNPV was applied as a bio-insecticide, and to identify arthropods that are important obligate carriers in dissemination. HearNPV spread 200 feet in 3 fields, and was …


In The Field The Women Saved The Crop: The Women’S Land Army Of World War Ii, Denna M. Clymer Dec 2017

In The Field The Women Saved The Crop: The Women’S Land Army Of World War Ii, Denna M. Clymer

Graduate Theses and Dissertations

The Women’s Land Army brought together rural and urban sectors of the United States in a climate of national and regional crisis. By the time the country was cast into war, the agricultural sector was already caught in a downward economic spiral that drove away laborers. With demand falling, and farms propped up only by experiments in subsidy and parity, when military and industrial jobs emerged in urban areas, farm laborers became scarce. At the same time the war created jobs for men outside of the agricultural sector, farm prices recovered and demand soared, forcing farmers to look to women …


Fall Risk In Sedentary, Recreationally Active, And Masters Athlete Older Adults, Felicia Elizabeth Squires Dec 2017

Fall Risk In Sedentary, Recreationally Active, And Masters Athlete Older Adults, Felicia Elizabeth Squires

Graduate Theses and Dissertations

The purpose of this study was to examine whether different habitual activity levels may affect balance ability in older adults. Balance must be studied as poor balance increases likelihood of falls. This study examined activity levels in older adults and effect on balance ability. Fifty-nine older adults aged 66.5 ± 9.5 participated. Three groups were separated by physical activity level. First group had 13 masters athletes, older adults performing least 150 minutes of aerobic activity a week and competing in nationally sanctioned event within the last six months. Twenty-seven older adults comprised recreationally active group performing at least 150 minutes …


A Study Of The Prevalence Of Gastrointestinal Nematodes In Goats Obtained From Northwest Arkansas, Christine Rose Weingartz Dec 2017

A Study Of The Prevalence Of Gastrointestinal Nematodes In Goats Obtained From Northwest Arkansas, Christine Rose Weingartz

Graduate Theses and Dissertations

Parasitic helminths have always been an issue in small ruminant production; pathogens that pose great negative impact on goat health and productivity. Insufficient work has been done to document the prevalence of parasitic helminths in the United States, especially in the south and southeast, where the largest goat populations are found.

The aim of this study was to survey the prevalence of infections by gastrointestinal nematodes in goats in Northwestern Arkansas. Gastrointestinal tracts were examined from 41 goats of various locations around Northwest Arkansas. Worm species were identified and population burdens were determined. Coprology was correlated with the actual worm …


The Effect Of Dietary Specialism And Generalism On Evolutionary Longevity In An Early Paleogene Mammalian Community, Samantha Glonek Dec 2017

The Effect Of Dietary Specialism And Generalism On Evolutionary Longevity In An Early Paleogene Mammalian Community, Samantha Glonek

Masters Theses

This study examines the relationship between relief index (RFI) on first and second mandibular molars and longevity of the genus. The molars were extracted from small-bodied, arboreal mammals during the late-Paleocene, early-Eocene in the Bighorn Basin in Wyoming. This study site is a well-known location to research and study fossil mammals of this time period. The study was conducted and analyzed at the genus level due to the relatively small number of specimens available and identifiable at the species level. Dietary breadth, or how broad or narrow a dietary preference is for a mammal, is an area of concentration within …


Whole Grain Processing And Effects On Carbohydrate Digestion And Fermentation, Sandrayee Brahma Dec 2017

Whole Grain Processing And Effects On Carbohydrate Digestion And Fermentation, Sandrayee Brahma

Department of Food Science and Technology: Dissertations, Theses, and Student Research

Whole grains are a major source of dietary fibers in the human diet that provide specific nutrients to the gut microbiota and thereby plays a major role in modulating microbiota composition and increasing diversity of the gut ecosystem. A common approach of consuming whole grains is in the form of ready-to-eat extruded breakfast cereals. Studies reported herein established that extrusion conditions not only affected the physicochemical properties but also in vitro starch digestibility, β-glucan extractability and in vitro fermentation characteristics of whole grain oats. Moderate screw speed (300 rpm) led to higher slowly digestible starch (SDS) with an accompanying decrease …


Radiofrequency Processing For Inactivation Of Salmonella Spp. And Enterococcus Faecium Nrrl B-2354 In Whole Black Peppercorn And Ground Black Pepper, Xinyao Wei Dec 2017

Radiofrequency Processing For Inactivation Of Salmonella Spp. And Enterococcus Faecium Nrrl B-2354 In Whole Black Peppercorn And Ground Black Pepper, Xinyao Wei

Department of Food Science and Technology: Dissertations, Theses, and Student Research

Black pepper has been implicated in several foodborne illness outbreaks and food product recalls due to Salmonella contamination. Conventional decontamination methods for black pepper are challenged by harmful residues or quality deterioration. Radiofrequency (RF) heating reduces the come-up time which allows to design a high-temperature short-time processing to inactivate Salmonella with minimal deterioration in product quality. The objectives of this study were to investigate RF heating for inactivation of Salmonella in whole black peppercorn and ground black pepper samples, evaluate Enterococcus faecium NRRL B-2354 as a surrogate for Salmonella, and assess quality deterioration during RF heating of whole black peppercorn …


Increasing Cis-Lycopene Content Of The Oleoresin From Tomato Processing Byproducts Using Supercritical Carbon Dioxide And Assessment Of Its Bioaccessibility, Lisbeth Vallecilla Yepez Dec 2017

Increasing Cis-Lycopene Content Of The Oleoresin From Tomato Processing Byproducts Using Supercritical Carbon Dioxide And Assessment Of Its Bioaccessibility, Lisbeth Vallecilla Yepez

Department of Food Science and Technology: Dissertations, Theses, and Student Research

In recent years, health- and wellness-promoting foods have been one of the major focus of consumers; therefore, the food industry is increasing its efforts in developing these food products. Tomatoes, tomato-food products and their byproducts have gained special attention in virtue of the carotenoids-rich source that they represent, especially lycopene (~90%). The role of lycopene in human diet has been highlighted as a result of its direct relationship with the decrease of chronic diseases. Nevertheless, lycopene is water-insoluble making its extraction simple with organic-toxic solvents; in addition, lycopene degrades easily with light, time, and storage. Lycopene exist in nature mostly …


Exploration Of The Enhancement Of Scientific Literacy By Nursery School Teachers: A Case Of Excel Nursery School, In Eastern Uganda., Adengo Emmanuel Dec 2017

Exploration Of The Enhancement Of Scientific Literacy By Nursery School Teachers: A Case Of Excel Nursery School, In Eastern Uganda., Adengo Emmanuel

Master of Education

This study investigated on the enhancement of scientific literacy (SL) by nursery school teachers in Uganda. It studied the teacher’s perception about SL, approaches used by teachers to enhance SL amongst learners and the challenges they face while promoting such approaches in the teaching and learning process. The study involved four nursery school teachers and one head teacher from a purposefully selected nursery school in Iganga Municipality, Uganda. The study engaged the qualitative research approach and case study design where by data were collected through one on one semi-structured interviews and also involved non-participatory classroom observation together with document analysis. …


Shallow Aggregate Ebb-And-Flow System For Greenhouse Lettuce Production, Joseph Chidiac Dec 2017

Shallow Aggregate Ebb-And-Flow System For Greenhouse Lettuce Production, Joseph Chidiac

Graduate Theses and Dissertations

A novel soilless technique for the production of lettuce was developed and evaluated for its viability for ornamental greenhouse growers adapting their ebb-and-flood irrigation benching systems to diversify into growing lettuce, without having to purchase the conventional nutrient film technique (NFT) or deep flow technique (DFT) hydroponic systems. The experimental design was a three by four factorial, with three treatments for aggregate depth (19, 38, and 57 mm) and four treatments for irrigation frequency (once every 1, 2, 4, or 8 hours), for a total of twelve treatment combinations. Each treatment was replicated three times in a randomized complete block …


Hydroxyurea Differentially Modulates Activator And Repressors Of Γ-Globin Gene In Erythroblasts Of Responsive And Non-Responsive Patients With Sickle Cell Disease In Correlation With Index Of Hydroxyurea Responsiveness, Xingguo Zhu, Tianxiang Hu, Meng Hsuan Ho, Yongchao Wang, Miao Yu, Niren Patel, Wenhu Pi, Jeong-Hyeon Choi, Hongyan Xu, Vadivel Ganapathy, Ferdane Kutlar, Abdullah Kutlar, Dorothy Tuan Dec 2017

Hydroxyurea Differentially Modulates Activator And Repressors Of Γ-Globin Gene In Erythroblasts Of Responsive And Non-Responsive Patients With Sickle Cell Disease In Correlation With Index Of Hydroxyurea Responsiveness, Xingguo Zhu, Tianxiang Hu, Meng Hsuan Ho, Yongchao Wang, Miao Yu, Niren Patel, Wenhu Pi, Jeong-Hyeon Choi, Hongyan Xu, Vadivel Ganapathy, Ferdane Kutlar, Abdullah Kutlar, Dorothy Tuan

Pharmacology and Nutritional Sciences Faculty Publications

Hydroxyurea (HU), the first of two drugs approved by the US Food and Drug Administration for treating patients with sickle cell disease (SCD), produces anti-sickling effect by re-activating fetal γ-globin gene to enhance production of fetal hemoglobin. However, approximately 30% of the patients do not respond to HU therapy. The molecular basis of non-responsiveness to HU is not clearly understood. To address this question, we examined HU-induced changes in the RNA and protein levels of transcription factors NF-Y, GATA-1, -2, BCL11A, TR4, MYB and NF-E4 that assemble the γ-globin promoter complex and regulate transcription of γ-globin gene. In erythroblasts cultured …


Pcb-Associated Steatohepatitis And The Role Of Nuclear Receptors., Heather Brooke Clair Dec 2017

Pcb-Associated Steatohepatitis And The Role Of Nuclear Receptors., Heather Brooke Clair

Electronic Theses and Dissertations

Metabolic diseases, including fatty liver disease, hyperglycemia, and obesity, result when body systems responsible for managing allostasis (dynamic homeostasis across systems) are pressured beyond their collective compensatory reserve. Nutritional excess contributes to this state, the capacity of which is limited by genetic variation, and failure of one system will gradually lead to pathological overload in the others. Agents which act directly on the communication machinery linking these connected systems can also change the point at which allostatic load becomes allostatic overload. Environmental exposure to polychlorinated biphenyls (PCBs), a class of persistent organic pollutant, is associated with a specific form of …


Effect Of Total Body Iron On Metabolic Dysfunction Among U.S. Females In The Nhanes 2003-2010, Aged 12-49., Joseph Michael Carhart Dec 2017

Effect Of Total Body Iron On Metabolic Dysfunction Among U.S. Females In The Nhanes 2003-2010, Aged 12-49., Joseph Michael Carhart

Electronic Theses and Dissertations

Experimental and epidemiological studies have reported positive associations between iron parameters and metabolic dysfunction including: Type 2 diabetes mellitus (T2DM) (1-6), metabolic syndrome (7-15), non-alcoholic fatty liver disease (NAFLD) (16-22) and insulin resistance (23,24) with a number of studies showing that reductions in total body iron via dietary modification (e.g., reducing red meat intake) or phlebotomy lead to increases in insulin sensitivity (25), decreases in insulin resistance (26), and reductions in the prevalence of complications associated with T2DM (5, 27), metabolic syndrome (28) and NAFLD (22, 29). Moreover, the risk associated with these outcomes and total body iron differ between …


Evaluating Work Place Wellness In Greater Louisville's Technology Organizations : A Case Study., Andrew L. Mccart Dec 2017

Evaluating Work Place Wellness In Greater Louisville's Technology Organizations : A Case Study., Andrew L. Mccart

Electronic Theses and Dissertations

Employers in the Southern Indiana and Greater Louisville region are looking for strategies to help them become a healthier workplace. Many employers see the expense of paying for an unhealthy workforce and they are looking to limit these expenses. The purpose of the study is to determine the state of workplace wellness activities in organizations in Southern Indiana and Greater Louisville. Due to the poor health statuses of Indiana and Kentucky, 39th and 45th, respectively, this study is significant for a number of stakeholders in our area. The purpose of this case study was to understand the state of health …


Since The Time Of Eve : La Leche League And Communities Of Mothers Throughout History., Joanna Paxton Federico Dec 2017

Since The Time Of Eve : La Leche League And Communities Of Mothers Throughout History., Joanna Paxton Federico

Electronic Theses and Dissertations

La Leche League International (LLL) is the oldest and largest breastfeeding support group in the world. This thesis examines how, beginning in 1956, seven Catholic housewives from suburban Chicago built up the institutional knowledge to sustain a cohesive global network of breastfeeding mothers. It also explores how LLL managed this knowledge over time in response to developments in scholarship and changing social conditions. Based on a narrative analysis of LLL publications, this thesis argues that the League’s founders drew selectively from existing bodies of knowledge and from their own cultural perspectives to establish a sense of community among breastfeeding women. …


Deficiency Of Rdh10 Causes Cleft Secondary Palate In Mouse., Swetha Raja Dec 2017

Deficiency Of Rdh10 Causes Cleft Secondary Palate In Mouse., Swetha Raja

Electronic Theses and Dissertations

The focus of this project is to understand the role of Retinoic Acid (RA) produced by RDH10-mediated metabolism of Vitamin A in palate development. For 80 years now, we have known that dietary restriction of RA/Vitamin A can cause cleft palate but we have failed to understand how RA deficiency causes cleft palate. Our gap in knowledge about how RA deficiency causes cleft palate is mainly owing to the fact that we lack a model system to study such defects. The aim of this thesis research project was to determine if conditional inactivation of the Vitamin A metabolic gene Rdh10 …


Self-Management As A Mediator Of The Relationship Between Social Support And Health Outcomes Of African American Adults With Type 2 Diabetes., Tariq N. Al-Dwaikat Dec 2017

Self-Management As A Mediator Of The Relationship Between Social Support And Health Outcomes Of African American Adults With Type 2 Diabetes., Tariq N. Al-Dwaikat

Electronic Theses and Dissertations

Type 2 diabetes (T2D) is often associated with serious complications. African American adults have higher rates of diabetes-related complications than other ethnicities. Diabetes self-management reduces the risk of developing biological and psychological symptoms. Social support promotes positive behavior change and self-management that leads to improved biobehavioral and psychosocial outcomes. Few studies explored the relationship between social support dimensions and self-management behaviors, diabetes biomarkers, and psychosocial outcomes of African American adults with T2D. The purpose of this dissertation was to examine the relationships of various dimensions of social support with self-management behaviors and diabetes biomarkers and psychosocial outcomes of African American …


Thermodynamic Limitations To Agricultural Productivity And Food Security: Livestock In Sub-Saharan Africa, Calvin Harman Dec 2017

Thermodynamic Limitations To Agricultural Productivity And Food Security: Livestock In Sub-Saharan Africa, Calvin Harman

Department of Agricultural and Biological Systems Engineering: Dissertations, Theses, and Student Research

By 2050, to feed a nearly tripling and more urbanized population in sub-Saharan Africa (SSA) will require significant increases in crop productivity throughout the region’s agricultural systems, if a greater reliance on imports is to be avoided. Increases in crop yields to maximum potential productivity (closure of crop yield gaps) can produce more calories and protein, but may be insufficient to sustain the burgeoning human population according to recent analysis (van Ittersum et al., 2016). In this thesis, alternative management options (i.e. crop allocation and crop substitutions) are found to increase total energy productivity and the thermodynamic efficiency of food …


Cultivation Of Chlorella Sorokiniana Using Beef Feedlot Runoff Holding Pond Effluent, Mitchell Klaus Goedeken Dec 2017

Cultivation Of Chlorella Sorokiniana Using Beef Feedlot Runoff Holding Pond Effluent, Mitchell Klaus Goedeken

Department of Agricultural and Biological Systems Engineering: Dissertations, Theses, and Student Research

A study was conducted to test the suitability of utilizing beef feedlot runoff holding pond effluent for cultivating algae. The algae strain used, Chlorella sorokiniana, was previously identified as a potential energy feedstock for cattle. The previous research was initiated in pursuit of a goal to develop a cycle of utilizing nutrients from beef manure to cultivate algae and then utilizing dewatered algae as a feed supplement for beef cattle.

Runoff holding pond effluent samples were collected from commercial beef production operations in Nebraska during spring 2016. Equal portions of samples from each cooperating farm were composited and then aliquoted …


Assessing Relationships Between Angling Effort And Larval Trematodes In Small Bluegill, Alexis Park Dec 2017

Assessing Relationships Between Angling Effort And Larval Trematodes In Small Bluegill, Alexis Park

School of Natural Resources: Dissertations, Theses, and Student Research

I wanted to determine if catch-and-release angling increased larval trematodes in small (50-160 mm) bluegill (Lepomis macrochirus). I used angling effort as a proxy for amount of catch-and-release angling. I assumed bluegill assessed, due to their size and age, experienced catch-and-release events. I assessed larval trematode intensity, black spot (Crassiphiala bulboglossa), and white grub (Posthodiplostomum minimum centrarchi), in 750 bluegill. The first objective was to quantify the association between angling effort and reservoir area. Angling effort and reservoir area were positively correlated. The second objective was to determine if angling effort, reservoir area, bluegill …


Effects Of Vagotomy And Fenugreek On Hyperlipidemia And Insulin Resistance, Rituraj Khound Dec 2017

Effects Of Vagotomy And Fenugreek On Hyperlipidemia And Insulin Resistance, Rituraj Khound

Department of Nutrition and Health Sciences: Dissertations, Theses, and Student Research

Hyperlipidemia is the impairment of lipid metabolism marked by abnormally high levels of lipid in circulation. This has been implicated in a number of metabolic diseases including diabetes, cardiovascular diseases, and nonalcoholic fatty liver disease. Insulin resistance is the impairment of insulin action, which leads to several diseases such as obesity and type 2 diabetes. New clinical and therapeutic approaches are warranted for the prevention and treatment of hyperlipidemia and insulin resistance. In our study, we investigated the mechanism underlying the effect of complete disruption of the sub-diaphragmatic vagus nerve (vagotomy) on hyperlipidemia and insulin sensitivity. We observed that vagotomy …


Per Pupil Expenditure, Graduation Rates, And Act Scores In Tennessee School Districts, Jay Irvin Dec 2017

Per Pupil Expenditure, Graduation Rates, And Act Scores In Tennessee School Districts, Jay Irvin

Electronic Theses and Dissertations

The purpose of this study was to investigate and identify possible relationships between academic achievement, as measured by high school graduation rate and ACT composite scores of individual school districts within the state of Tennessee, and the per-pupil expenditure of each district. Research was conducted to determine whether a significant difference existed in academic achievement measures (high school graduation rate, ACT composite score) among school districts in the state of Tennessee that were classified as above average, average, and below average in relation to their per-pupil expenditure (PPE) in the 2013-2014, 2014-2015, and 2015-16 school years.

Ex post facto data …


Management Of Late Presentation Congenital Heart Disease, Parvathi U. Iyer U. Iyer, Guillermo E. Moreno,, Luiz Fernando Caneo, Tahira Faiz, Lara S. Shekerdemian, Krishna S. Iye Dec 2017

Management Of Late Presentation Congenital Heart Disease, Parvathi U. Iyer U. Iyer, Guillermo E. Moreno,, Luiz Fernando Caneo, Tahira Faiz, Lara S. Shekerdemian, Krishna S. Iye

Section of Cardiothoracic Surgery

In many parts of the world, mostly low- and middle-income countries, timely diagnosis and repair of congenital heart diseases (CHDs) is not feasible for a variety of reasons. In these regions, economic growth has enabled the development of cardiac units that manage patients with CHD presenting later than would be ideal, often after the window for early stabilisation - transposition of the great arteries, coarctation of the aorta - or for lower-risk surgery in infancy - left-to-right shunts or cyanotic conditions. As a result, patients may have suffered organ dysfunction, manifest signs of pulmonary vascular disease, or the sequelae of …


Determining The Effectiveness Of The Cancer Phase Training Model In A Group Setting, Scott F. Eberhardt Dec 2017

Determining The Effectiveness Of The Cancer Phase Training Model In A Group Setting, Scott F. Eberhardt

Master's Theses

The role of exercise as a primary therapy has been well documented and has the capacity to act across multiple body systems to attenuate cancer-related toxicities. To date, the Cancer Phase Training Model is the only cancer rehabilitation intervention that includes recommended modes, intensity, frequency, and duration of exercise for cancer survivors. The one-on-one model has been shown to be the most effective method of cancer rehabilitation; however the largest perceived limitation of this model is the expense of the program and its lack of scalability. By creating a structured cancer specific group model that can produce similar results to …


Health Habits Of Nurses And Nursing College Students, Efret M. Ghirmazion Dec 2017

Health Habits Of Nurses And Nursing College Students, Efret M. Ghirmazion

McNair Scholars Research Journal

No abstract provided.


Analysis Of Form And Function In Snakes, Acacia Young Dec 2017

Analysis Of Form And Function In Snakes, Acacia Young

McNair Scholars Research Journal

No abstract provided.


Ecology Of Hatchling Alligator Snapping Turtles (Macrochelys Temminckii), Sarah J. Spangler Dec 2017

Ecology Of Hatchling Alligator Snapping Turtles (Macrochelys Temminckii), Sarah J. Spangler

Graduate Theses/Dissertations

Little is known about the first year of life for many of the world’s freshwater turtles. This is due in part to their cryptic nature and the difficulty of locating hatchlings in the wild. The lack of information about this demographically important age group has led researchers to draw conclusions from indirect inferences about survival rates and ecological roles of hatchlings that may or may not be accurate. To begin filling in some of these gaps, I focused on the first year in an alligator snapping turtle’s life. I studied: (1) circadian and circannual patterns of activity, (2) growth rates …


Monitoring And Anticipating The Convergence Of Lighting Control Strategies, Nina Chaichi, Tugrul Unsal Daim Dec 2017

Monitoring And Anticipating The Convergence Of Lighting Control Strategies, Nina Chaichi, Tugrul Unsal Daim

Engineering and Technology Management Faculty Publications and Presentations

IPC co-classification in conjunction with cross impact analysis has been used to identify technology convergence and its strength over specific period of time. In this study, we tried to monitor the convergence of lighting control strategies which yields energy efficiency from 2009 to 2013. Also, we tried to anticipate the trend of impacts for near future. We take new approach to utilize detailed information including rate of change of co-classified patents, number of patents in each class, and convergence strength between two classes over time and build possible scenarios to anticipate the convergence trend. In our new approach, convergence strength …


Comparative Effectiveness And Safety Of Empagliflozin On Cardiovascular Mortality And Morbidity In Adults With Type 2 Diabetes, Wilbert S. Aronow, Tatyana Shamliyan Dec 2017

Comparative Effectiveness And Safety Of Empagliflozin On Cardiovascular Mortality And Morbidity In Adults With Type 2 Diabetes, Wilbert S. Aronow, Tatyana Shamliyan

NYMC Faculty Publications

Background: Based on a single placebo-controlled randomized clinical trial, empagliflozin is licensed to reduce cardiovascular death in diabetes and comorbid cardiovascular disease. Methods: We examined the comparative effectiveness of empagliflozin on mortality and cardiovascular morbidity in type 2 diabetes. We conducted random-effects direct frequentist meta-analyses of aggregate data and appraised the quality of evidence using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology. Our search in PubMed, EMBASE, the Cochrane Library, clinicaltrials.gov, and PharmaPendium up to May 2017 identified 11 meta-analyses, multiple publications, and unpublished data from 29 randomized controlled trials (RCTs). Results: Empagliflozin reduces all-cause mortality [relative …