Efficacy and safety of semaglutide in patients with heart failure with preserved ejection fraction and obesity.

BACKGROUND: Semaglutide, a once-weekly glucagon-like peptide-1 receptor agonist, has shown promise in weight management and cardiovascular outcomes in other populations. This study aimed to evaluate the efficacy of semaglutide in heart failure with preserved ejection fraction (HFpEF) patients with obesity. METHODS: A retrospective study analyzed 318 patients with HFpEF, of which 104 received semaglutide and 214 received placebo. Primary endpoints included evaluating changes in exercise capacity and weight management. RESULTS: Semaglutide treatment led to significant improvements in the primary endpoints. Patients in the semaglutide group demonstrated substantial enhancements in exercise capacity, as measured by the 6-min walk distance, compared to the placebo group (mean difference 15.1 meters, 95% CI 5.8 to 24.4, p = 0.002). Additionally, semaglutide resulted in substantial weight loss compared to placebo (mean difference -2.9%, 95% CI -4.1--1.7, p = 0.001). Several secondary endpoints, including reductions in C-reactive protein levels and improvements in other clinical parameters, further supported the efficacy of semaglutide. Adverse events were generally well-tolerated, with no unexpected safety concerns. CONCLUSION: Semaglutide demonstrated significant clinical benefits in HFpEF patients with obesity, as evidenced by improved symptoms, physical function, and weight reduction.

Two-dimensional titanium carbide (Ti3C2Tx) MXenes to inhibit the shuttle effect in sodium sulfur batteries.

Room-temperature sodium sulfur batteries (RT-NSBs) are among the promising candidates for large-scale energy storage applications because of the natural abundance of the electrode materials and impressive energy density. However, one of the main technical challenges of RT-NSBs is the shuttle effect by which active redox intermediates (i.e., sodium polysulfides Na2Sn, n = 1-8) are dissolved in electrolytes, which hamper the battery reversibility. The interfacial interplays between Na2Sn and the electrodes (or electrolytes) at the atomic level thus play an intrinsic role in elucidating the shuttle effect. This work reports the ab initio calculations to unravel the suppression of the shuttle effect using titanium carbide MXenes (Ti3C2Tx, Tx = F, O) as the cathode additives. The findings reveal that the shuttle phenomenon is efficiently resolved because the immense chemical bonding of Na2Sn-Ti3C2Tx interfaces competitively surpasses the binding magnitudes of Na2Sn-electrolyte interaction. The analysis of the electronic density of states and charge density further manifests that there is charge donation from the Na-3s orbital of Na2Sn to the unfilled F(O)-2p orbitals of metallic Ti3C2Tx. The metallicity of the Ti3C2Tx remains preserved during the entire course of the redox process, ensuring the rapid electrochemical kinetics. Furthermore, the presence of Ti3C2Tx additives drastically reduces the dissociation barrier of the final redox product Na2S, yielding the efficient utilization of sulfur during the discharge process. This work has proposed the unexplored functionality of Ti3C2Tx as the anchoring materials for RT-NSBs.

Efficient suppression of the shuttle effect in Na-S batteries with an As2S3 anchoring monolayer.

Sodium-sulfur batteries (NaSBs) have emerged as a promising energy storage technology for large-scale stationary applications such as smart electrical grids due to their exceptionally high energy density and cost-effectiveness. However, one of the challenging problems impeding their practical applications is the sulfur shuttle effect by which the active redox intermediates are gradually dissolved in electrolytes. In this work, we have employed first-principles density functional theory (DFT) calculations to unravel the suppression of the shuttle effect in NaSBs with a two-dimensional (2D) As2S3 monolayer as the anchoring material. We show that semiconducting As2S3 is a suitable anchoring layer to inhibit the dissolution of the polysulfide intermediates in common electrolytes because of its stronger chemical binding with sodium polysulfides than with the electrolytes. The immense adsorption is attributed to the electron donation from the unfilled S-3p states of the polysulfides to As2S3. These mechanisms increase the carrier population and consequently improve the electrical conductivity of As2S3. Hence, the use of As2S3 can both reduce the shuttle effect and enhance the cathode electron conductivity to enable improved cycling stability and coulombic efficiency of the battery.

Anatomic total shoulder arthroplasty for patients receiving workers' compensation.

BACKGROUND: Studies have demonstrated that receiving workers' compensation (WC) benefits can be a negative predictor of outcomes after orthopedic procedures. This study compares postoperative outcomes of anatomic total shoulder arthroplasty (TSA) between patients receiving WC benefits and a control group that did not. METHODS: A cohort of 13 consecutive TSA patients with WC benefits were compared with a control group of 63 consecutive patients with a minimum of 2 years of follow-up during the same period. Patient demographics, American Shoulder and Elbow Surgeons scores, 12-Item Short Form Health Survey scores, return to work status, and time out of work were evaluated. RESULTS: The WC TSA cohort consisted of 13 men and no women with a mean age of 55.9 years. Twelve of the 13 were laborers. The TSA control group consisted of 36 men and 27 women with a mean age of 63.2 years (P = .01). The American Shoulder and Elbow Surgeons scores at final follow-up were significantly lower in the WC cohort (73.6) compared with the control group (86.6; P = .01). However, the 12-Item Short Form Health Survey physical and mental component summary scores were not significantly different (P = .09 and P = .6). Only 4 of the 13 WC patients returned to work. CONCLUSION: Compared with a non-WC population, patients with WC who received an anatomic TSA are more likely to be male, younger, and a laborer. Outcomes are generally excellent and better than those of other WC shoulder surgery cohorts in the literature; however, the outcomes are relatively worse than in the non-WC TSA patients. A significant number of WC patients are unable to return to work after TSA.

Ipsilateral anterior then irreducible posterior hip dislocation without fracture: a case report.

Anterior hip dislocations and posterior hip dislocations are injuries that commonly result from high-energy trauma. Different mechanisms of injury and forces are typically required for anterior and posterior hip dislocations. We present the case of a patient who sustained an injury that initially resulted in an anterior hip dislocation. After reduction and without experiencing further significant trauma, the patient dislocated posteriorly while being transferred from a stretcher to a table in radiology some 14 hours later. To our knowledge, there have been no such presentations in the literature.