Peripheral blood RNA biomarkers can predict lesion severity in degenerative cervical myelopathy.

JOURNAL/nrgr/04.03/01300535-202506000-00027/figure1/v/2024-08-05T133530Z/r/image-tiff Degenerative cervical myelopathy is a common cause of spinal cord injury, with longer symptom duration and higher myelopathy severity indicating a worse prognosis. While numerous studies have investigated serological biomarkers for acute spinal cord injury, few studies have explored such biomarkers for diagnosing degenerative cervical myelopathy. This study involved 30 patients with degenerative cervical myelopathy (51.3 ± 7.3 years old, 12 women and 18 men), seven healthy controls (25.7 ± 1.7 years old, one woman and six men), and nine patients with cervical spondylotic radiculopathy (51.9 ± 8.6 years old, three women and six men). Analysis of blood samples from the three groups showed clear differences in transcriptomic characteristics. Enrichment analysis identified 128 differentially expressed genes that were enriched in patients with neurological disabilities. Using least absolute shrinkage and selection operator analysis, we constructed a five-gene model (TBCD, TPM2, PNKD, EIF4G2, and AP5Z1) to diagnose degenerative cervical myelopathy with an accuracy of 93.5%. One-gene models (TCAP and SDHA) identified mild and severe degenerative cervical myelopathy with accuracies of 83.3% and 76.7%, respectively. Signatures of two immune cell types (memory B cells and memory-activated CD4+ T cells) predicted levels of lesions in degenerative cervical myelopathy with 80% accuracy. Our results suggest that peripheral blood RNA biomarkers could be used to predict lesion severity in degenerative cervical myelopathy.

Terephthalate Copolyesters Based on 2,3-Butanediol and Ethylene Glycol and Their Properties.

This study explores the synthesis and performance of novel copolyesters containing 2,3-butanediol (2,3-BDO) as a biobased secondary diol. This presents an opportunity for improving their thermal properties and reducing crystallinity, while also being more sustainable. It is, however, a challenge to synthesize copolyesters of sufficient molecular weight that also have high 2,3-BDO content, due to the reduced reactivity of secondary diols compared to primary diols. Terephthalate-based polyesters were synthesized in combination with different ratios of 2,3-BDO and ethylene glycol (EG). With a 2,3-BDO to EG ratio of 28:72, an Mn of 31.5 kDa was reached with a Tg of 88 °C. The Mn dropped with increasing 2,3-BDO content to 18.1 kDa for a 2,3-BDO to EG ratio of 78:22 (Tg = 104 °C) and further to 9.8 kDa (Tg = 104 °C) for the homopolyester of 2,3-BDO and terephthalate. The water and oxygen permeability both increased significantly with increasing 2,3-BDO content and even the lowest content of 2,3-BDO (28% of total diol) performed significantly worse than PET. The incorporation of 2,3-BDO had little effect on the tensile properties of the polyesters, which were similar to PET. The results suggest that 2,3-BDO can be potentially applied for polyesters requiring higher Tg and lower crystallinity than existing materials (mainly PET).

Validation of classification system for isolated superior mesenteric artery dissections using image-based computational flow analysis.

BACKGROUND AND OBJECTIVE: The isolated superior mesenteric artery dissection (ISMAD) is a rare but potentially fatal vascular disorder. Classifications for ISMAD were previously proposed based on morphometric features. However, the classification systems were not standardized and verified yet. This study conducted computational flow analysis to validate the latest classification system of ISMAD and aid clinical decision-making based on hemodynamic parameters. METHODS: 62 patients with ISMAD were included and classified into different types according to false lumen structures (five types, Type I-V) and true lumen patency (two types, Type P and Type S) according to Qiu classification system. Computational fluid dynamics and three-dimensional structural analyses were conducted on the basis of computed tomography angiography datasets. Quantitative and qualitative functional analyses were performed via parameters of interest including volume flow of each minute, pressure drop, pressure gradient, the derivative parameters of wall shear stress such as time-averaged wall shear stress (TAWSS), oscillatory shear index (OSI), and the relative residence time (RRT). Statistical analyses were conducted among different ISMAD types. RESULTS: TAWSS, OSI and RRT showed significant difference among different types when classified using false lumen structures. In detail, Type IV showed significantly higher TAWSS than other types (p = 0.007). OSI was obviously higher in Type II (p = 0.015). Type IV also presented the lowest RRT (p = 0.005). The pressure drop, pressure gradient, OSI and RRT showed higher value in Type S than that in Type P, demonstrating a statistical significance with p values of 0.017, 0.041, 0.001 and 0.012, respectively. While Type P had larger volume flow than Type S (p = 0.041). CONCLUSIONS: The notable differences in hemodynamic features among different types demonstrated the feasibility of Qiu classification system. The evaluation based on hemodynamic simulation might also provide insights into risk identification and guide therapeutic decisions for ISMAD.

Dual-mode electrochemiluminescence sensing and phone imaging assays based on bipolar electrode for kanamycin detection.

Excessive use of antibiotics will enter the water environment and soil through the biological chain, and then transfer to the human body through food, resulting in drug resistance, kidney toxicity and other health problems, so it is urgent to develop highly sensitive detection methods of antibiotics. Here, we designed a dual-mode sensor platform based on closed bipolar electrode (cBPE) electroluminescence (ECL) and mobile phone imaging to detect kanamycin in seawater. The prepared CN-NV-550 displayed extremely intense ECL signal, allowing for convenient mobile phone imaging. The cBPE was combined with DNA cycle amplification technology to prevent the mutual interference between target and the luminescent material, and realized the amplification of signal. In the presence of target Kana, Co3O4 was introduced to the cBPE anode by DNA cycle amplification product, and accelerated the oxidation rate of uric acid (UA). Thus, the electroluminescence response of CN-NV-550 on cBPE cathode was much improved due to the charge balance of the cBPE, achieving both ECL detection and mobile phone imaging assay of Kana, which much improved the accuracy and efficiency of assay. The limit of detection (LOD) in this work is 0.23 pM, and LOD for mobile phone imaging is 0.39 pM. This study integrate ECL imaging visualization of CN-NV-550 and high electrocatalytic activity of Co3O4 into cBPE-ECL detection, providing a new perspective for antibiotic analysis, and has great potential for practical applications, especially in Marine environmental pollution monitoring.

High-purity butoxydibutylborane catalysts enable the low-exothermic polymerization of PMMA bone cement with enhanced biocompatibility and osseointegration.

Polymethyl methacrylate (PMMA) based biomaterials have been widely utilized in clinics. However, currently, PMMA catalyzed by benzoyl peroxide (BPO) exhibits disquieting disadvantages including an exothermic polymerization reaction and a lack of bioactivity. Here, we first designed three industrial-scale synthesis methods for high-purity butoxydibutylborane (BODBB), achieving purity levels greater than 95% (maximum: 97.6%) and ensuring excellent fire safety. By utilizing BODBB as a catalyst, the highest polymerization temperature of PMMA bone cement (PMMA-BODBB) reached only 36.05 °C, ensuring that no thermal damage occurred after implantation. Compared to PMMA catalyzed by BPO and partially oxidized tributylborane (TBBO, catalyst of Super Bond C&B), PMMA-BODBB exhibited superior cell adhesion, proliferation, and osteogenesis, attributed to the reduced release of free radicals and toxic monomer, and moderate bioactive boron release. After injection into a 5 mm defect in the rat cranial bone, PMMA-BODBB demonstrated the highest level of osteointegration. This work not only presents an industrial-scale synthesis of high-purity BODBB, but also offers an innovative PMMA biomaterial system with intrinsic biocompatibility and osseointegration, paving the way for the next generation of PMMA-based biomaterials with broader applications.

Development and validation of a novel vault prediction formula based on structural parameters of the anterior and posterior chambers.

BACKGROUND: Accurate prediction of postoperative vault in implantable collamer lens (ICL) implantation is crucial; however, current formulas often fail to account for individual anatomical variations, leading to suboptimal visual outcomes and necessitating improved predictive models. We aimed to verify the prediction accuracy of our new predictive model for vaulting based on anterior and posterior chamber structural parameters. METHODS: This retrospective observational study included 137 patients (240 eyes) who previously underwent ICL surgery. Patients were randomly divided into the model establishment (192 eyes) or validation (48 eyes) groups. Preoperative measurements of the anterior and posterior chamber structures were obtained using Pentacam, CASIA2 anterior segment optical coherence tomography (AS-OCT), ultrasound biomicroscopy, and other devices. Stepwise multiple linear regression analysis was used to evaluate the relationship between the vault and each variable (WL formula). The Friedman test was performed for the vaulting prediction results of the WL, NK (Ver. 3), and KS formulas (Ver. 4) in CASIA2 AS-OCT, as well as the Zhu formula and vault measurements. The proportions of prediction error within ± 250 µm per formula were compared. RESULTS: The predicted vault values of the WL, NK, KS, and Zhu formulas and vault measurements were 668.74 ± 162.12, 650.85 ± 248.47, 546.56 ± 128.99, 486.56 ± 210.76, and 716.06 ± 233.84 µm, respectively, with a significant difference (χ2 = 69.883, P = 0.000). Significant differences were also found between the measured vault value and Zhu formula, measured vault value and KS formula, WL formula and Zhu formula, WL formula and KS formula, NK formula and KS formula, and NK formula and Zhu formula (P < 0.001) but not between other groups. The proportions of prediction error within ± 250 µm per formula were as follows: WL formula (81.3%) > NK formula (70.8%) > KS formula (66.7%) > Zhu formula (54.2%). CONCLUSIONS: The WL formula, which considers the complexity of the anterior and posterior chamber structures, demonstrates greater calculation accuracy, compared with the KS (Ver. 4) and Zhu formulas. The proportion of absolute prediction error ≤ 250 µm is higher with the WL formula than with the NK formula (ver. 3). This enhanced predictive capability can improve ICL sizing decisions, thereby increasing the safety and efficacy of ICL implantation surgeries.

Metal Ion Modulated Electron Transfer in Metalloviologen Compounds: Photochromism and Differentiable Amine Detection.

Different types of electron transfers (ETs) underlie the versatile use of various solid viologen-derived compounds, which is still insufficiently understood and difficult to control. Here, we demonstrate an effective strategy for modulating the key ET process in crystalline metalloviologen compounds (MVCs). By adjusting the coordinated transition metal ions bearing different electronic structures (e.g., d5, d7, d10), three MVCs (i.e., Mn-1, Co-2, and Cd-3) with highly consistent coordination environments have been synthesized successfully. Surprisingly, whether the photochromism (energy-induced ET mechanism) or the specific analyte recognition (molecule-induced ET mechanism), compound Cd-3 exhibits obvious photochromic behavior and differential dimethylamine detection. Combined detailed structural analysis with theoretical calculations, such unique ion-dependent properties, were correlated to the fine modulation of the electron density of the bipyridinium cores by metal ions. Additionally, thanks to the delicate recognition of dimethylamine vapor, a convenient test strip Cd-3-PAN was prepared as a sensitive biogenic amine sensor for evaluating the real-time freshness of seafood.

Effect of different chain-length fatty acids on the retrogradation properties of rice starch.

In order to delay the retrogradation of rice starch, the effects of three different chain length fatty acids (lauric acid, myristic acid and palmitic acid) on rice starch were studied. The fatty acids with longer carbon chains had strong steric hindrance and hydrophobicity, which formed a more compact structure in the helical cavity of amylose, and significantly reduced degree of expansion, migration of water, short-range ordered structure, number of double helical structures and crystallinity. These structural changes endowed the rice starch-long chain fatty acid complexes with better gel viscosity, liquid fluidity and thermal stability than in the rice starch-short chain fatty acid complexes. The results showed that fatty acids with longer chain length inhibited the retrogradation of rice starch, most obviously when 5% palmitic acid was added. This study provides an important reference for the processing of rice starch-based foods.

Rare earth elements sequestration in phytoliths: Partitioning patterns and influencing mechanism.

Rare earth elements (REEs) are integral to numerous high-tech industries, yet their biogeochemical cycling within ecosystems remains inadequately characterized. Recently, phytoliths have been identified as potentially significant sinks for REEs; however, their role in the cycling of these elements has been underestimated. In this work, we investigate the accumulation of REEs in phytoliths (PhytREEs) within the Greater Khingan Mountains region, employing an optimized wet oxidation method combined with heavy liquid flotation to quantify PhytREEs contents in surface soils. The results revealed an elevation-dependent pattern of PhytREEs concentration, with heightened levels at higher altitudes and diminishing concentrations towards the eastern plains. The enrichment coefficient of PhytREEs (ECPhytREEs) was found to be approximately 2.7 %, indicative of a moderately selective sequestration process. The multivariate analysis indicated that terrain complexity, climatic patterns, soil texture, and organic matter significantly influence the uptake and storage of REEs in plants, subsequently affecting their partitioning in phytoliths. Among these factors, the complexation of REEs with organic matter emerged as a pivotal mechanism facilitating their immobilization within phytoliths. Soil characteristics also play a non-negligible role in modulating REEs dynamics. Our findings highlight the predominant influence of climate on PhytREE storage, suggesting that climatic variables are the primary drivers modulating the bioavailability and ultimate sequestration of REEs within phytoliths. This study enhances our understanding of the biotic-abiotic interplay in the sequestration of REEs and underscores the need to incorporate phytoliths into models of terrestrial REE cycling.

Evolution stage identification and spatial pattern analysis of Nitraria tangutorum nebkhas based on Gaofen-2 satellite data.

The quantitative extraction and evolution stage identification of the Nitraria tangutorum nebkhas are the basis for the restoration of regional plants and the reconstruction of degraded ecosystems. In this paper, the Nitraria tangutorum nebkha in Dengkou County of China was taken as the research object. Through the spectral and texture information of Gaofen-2 satellite image, the quantitative extraction of Nitraria tangutorum nebkha area and coverage information was completed using methods of gray threshold method, mathematical morphology, FCLSU mixed pixel decomposition, kernel density spatial analysis; the current evolution stage of the Nitraria tangutorum nebkha was identified, and their spatial distribution characteristics were analyzed. The results showed that: (1) The user accuracy and mapping accuracy of Nitraria tangutorum nebkha extracted from Random Forest combined with object-oriented classification method were up to 90.32%. (2) The method proposed can achieve an accuracy of 93.76% in extracting the spatial position of Nitraria tangutorum nebkhas. (3) The evolution of Nitraria tangutorum nebkhas can be divided into three stages: embryonic or developmental stage, stable stage, and declining stage, with a proportion of 60.70%, 20.97%, and 18.33%, respectively; The Nitraria tangutorum nebkhas in the study area is mainly in their embryonic or developmental stage, and the proportion of Nitraria tangutorum nebkhas in the declining stage is also large. It can provide technical and theoretical support for the precise extraction of nebkhas in arid and semi-arid desert areas, the identification of their current evolutionary stages, and the study of their spatial distribution patterns.

Development and Validation of a Nomogram for Predicting Lacunar Infarction in Patients with Hypertension.

Background: A considerable proportion of hypertensive patients may experience lacunar infarction. Therefore, early identification of the risk for lacunar infarction in hypertensive patients is particularly important. This study aimed to develop and validate a concise nomogram for predicting lacunar infarction in hypertensive patients. Methods: Retrospectively analyzed the clinical data of 314 patients with accurate history of hypertension in the Second Affiliated Hospital of Wannan Medical College from January 2021 to December 2022. All the patients were randomly assigned to the training set (n=220) and the validation set (n=94) with 7:3. The diagnosis of lacunar infarction in patients was confirmed using cranial CT or MRI. The independent risk factors of lacunar infarction were determined by Least absolute shrinkage and selection operator (LASSO) regression and multivariable logistic regression analysis. The nomogram was built based on the independent risk factors. The nomogram's discrimination, calibration, and clinical usefulness were evaluated by receiver operating characteristics (ROC) curve, calibration curve, and decision curve analysis (DCA) analysis, respectively. Results: The incidence of lacunar infarction was 34.50% and 33.00% in the training and validation sets, respectively. Five independent predictors were made up of the nomogram, including age (OR=1.142, 95% CI: 1.089-1.198, P<0.001), diabetes mellitus (OR=3.058, 95% CI: 1.396-6.697, P=0.005), atrial fibrillation (OR=3.103, 95% CI: 1.328-7.250, P=0.009), duration of hypertension (OR=1.130, 95% CI: 1.045-1.222, P=0.002), and low-density lipoprotein (OR=2.147, 95% CI: 1.250-3.688, P=0.006). The discrimination with area under the curve (AUC) was 0.847 (95% CI: 0.789-0.905) in the training set and was a slight increase to 0.907 (95% CI: 0.838-0.976) in the validation set. The calibration curve showed high coherence between the predicted and actual probability of lacunar infarction. Moreover, the DCA analysis indicated that the nomogram had a higher overall net benefit of the threshold probability range in both two sets. Conclusion: Age, diabetes mellitus, atrial fibrillation, duration of hypertension, and low-density lipoprotein were significant predictors of lacunar infarction in hypertensive patients. The nomogram based on the clinical data was constructed, which was a useful visualized tool for clinicians to assess the risk of the lacunar infarction in hypertensive patients.

Effect of Alleviating Preoperative Anxiety on Gastrointestinal Function Recovery After Laparoscopic High Ligation of the Hernia Sac in Children with Indirect Inguinal Hernia.

Purpose: Anxiety and depression can affect the physiology of the gastrointestinal tract through the brain-gut axis, causing gastrointestinal dysfunction, which is mainly manifested as indigestion, diarrhoea, constipation, or abdominal pain. Preoperative anxiety arises in children due to separation from parents, fear of unfamiliar surroundings and anaesthesia and surgical procedures.To discuss the effect of alleviating preoperative anxiety on postoperative recovery of gastrointestinal function in children with indirect inguinal hernia after laparoscopic high ligation of the hernia sac. Patients and Methods: 90 children with laparoscopic high ligation of the herniated sac in oblique inguinal hernia were randomly divided into control group (Group C) and experimental group (Group M). The Group M was given midazolam oral solution 0.5mg/kg (maximum dose 20mg), and The Group C was given 5% glucose solution with the same dose.Primary outcome was the time to first postoperative defecation and I-FEED scores.The secondary outcomes included mYPAS-SF scores; child sedation scores; child-parent separation scores; parental STAI scores;PHBQ scores;FLACC scores, operative time, and fluid input and surgeon job satisfaction. Results: Compared with Group C, there was a shorter time to first postoperative defecation (P < 0.05), and lower I-FEED scores on postoperative day 1 (P < 0.05). The mYPAS-SF scores, which were significantly different in Group M at T1, T2, and T3 (P < 0.05), parental STAI scores at S1, child sedation scores and child-parent separation scores in T1, and surgeon job satisfaction between the two groups were significantly different (P < 0.05). There were no statistically significant differences in I-FEED scores on days 2 and 3, PHBQ scores, FLACC scores, operative time, and fluid input between the two groups of children (P > 0.05). Conclusion: Preoperative application of midazolam oral solution to relieve preoperative anxiety helps to promote the recovery of postoperative gastrointestinal function in children with indirect inguinal hernia and increases the surgeon job satisfaction.

Effect of High Calcium and High Iron Coal on Ash Fusion Characteristics of Petroleum Coke during Cogasification.

Entrained flow gasification provides a more efficient utilization method for high-sulfur petroleum coke. The operation temperature of the entrained flow gasifier must be above the ash fusion temperature (AFT) of petroleum coke due to the liquid slag discharge. In this work, petroleum coke was blended with high-calcium coal and high-iron coal, respectively, under a reducing atmosphere, and the variations in AFTs were recorded by an ash fusion temperature analyzer. The influence of mineral transformations on the ash fusion characteristics of blended ash was analyzed by X-ray diffraction and FactSage. The results showed that both high calcium coal and high iron coal could efficiently reduce the AFTs of petroleum coke. When the ratio of high calcium coal and high iron coal reached 60 wt %, the corresponding flow temperature (FT) of mixed ash decreased to 1225 and 1312 °C, respectively. With the content of high calcium coal increasing, coulsonite (FeV2O4), vanadium trioxide (V2O3) and nickel (Ni) with high-melting points tended to decrease, causing the decrease of AFT for mixed ash. As high iron coal was added, Ni and V2O3 continuously kept decreasing. In particular, the percentage of FeV2O4 first increased and thereafter decreased with high iron coal above 40 wt %.

Hexagonal Mg2B2 and Ca2B2 monolayers as promising anode materials for Li-ion and Na-ion batteries.

Exploring new high-performance anode materials is of great significance for next generation renewable energy technologies. Two-dimensional (2D) transition metal borides, named as MBenes, are receiving increasing attention in energy storage fields due to their structure-and-composition diversities and high electrical conductivities. Expanding the family of hexagonal MBenes to non-transition metal borides, we report two hexagonal IIA metal M2B2-typed MBenes and demonstrate the feasibility of exfoliation and application as anode materials for Li-ion batteries (LIBs) and Na-ion batteries (SIBs) using ab initio calculations. The predicted 2D Mg2B2 and Ca2B2 monolayers exhibit robust thermal and mechanical stabilities, inherent metallic properties, electrical conductivities, and excellent electrode performance. The outstanding theoretical specific capacities of Mg2B2 and Ca2B2 for Li/Na ions reach up to 764/527 and 859/527 mA h g-1, respectively. Furthermore, the average open-circuit voltages (OCVs) of Mg2B2 and Ca2B2 range from 0.275 to 0.395 V, indicating their suitability for anode materials. Additionally, the low diffusion energy barriers of Mg2B2 and Ca2B2 for Li/Na ions at delithiated/desodiated states (27/14 and 16/12 meV) and lithiated/sodiated states (187/58 and 52/34 meV) illustrate their excellent charge-discharge capabilities. These intriguing findings demonstrate the superior performance of the predicted IIA metal boride monolayers as promising anode materials for LIBs and SIBs and break through the limitations of transition metal MBenes as anode materials in terms of overall performance. Our study opens the door to the application of the main group metal MBenes in ion energy storage.

Templated Nucleation of Clotrimazole and Ketoprofen on Polymer Substrates.

The use of different template surfaces in crystallization experiments can directly influence the nucleation kinetics, crystal growth, and morphology of active pharmaceutical ingredients (APIs). Consequently, templated nucleation is an attractive approach to enhance crystal nucleation kinetics and preferentially nucleate desired crystal polymorphs for solid-form drug molecules, particularly large and flexible molecules that are difficult to crystallize. Herein, we investigate the effect of polymer templates on the crystal nucleation of clotrimazole and ketoprofen with both experiments and computational methods. Crystallization was carried out in toluene solvent for both APIs with a template library consisting of 12 different polymers. In complement to the experimental studies, we developed a computational workflow based on molecular dynamics (MD) and derived descriptors from the simulations to score and rank API-polymer interactions. The descriptors were used to measure the energy of interaction (EOI), hydrogen bonding, and rugosity (surface roughness) similarity between the APIs and polymer templates. We used a variety of machine learning models (14 in total) along with these descriptors to predict the crystallization outcome of the polymer templates. We found that simply rank-ordering the polymers by their API-polymer interaction energy descriptors yielded 92% accuracy in predicting the experimental outcome for clotrimazole and ketoprofen. The most accurate machine learning model for both APIs was found to be a random forest model. Using these models, we were able to predict the crystallization outcomes for all polymers. Additionally, we have performed a feature importance analysis using the trained models and found that the most predictive features are the energy descriptors. These results demonstrate that API-polymer interaction energies are correlated with heterogeneous crystallization outcomes.

The optimal dose of metformin to control conversion to diabetes in patients with prediabetes: A meta-analysis.

AIM: This study aims to investigate the optimal dose of metformin for controlling the transition to diabetes in patients diagnosed with prediabetes. METHODS: We systematically searched randomized controlled trials (RCTs) in CNKI, Wanfang, VIP, SinoMed, Scopus, PubMed, Embase, Cochrane Library, Web of Science, and Cumulative Index to Nursing and Allied Health Literature (CINAHL) from inception to February 2024. Meta-analysis was conducted using RevMan 5.4 software. RESULTS: We included 25 randomized controlled trials comprising 2437 patients. The results of the meta-analysis revealed that compared to dose groups of 500 mg/d, 850 mg/d, 1000 mg/d, 1500 mg/d, 1700 mg/d, and 2000 mg/d, a dosage of 750 mg/d of metformin significantly reduced the incidence of diabetes in patients (risk ratio [RR] = 0.21, 95 % confidence interval [CI]: 0.11, 0.41; p < 0.00001), lowered Postprandial Blood Glucose (PBG) (mean difference[MD] = -2.60, 95 % CI: -4.34, -0.86; p = 0.003), and promoted the normalization of blood glucose levels (RR = 2.13, 95 % CI: 1.68, 2.71; p < 0.00001). Regarding safety evaluation, no significant differences were identified among the various dose groups. In contrast, the cohort receiving a daily dosage of 750 mg demonstrated the most pronounced decrease in the incidence of adverse reactions. CONCLUSION: Based on the efficacy and safety evaluation results, our findings suggest that a daily dosage of 750 mg of metformin may represent the optimal dose for controlling the progression from pre-diabetes to diabetes. REGISTRATION: PROSPERO registration ID: CRD42024538322.

Catalyst free PET and PEF polyesters using a new traceless oxalate chain extender.

Plastic material performance is strongly correlated to the polymer's molecular weight. Obtaining a sufficiently high molecular weight is therefore a key goal of polymerization processes. The most important polyester polyethylene terephthalate (PET) and the new polyethylene furanoate (PEF) require metal catalysts and time-consuming production processes to reach sufficiently high molecular weights. Metal catalysts, which are typically antimony or tin for polyesters, end up in the plastic products which may result in sustainability and ecological challenges. When the less reactive comonomer isosorbide is introduced to produce (partly) biobased materials with enhanced thermal properties, such as polyethylene-co-isosorbide furanoate (PEIF), reaching high enough molecular weight becomes even more challenging. This study presents an easily implementable approach to produce high molecular weight PET and PEF polyesters and their isosorbide copolyesters PEIT and PEIF by coupling lower molecular weight polymer chains by the reactive diguaiacyl oxalate (DGO) chain extender. DGO is so reactive, that the use of metal catalysts can be completely avoided and it helps avoiding an extra solid-state polymerization step. In addition, DGO distinguishes itself from typical chain extenders by its ability to be completely removed from the resulting polymer, thereby avoiding the inherent drawbacks associated with typical chain extenders.

The traditional Chinese medicine Qiliqiangxin in heart failure with reduced ejection fraction: a randomized, double-blind, placebo-controlled trial.

Previous findings have indicated the potential benefits of the Chinese traditional medicine Qiliqiangxin (QLQX) in heart failure. Here we performed a double-blind, randomized controlled trial to evaluate the efficacy and safety of QLQX in patients with heart failure and reduced ejection fraction (HFrEF). This multicenter trial, conducted in 133 hospitals in China, enrolled 3,110 patients with HFrEF with NT-proBNP levels of ≥450 pg ml-1 and left ventricular ejection fraction of ≤40%. Participants were randomized to receive either QLQX capsules or placebo (four capsules three times daily) alongside standard heart failure therapy. The trial met its primary outcome, which was a composite of hospitalization for heart failure and cardiovascular death: over a median follow-up of 18.3 months, the primary outcome occurred in 389 patients (25.02%) in the QLQX group and 467 patients (30.03%) in the placebo group (hazard ratio (HR), 0.78; 95% confidence interval (CI), 0.68-0.90; P < 0.001). In an analysis of secondary outcomes, the QLQX group showed reductions in both hospitalization for heart failure (15.63% versus 19.16%; HR, 0.76; 95% CI, 0.64-0.90; P = 0.002) and cardiovascular death (13.31% versus 15.95%; HR, 0.83; 95% CI, 0.68-0.996; P = 0.045) compared to the placebo group. All-cause mortality did not differ significantly between the two groups (HR, 0.84; 95% CI, 0.70-1.01; P = 0.058) and adverse events were also comparable between the groups. The results of this trial indicate that QLQX may improve clinical outcomes in patients with HFrEF when added to conventional therapy. ChiCTR registration: ChiCTR1900021929 .