RESUMO
HbA1c is the gold standard test for monitoring medium/long term glycemia conditions in diabetes care, which is a critical factor in reducing the risk of chronic diabetes complications. Current technologies for measuring HbA1c concentration are invasive and adequate assays are still limited to laboratory-based methods that are not widely available worldwide. The development of a non-invasive diagnostic tool for HbA1c concentration can lead to the decrease of the rate of undiagnosed cases and facilitate early detection in diabetes care. We present a preliminary validation diagnostic study of W-band spectroscopy for detection and monitoring of sustained hyperglycemia, using the HbA1c concentration as reference. A group of 20 patients with type 1 diabetes mellitus and 10 healthy subjects were non-invasively assessed at three different visits over a period of 7 months by a millimeter-wave spectrometer (transmission mode) operating across the full W-band. The relationship between the W-band spectral profile and the HbA1c concentration is studied using longitudinal and non-longitudinal functional data analysis methods. A potential blind discrimination between patients with or without diabetes is obtained, and more importantly, an excellent relation (R-squared = 0.97) between the non-invasive assessment and the HbA1c measure is achieved. Such results support that W-band spectroscopy has great potential for developing a non-invasive diagnostic tool for in-vivo HbA1c concentration monitoring in humans.
RESUMO
BACKGROUND: Despite its high market potential, bio-based succinic acid production experienced recently a declining trend because the initial investments did not meet the expectations for rapid market growth. Thus, reducing the succinic acid production cost is imperative to ensure industrial implementation. RESULTS: Succinic acid production has been evaluated using hydrolysates from the organic fraction of municipal solid waste (OFMSW) collected from MSW treatment plants. A tailor-made enzymatic cocktail was used for OFMSW hydrolysate production containing up to 107.3 g/L carbon sources and up to 638.7 mg/L free amino nitrogen. The bacterial strains Actinobacillus succinogenes and Basfia succiniciproducens were evaluated for succinic acid production with the latter strain being less efficient due to high lactic acid production. Batch A. succinogenes cultures supplemented with 5 g/L yeast extract and 5 g/L MgCO3 reached 29.4 g/L succinic acid with productivity of 0.89 g/L/h and yield of 0.56 g/g. Continuous cultures at dilution rate of 0.06 h-1 reached 21.2 g/L succinic acid with yield of 0.47 g/g and productivity of 1.27 g/L/h. Downstream separation and purification of succinic acid was achieved by centrifugation, treatment with activated carbon, acidification with cation exchange resins, evaporation and drying, reaching more than 99% purity. Preliminary techno-economic evaluation has been employed to evaluate the profitability potential of bio-based succinic acid production. CONCLUSIONS: The use of OFMSW hydrolysate in continuous cultures could lead to a minimum selling price of 2.5 $/kg at annual production capacity of 40,000 t succinic acid and OFMSW hydrolysate production cost of 25 $/t sugars.
RESUMO
Antiplatelet switching in the management of acute coronary syndrome (ACS) seems to be safe, but prospective data are limited. This retrospective study assessed the safety and efficacy of in-hospital clopidogrel-to-prasugrel switching in patients with ACS. We analysed 525 consecutive patients with ACS admitted to our coronary care unit. We assessed the prevalence and the short-term outcomes of in-hospital clopidogrel-to-prasugrel switching. Bleeding and thrombotic events were assessed using propensity score matching analysis. A total of 468 patients received acetylsalicylic acid and a P2Y12 ADP receptor inhibitor. Medication switching occurred in 117 patients (25 %). Compared with the clopidogrel group, the switching group consisted preferentially of younger males with STEMI, exhibited fewer comorbidities, and had lower ischaemic risk. We found no differences between the switching group and the clopidogrel group in the bleeding rate [3.6 vs. 2.3 %, odds ratio (OR):1.59 95 % confidence interval (CI): 0.26-9.7, p NS], and in adverse cardiac or cerebrovascular events (MACCE) (5 vs. 8.4 %, OR: 0.57 95 % CI 0.16-2, p NS). In-hospital switching from clopidogrel to prasugrel in a selected high-risk ACS population resulted in a similar incidence of in-hospital haemorrhagic and thrombotic events. This strategy should be clarified in further randomised studies.