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Background: There are insufficient studies to determine whether sodium-glucose cotransporter type 2 inhibitors (SGLT2i) will help reduce early diabetic cardiomyopathy, especially in patients without documented cardiovascular disease. Methods: We performed a single center, prospective observation study. A total of 90 patients with type 2 diabetes patients without established heart failure or atherosclerotic cardiovascular disease were enrolled. Echocardiography, cardiac enzyme, and glucose-control data were examined before and 3 months after the administration of SGLT2i (dapagliflozin 10 mg per day). Cardiovascular risk factors included hypertension, smoking, obesity, dyslipidemia, and old age. The primary end point was the change of E/e' before and after administration of SGLT2i. Results: Most patients (86.7%) had three or more cardiovascular risk factors, and about 32% had all five risk factors. Although the decrease in E/e' after the administration of SGLT2i was observed in 20% of enrolled patients, there was no significant difference in average E/e' value or left atrial volume index before and after the SGLT2i medication. Even in patients with all known risk factors including old age, E/e' value did not decrease after adding SGLT2i (8.9 ± 2.4 vs. 8.7 ± 3.2). There was a statistically significant difference in E/e' change after the SGLT2i administration between patients younger than 60 years and those older than 60 years (–0.7 ± 2.2 vs. 1.1 ± 2.8, P = 0.002). Conclusions: In type 2 diabetes patients without documented cardiovascular disease including heart failure, administration of SGLT2i showed no improvement in diastolic function profile. Further large-scale randomized studies are needed to determine who will benefit from potential cardiovascular events with early addition of SGLT2i. [ABSTRACT FROM AUTHOR]

Introduction: This study aimed to compare the long‐term effects of neoadjuvant therapy and upfront surgery on overall survival (OS) and progression‐free survival (PFS) in patients with resectable pancreatic ductal adenocarcinoma (PDAC). Methods: We retrospectively analyzed 202 patients, including 167 who had upfront surgery and 35 who received neoadjuvant therapy followed by surgery. Surgical outcomes and survival rates were compared using propensity score matching to minimize selection bias. Results: Neoadjuvant therapy showed significantly longer 75% OS (72.7 months vs. 28.3 months, p = 0.032) and PFS (29.6 months vs. 13.2 months, p < 0.001) compared to upfront surgery. Additionally, neoadjuvant therapy demonstrated significant improvements in surgical outcomes, including higher R0 resection rates (74.3% vs. 49.5%, p = 0.034), reduced tumor size (22.0 mm vs. 28.0 mm, p = 0.001), and decreased lymphovascular invasion (20.0% vs. 52.4%, p = 0.001). Conclusion: Our study demonstrates the potential benefits of neoadjuvant therapy for resectable PDAC. The improved survival rates, delayed disease progression, and enhanced surgical outcomes underscore the potential of neoadjuvant therapy in addressing this aggressive disease. Despite limitations such as the retrospective design and small sample size, these findings support the effectiveness of neoadjuvant therapy in improving treatment outcomes for PDAC patients in real‐world settings. Further prospective studies are required to validate these results. This study suggests that neoadjuvant therapy in patients with resectable pancreatic cancer improves overall survival and surgical outcomes, while also delaying disease progression compared to upfront surgery. These findings underscore the pivotal role of neoadjuvant therapy in treatment strategies for resectable pancreatic cancer. [ABSTRACT FROM AUTHOR]

Cysteine plays a crucial role in the development of an efficient copper-catalyst system, where its thiol group serves as a strong anchoring site for metal coordination. By immobilizing copper onto cysteine-modified, polydopamine-coated magnetite particles, this advanced catalytic platform exhibits exceptional stability and catalytic activity. Chemical modification of the polydopamine (PDA) surface with cysteine enhances copper salt immobilization, leading to the formation of the Fe3O4@PDA-Cys@Cu platform. This system was evaluated in palladium-free, copper-catalyzed Sonogashira coupling reactions, effectively catalyzing the coupling of terminal acetylenes with aryl halides. Additionally, the Fe3O4@PDA-Cys@Cu platform was employed in click reactions, confirming the enhanced catalytic efficiency due to increased copper content. The reusability of the platform was further investigated, demonstrating improved performance, especially in recyclability tests in click reaction, making it a promising candidate for sustainable heterogeneous catalysis. [ABSTRACT FROM AUTHOR]

With the rise of eco-friendly policies, advanced motor technologies are being developed to replace fossil fuel-based engines in the mobility industry. Axial flux motors, known for their ability to reduce size and increase output torque compared to radial flux motors, require different materials and manufacturing techniques. Specifically, the production of complex stator cores and segmented magnets presents significant challenges, often leading to higher costs. To address this issue, soft magnetic composite (SMC) materials, which offer greater design flexibility, are being explored for use in stator cores. However, soft magnetic composite materials exhibit lower permeability and saturation flux density compared to laminated silicon steel, resulting in reduced output torque and efficiency. This paper investigates the effects of stator geometry on axial flux motor performance and explores cladding core technology, which combines soft magnetic composite materials with silicon steel. By conducting finite element method (FEM) analysis to evaluate the output torque and efficiency based on the shape of the silicon steel within the cladding core, this study proposes an optimized cladding core design to enhance the efficiency and output torque of axial flux motors. [ABSTRACT FROM AUTHOR]

Background: Approximately half of the patients with advanced pancreatic ductal adenocarcinoma (PDAC) receive subsequent lines of chemotherapy. Recently, the liposomal irinotecan (nal-IRI) plus 5-fluorouracil/leucovorin (5-FU/LV) regimen is recommended as subsequent lines of chemotherapy. However, little is known about the predictive factors for the nal-IRI + 5-FU/LV regimen, especially in patients with previous irinotecan (IRI) exposure. Objectives: We investigated the predictive factors associated with nal-IRI + 5-FU/LV treatment in patients with PDAC. Design: Multicenter, retrospective cohort study. Methods: This study included patients with advanced PDAC who received the nal-IRI + 5-FU/LV regimen for palliative purposes. Results: Overall, 268 patients were treated with nal-IRI + 5-FU/LV. The median overall survival (OS) was 7.9 months (95% confidence interval (CI): 7.0–8.8), while the median progression-free survival (PFS) was 2.6 months (95% CI: 1.9–3.2). An albumin level of<4.0 g/dL, neutrophil-to-lymphocyte ratio (NLR) of ⩾3.5, liver or peritoneal metastasis, and a history of >3 lines of palliative chemotherapy were associated with worse OS. An NLR of ⩾3.5 and liver metastasis were significant predictive factors for worse PFS. Previous exposure to IRI was not a significant predictor. Patients without prior IRI (no-IRI) treatment showed relatively longer OS and PFS compared to IRI responders and nonresponders, but these differences were not significant when compared specifically to the responders (OS: 8.8 vs 8.1 months, p = 0.388; PFS: 3.6 vs 2.6 months, p = 0.126). Conclusion: An NLR of ⩾3.5 and liver metastasis were associated with worse PFS. Prior IRI exposure was not a significant predictive factor for OS and PFS, especially in IRI responders. [ABSTRACT FROM AUTHOR]

Background and Aims Even though vegetation size in infective endocarditis (IE) has been associated with embolic events (EEs) and mortality risk, it is unclear whether vegetation size associated with these potential outcomes is different in left-sided IE (LSIE). This study aimed to seek assessing the vegetation cut-off size as predictor of EE or 30-day mortality for LSIE and to determine risk predictors of these outcomes. Methods The European Society of Cardiology EURObservational Research Programme European Infective Endocarditis is a prospective, multicentre registry including patients with definite or possible IE throughout 2016–18. Cox multivariable logistic regression analysis was performed to assess variables associated with EE or 30-day mortality. Results There were 2171 patients with LSIE (women 31.5%). Among these affected patients, 459 (21.1%) had a new EE or died in 30 days. The cut-off value of vegetation size for predicting EEs or 30-day mortality was >10 mm [hazard ratio (HR) 1.38, 95% confidence interval (CI) 1.13–1.69, P =.0015]. Other adjusted predictors of risk of EE or death were as follows: EE on admission (HR 1.89, 95% CI 1.54–2.33, P <.0001), history of heart failure (HR 1.53, 95% CI 1.21–1.93, P =.0004), creatinine >2 mg/dL (HR 1.59, 95% CI 1.25–2.03, P =.0002), Staphylococcus aureus (HR 1.36, 95% CI 1.08–1.70, P =.008), congestive heart failure (HR 1.40, 95% CI 1.12–1.75, P =.003), presence of haemorrhagic stroke (HR 4.57, 95% CI 3.08–6.79, P <.0001), alcohol abuse (HR 1.45, 95% CI 1.04–2.03, P =.03), presence of cardiogenic shock (HR 2.07, 95% CI 1.29–3.34, P =.003), and not performing left surgery (HR 1.30 95% CI 1.05–1.61, P =.016) (C -statistic =.68). Conclusions Prognosis after LSIE is determined by multiple factors, including vegetation size. [ABSTRACT FROM AUTHOR]