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OBJECTIVE: Glycemia management in critical care is posing a challenge in frequent measuring and adequate insulin dose adjustment. In recent years, continuous glucose measurement has gained accuracy and reliability in outpatient and inpatient settings. The aim of this study was to assess the feasibility and accuracy of real-time continuous glucose monitoring (CGM) in ICU patients after major abdominal surgery. RESEARCH DESIGN AND METHODS: We included patients undergoing pancreatic surgery and solid organ transplantation (liver, pancreas, islets of Langerhans, kidney) requiring an ICU stay after surgery. We used a Dexcom G6 sensor, placed in the infraclavicular region, for real-time CGM. Arterial blood glucose measured by the amperometric principle (ABL 800; Radiometer, Copenhagen, Denmark) served as a reference value and for calibration. Blood glucose was also routinely monitored by a StatStrip bedside glucose meter. Sensor accuracy was assessed by mean absolute relative difference (MARD), bias, modified Bland-Altman plot, and surveillance error grid for paired samples of glucose values from CGM and acid-base analyzer (ABL). RESULTS: We analyzed data from 61 patients and obtained 1,546 paired glucose values from CGM and ABL. Active sensor use was 95.1%. MARD was 9.4%, relative bias was 1.4%, and 92.8% of values fell in zone A, 6.1% fell in zone B, and 1.2% fell in zone C of the surveillance error grid. Median time in range was 78%, with minimum (

In this work, CeBTC (a cerium(III) 1,3,5-benzene-tricarboxylate), was used as a precursor for obtaining CeO2 nanoparticles (nanoceria) with better sensor performances than CeO2 nanoparticles synthesized by the solvothermal method. Metal–organic framework-derived nanoceria (MOFdNC) were functionalized with spheric gold nanoparticles (AuNPs) to further improve non-enzymatic electrode material for highly sensitive detection of prominent biocompound uric acid (UA) at this modified carbon paste electrode (MOFdNC/AuNPs&CPE). X-ray powder diffraction (XRPD) and transmission electron microscopy (TEM) analysis were used for morphological structure characterization of the obtained nanostructures. Cyclic voltammetry and electrochemical impedance spectroscopy, both in an [Fe(CN)6]3−/4− redox system and uric acid standard solutions, were used for the characterization of material electrocatalytic performances, the selection of optimal electrode modifier, and the estimation of nature and kinetic parameters of the electrode process. Square-wave voltammetry (SWV) was chosen, and the optimal parameters of technique and experimental conditions were established for determining uric acid over MOFdNC/AuNPs&CPE. Together with the development of the sensor, the detection procedure was optimized with the following analytical parameters: linear operating ranges of 0.05 to 1 µM and 1 to 50 µM and a detection limit of 0.011 µM, with outstanding repeatability, reproducibility, and stability of the sensor surface. Anti-interference experiments yielded a stable and nearly unchanged current response with negligible or no change in peak potential. After minor sample pretreatment, the proposed electrode was successfully applied for the quantification of UA in milk.

Osteoporosis occurs in every third individual after simultaneous pancreas kidney transplantation (SPKT). Currently used bone measures insufficiently predict their fracture risk. Lumbar spine Trabecular bone score (TBS) and distal radius areal and volumetric bone mineral density (BMD) were monitored for the first time in patients with type 1 diabetes and chronic renal failure after SPKT with steroid-sparing protocol. In 33 subjects (mean age 43.4 ± 9.8 years), dual-energy X-ray absorptiometry and peripheral quantitative computed tomography were performed just after SPKT (baseline) and one and three years later. While TBS Z-scores increased (−1.1 ± 1.2 and −0.3 ± 1.0; p˂0.001, at baseline and year three, respectively), trabecular volumetric BMD Z-scores at distal radius metaphysis did not change during the study (−1.3 ± 1.3 and −1.3 ± 1.0; p = 0.38). Similarly, areal BMD Z-scores increased at lumbar spine, total hip and femoral neck (all p

Strontium ferromolybdate, Sr2FeMoO6, is an important member of the family of double perovskites with the possible technological applications in the field of spintronics and solid oxide fuel cells. Its preparation via a multi-step ceramic route or various wet chemistry-based routes is notoriously difficult. The present work demonstrates that Sr2FeMoO6 can be mechanosynthesized at ambient temperature in air directly from its precursors (SrO, α-Fe, MoO3) in the form of nanostructured powders, without the need for solvents and/or calcination under controlled oxygen fugacity. The mechanically induced evolution of the Sr2FeMoO6 phase and the far-from-equilibrium structural state of the reaction product are systematically monitored with XRD and a variety of spectroscopic techniques including Raman spectroscopy, 57Fe Mössbauer spectroscopy, and X-ray photoelectron spectroscopy. The unique extensive oxidation of iron species (Fe0 → Fe3+) with simultaneous reduction of Mo cations (Mo6+ → Mo5+), occuring during the mechanosynthesis of Sr2FeMoO6, is attributed to the mechanically triggered formation of tiny metallic iron nanoparticles in superparamagnetic state with a large reaction surface and a high oxidation affinity, whose steady presence in the reaction mixture of the milled educts initiates/promotes the swift redox reaction. High-resolution transmission electron microscopy observations reveal that the mechanosynthesized Sr2FeMoO6, even after its moderate thermal treatment at 923 K for 30 min in air, exhibits the nanostructured nature with the average particle size of 21(4) nm. At the short-range scale, the nanostructure of the as-prepared Sr2FeMoO6 is characterized by both, the strongly distorted geometry of the constituent FeO6 octahedra and the extraordinarily high degree of anti-site disorder. The degree of anti-site disorder ASD = 0.5, derived independently from the present experimental XRD, Mössbauer, and SQUID magnetization data, corresponds to the completely random distribution of Fe3+ and Mo5+ cations over the sites of octahedral coordination provided by the double perovskite structure. Moreover, the fully anti-site disordered Sr2FeMoO6 nanoparticles exhibit superparamagnetism with the blocking temperature T B = 240 K and the deteriorated effective magnetic moment μ = 0.055 μ B per formula unit.

BackgroundProton-pump inhibitors (PPIs) are widely prescribed as acid-suppression therapy. Some observational studies suggest that long-term use of PPIs is potentially associated with certain adverse kidney outcomes. We conducted a systematic literature review to assess potential bias in non-randomized studies reporting on putative associations between PPIs and adverse kidney outcomes (acute kidney injury, acute interstitial nephritis, chronic interstitial nephritis, acute tubular necrosis, chronic kidney disease, and end-stage renal disease).MethodsWe searched the medical literature within 10 years of 17 December 2020. Pre-specified criteria guided identification of relevant English language articles for assessment. Risk of bias on an outcome-specific basis was evaluated using the Risk of Bias in Non-randomized Studies of Interventions (ROBINS-I) tool by two independent reviewers.ResultsOf 620 initially identified records, 26 studies met a priori eligibility criteria and underwent risk of bias assessment. Nineteen studies were judged as having a moderate risk of bias for reported adverse kidney outcomes, while six studies were judged as having a serious risk of bias (mainly due to inadequate control of confounders and selection bias). We were unable to determine the overall risk of bias in two studies (one of which was assessed as having a moderate risk of bias for a different adverse kidney outcome) due to insufficient information presented. Effect estimates for PPIs in relation to adverse kidney outcomes varied widely (0.24-7.34) but associations mostly showed increased risk.ConclusionUsing ROBINS-I, we found that non-randomized observational studies suggesting kidney harm by PPIs have moderate to serious risk of bias, making it challenging to establish causality. Additional high-quality, real-world evidence among generalizable populations are needed to better understand the relation between PPI treatment and acute and chronic kidney outcomes, accounting for the effects of varying durations of PPI treatment, self-treatment with over-the-counter PPIs, and potential critical confounders.

Abstract Background Patients with overactive bladder (OAB) experience sudden, intense urges to urinate, which may include urge urinary incontinence and nocturia. Pharmacotherapy includes β3-adrenergic receptor agonists such as mirabegron; however, mirabegron contains a label warning for cytochrome P450 (CYP) 2D6 inhibition, making coadministration with CYP2D6 substrates require monitoring and dose adjustment to avoid unintended increases in substrate concentration. Objective To understand the codispensing patterns of mirabegron among patients using ten predefined CYP2D6 substrates with and before mirabegron dispensing. Methods This retrospective claims database analysis used the IQVIA PharMetrics® Plus Database to assess codispensing of mirabegron with ten predefined CYP2D6 substrate groups identified on the basis of medications most frequently prescribed in the United States, those with high susceptibility to CYP2D6 inhibition, and those with evidence for exposure-related toxicity. Patients had to be ≥ 18 years old before initiation of the CYP2D6 substrate episode that overlapped with mirabegron. The cohort entry period was November 2012 to September 2019, and the overall study period was 1 January 2011 to 30 September 2019. Comparisons of patient profiles at dispensing were made between time periods with and before mirabegron use in the same patient. Descriptive statistics were used to assess the number of exposure episodes, total duration of exposure, and median duration of exposure of CYP2D6 substrate dispensing with and before mirabegron. Results CYP2D6 substrate exposure periods totaling ≥ 9000 person-months were available before overlapping exposure to mirabegron for all ten CYP2D6 substrate cohorts. Median codispensing duration for chronically administered CYP2D6 substrates was 62 (interquartile range [IQR] 91) days for citalopram/escitalopram, 71 (105) days for duloxetine/venlafaxine, and 75 (115) days for metoprolol/carvedilol; median codispensing duration for acutely administered CYP2D6 substrates was 15 (33) days for tramadol and 9 (18) days for hydrocodone. Conclusions In this claims database analysis, the dispensing patterns of CYP2D6 substrates with mirabegron displayed frequent overlapping of exposure. Thus, a need exists to better understand the outcomes experienced by patients with OAB who are at increased risk for drug‒drug interactions when taking multiple CYP2D6 substrates concurrently with a CYP2D6 inhibitor.

Abstract Background Overactive bladder (OAB) is characterized by the presence of bothersome urinary symptoms. Pharmacologic treatment options for OAB include anticholinergics and β3-adrenergic agonists. Use of β3-adrenergic agonists may result in similar treatment efficacy with a decreased side effect profile compared with anticholinergics because high anticholinergic burden is associated with cardiovascular and neurologic side effects. However, the β3-adrenergic agonist mirabegron, one of two approved drugs within this class, is a moderate cytochrome P450 (CYP) 2D6 inhibitor, and coadministration of drugs that are CYP2D6 substrates with mirabegron may lead to adverse drug effects. Objective The aim of this study was to quantify how often CYP2D6 substrates were dispensed in patients receiving mirabegron among adults of any age and among those ≥ 65 years of age. Methods In this retrospective descriptive analysis, a deidentified administrative claims database in the United States, IQVIA PharMetrics® Plus, was used to identify dispensing claims for CYP2D6 substrates and mirabegron from November 2012 to September 2019. Prevalence of CYP2D6 substrate dispensing was assessed in patients dispensed mirabegron among all adults ≥ 18 years old and additionally among a cohort of those ≥ 65 years old. Patient baseline profiles at the time of mirabegron and CYP2D6 substrate codispensing and at the time of mirabegron dispensing were compared. CYP2D6 substrates were categorized as those with the potential for increased risk of QT prolongation, with anticholinergic properties, with narrow therapeutic index (NTI), contraindicated or having a black box warning when used with CYP2D6 inhibitors, or used for depression or other psychiatric disease. Dispensing data and patient profiles were summarized descriptively. Results Overall, 68.5% of adults ≥ 18 years old dispensed mirabegron had overlapping dispensings for one or more CYP2D6 substrate; 60.6% and 53.6% had overlapping dispensings for CYP2D6 substrates with anticholinergic properties or risk of QT prolongation, respectively. CYP2D6 substrates with NTI, contraindicated with CYP2D6 inhibitors, or for psychiatric use were codispensed in 17.7%, 16.6%, and 38.0% of adult mirabegron users, respectively. Mirabegron users receiving one or more concurrent CYP2D6 substrate were more likely to be older, have more comorbidities and baseline polypharmacy, and have increased healthcare resource utilization compared with those without concurrent CYP2D6 substrates. Commonly codispensed CYP2D6 substrates included hydrocodone, oxycodone, tramadol, metoprolol, and tamsulosin. Findings were similar for patients in the older cohort (≥ 65 years old), with 72.1% receiving overlapping CYP2D6 substrates. Conclusions Codispensing of CYP2D6 substrates, especially those with anticholinergic properties or risk of QT prolongation, was common among adults and older adults receiving mirabegron. Results highlight the need for improved awareness of CYP2D6 substrate prescribing among patients receiving pharmacologic treatment for OAB that inhibits the CYP2D6 pathway.

This work reports about preparation of W/Fe co-sputtered layers between tungsten and steel in order to ease their coefficient of thermal expansion mismatch.Iron and tungsten have been gradually co-sputtered on W tiles with real time deposition parameters changing to obtain a graded interlayer: SEM, EDS, XPS, HR-TEM have been used to characterize the W/Fe co-sputtered layer.W tiles co-sputtered with the W/Fe layers have been hot pressed to steel tiles: morphology and mechanical strength have been investigated for joints with and without W/Fe co-sputtered layer.Lap-shear tests in compression at room temperature have been made on hot pressed W/steel joints with and without W/Fe co-sputtered layer, showing a different behaviour.High flux test on joints with and without W/Fe co-sputtered layer are reported and discussed. The mechanical test results of manufactured joints are in good accordance with high heat flux test results, showing that the behaviour of hot-pressed joints with W/Fe co-sputtered layer was slightly worse if compared to joints without co-sputtered layer at the interface.

Abstract The series of advanced nanocomposites consisting of Gd2O3 nanoparticles (NPs) embedded into periodic porous SiO2 matrix have been investigated with respect to their structural and magnetocaloric properties. By means of small angle neutron scattering and transmission electron microscopy, regular nanopores organized in the cubic or hexagonal superlattice have been documented. The pores are occupied by the NPs of progressive concentration within the nanocomposite series. All of the examined systems have exhibited extraordinarily high values of magnetic entropy change (up to 70 J kg−1 K−1) at low temperatures with the absence of thermal hysteresis, indicating their perspective utilization in cryogenic refrigeration. Profound analysis of magnetic entropy change data via scaling laws has been applied to the nanocomposite materials for the very first time. With the aid of scaling analysis, conclusions on magnetic properties and phase transition type have been made, even for the conditions unavailable in the laboratory.

Abstract A drug delivery system based on mesoporous particles MCM-41 was post-synthetically modified by photo-sensitive ligand, methyl-(2E)-3-(4-(triethoxysilyl)-propoxyphenyl)-2-propenoate (CA) and the pores of MCM-41 particles were loaded with Naproxen sodium salt (NAP). The CA was used as a photoactive molecule that can undergo a reversible photo-dimerization by [2π + 2π] cycloaddition when irradiated with UV light of specific wavelengths. Thus, it has a function of gate-keeper that is responsible for opening/closing the pores and minimizing premature release of NAP. The physicochemical properties of the prepared system were studied by infrared spectroscopy (IR), nitrogen adsorption measurements, thermogravimetric analysis (TGA), scanning transmission electron microscopy (STEM) and energy dispersive X-ray spectroscopy (EDX). The mechanism of the opening/closing pores was confirmed by UV measurements. In vitro and in vivo drug release experiments and the concentration of released NAP was determined by UV spectroscopy and high-performance liquid chromatography (HPLC). In vivo drug release in the blood circulatory system of rats has demonstrated the effective photo-cleavage reaction of CA molecules after UV-light stimulation. The localization and morphological changes of the particles were studied in the blood and liver of rats at different time intervals. The particles in the blood have been shown to retain their original rod-like shape, and the particles in the liver have been hydrolysed, which has resulted in spherical shape with a reduced size.

Cell-based therapeutics offer diverse options for treating retinal degenerative diseases, such as age-related macular degeneration (AMD) and retinitis pigmentosa (RP). AMD is characterized by both genetic and environmental risks factors, whereas RP is mainly a monogenic disorder. Though treatments exist for some patients with neovascular AMD, a majority of retinal degenerative patients have no effective therapeutics, thus indicating a need for universal therapies to target diverse patient populations. Two main cell-based mechanistic approaches are being tested in clinical trials. Replacement therapies utilize cell-derived retinal pigment epithelial (RPE) cells to supplant lost or defective host RPE cells. These cells are similar in morphology and function to native RPE cells and can potentially supplant the responsibilities of RPE in vivo. Preservation therapies utilize supportive cells to aid in visual function and photoreceptor preservation partially by neurotrophic mechanisms. The goal of preservation strategies is to halt or slow the progression of disease and maintain remaining visual function. A number of clinical trials are testing the safety of replacement and preservation cell therapies in patients; however, measures of efficacy will need to be further evaluated. In addition, a number of prevailing concerns with regards to the immune-related response, longevity, and functionality of the grafted cells will need to be addressed in future trials. This review will summarize the current status of cell-based preclinical and clinical studies with a focus on replacement and preservation strategies and the obstacles that remain regarding these types of treatments.

This study shows that in an atmosphere containing water vapor, the oxide layer on the surface of the 9CrNB steel MarBN (Martensitic 9Cr steel strengthened by Boron and MX Nitrides) was formed by an outer layer of hematite Fe2O3 and Cr2O3 and an inner two-phase layer of Fe3O4 and Fe3O4 + (Fe, Cr)2O4, which was confirmed by XRD analysis. Part of the layer consisted of nodules and pores that were formed during the increase in oxides when the present H2O(g) acted on the steel surface. The diffusion mechanism at temperatures of 600 and 650 °C and at longer oxidation times supported the “healing process” with a growing layer of Fe oxides and the presence of Cr and minor alloying elements. The effects of alloying elements were quantified using a concentration profile of the oxide layer based on quantitative SEM analysis, as well as an explanation of the mechanism influencing the structure and chemical composition of the oxide layer and the steel-matrix–oxide interface. In addition to Cr, for which the content reached the requirement of exceeding 7.0 wt. % in the inner oxide layer, W, Co, Mn, and Si were also found in increased concentrations, whether in the form of the present Fe-Cr spinel oxide or as part of a continuously distributed layer of Mn2O3 and SiO2 oxides at the steel-matrix–oxide interface. After long-term high-temperature oxidation, coarser carbides of the M23C6 type (M = Fe,W) significantly depleted in Cr were formed at the oxide-layer/matrix interface. In the zone under the oxide layer, very fine particles of MC (M = V, Nb, and to a lesser extent also Cr in the particle lattice of the given phase) were observed, with a higher number of particles per unit area compared to the state before oxidation. This fact was a consequence of Cr diffusion to the steel surface through the subsurface zone.

A colloidal solution of magnetic nanoparticles (MNPs) modified with biocompatible positively charged poly-L-lysine (PLL) with an oleate (OL) layer employed as an initial coating was produced as a potential MRI contrast agent. The effect of various PLL/MNPs’ mass ratios on the samples’ hydrodynamic diameter, zeta potential, and isoelectric point (IEP) was studied by the dynamic light-scattering method. The optimal mass ratio for MNPs’ surface coating was 0.5 (sample PLL0.5-OL-MNPs). The average hydrodynamic particle size in the sample of PLL0.5-OL-MNPs was 124.4 ± 1.4 nm, and in the PLL-unmodified nanoparticles, it was 60.9 ± 0.2 nm, indicating that the OL-MNPs’ surface became covered by PLL. Next, the typical characteristics of the superparamagnetic behavior were observed in all samples. In addition, the decrease in saturation magnetizations from 66.9 Am2/kg for MNPs to 35.9 and 31.6 Am2/kg for sample OL-MNPs and PLL0.5-OL-MNPs also confirmed successful PLL adsorption. Moreover, we show that both OL-MNPs and PLL0.5-OL-MNPs exhibit excellent MRI relaxivity properties and a very high r2(*)/r1 ratio, which is very desirable in biomedical applications with required MRI contrast enhancement. The PLL coating itself appears to be the crucial factor in enhancing the relaxivity of MNPs in MRI relaxometry.

Robert S Epstein,1 Upal K Basu Roy,2 Matti Aapro,3 Tehseen Salimi,4 Donald Moran,4 JoAnn Krenitsky,1 Megan L Leone-Perkins,5 Cynthia Girman,6 Courtney Schlusser,7 Jeffrey Crawford8 1Epstein Health, LLC., Woodcliff Lake, NJ, USA; 2LUNGevity Foundation, Bethesda, MD, USA; 3Clinique De Genolier, Genolier, Switzerland; 4G1 Therapeutics Ltd., Research Triangle Park, NC, USA; 5HealthiVibe, a Division of Corrona, LLC., Arlington, VA, USA; 6Chapel Hill Consulting, LLC., Chapel Hill, NC, USA; 7UNC Gillings School of Global Public Health, Chapel Hill, NC, USA; 8Duke University Medical Center, Durham, NC, USACorrespondence: Robert S EpsteinEpstein Health, LLC., Woodcliff Lake, NJ, 07677, USATel +1 201-285-5800Email repstein@epsteinhealth.comPurpose: To evaluate which side effects of chemotherapy are considered most burdensome by patients with cancer, identify which health care professionals pay most attention to symptoms associated with chemotherapy-induced myelosuppression (CIM) from the patient perspective, and capture the “patient voice” describing how CIM impacts their daily lives.Participants and Methods: Online survey of participants with breast, lung, or colorectal cancer who had received chemotherapy within the past 12 months and experienced ≥ 1 episode of CIM in the past year. Participants were asked to answer close-ended questions and provide qualitative responses to: “In your own words, please describe how side effects from myelosuppression have impacted your life.”Results: Among 301 survey participants, fatigue was the most frequently reported side effect of chemotherapy; 55% of participants rated fatigue as highly bothersome (9 or 10 on a 1– 10 scale of “bothersomeness”). Participants rated symptoms associated with CIM, including fatigue, weakened immune system (infections), bleeding and/or bruising, and shortness of breath, as being as bothersome as other side effects of chemotherapy, including alopecia, neuropathy, and nausea/vomiting. Overall, 24– 43% of participants thought that CIM and its symptoms had a negative impact on their daily lives, including their ability to complete tasks at home and work, and to socialize. Qualitative responses supported these findings; participants highlighted that CIM-related symptoms, particularly fatigue and fear of infections, affected their ability to be physically active, complete work, or continue meaningful relationships with friends and family.Conclusion: Participants described a real-world impact of CIM that often isolates them from family and friends, and means that they are unable to work or perform tasks of daily living. Using measures that help patients to recognize and communicate the signs and symptoms of CIM might increase the likelihood of maintaining daily lives as close to normal as possible, during and after chemotherapy treatment.Keywords: cancer, chemotherapy, myelosuppression, real world, quality of life, patient burden

BackgroundData are limited on genome-wide association studies (GWAS) for incident coronary heart disease (CHD). Moreover, it is not known whether genetic variants identified to date also associate with risk of CHD in a prospective setting.MethodsWe performed a two-stage GWAS analysis of incident myocardial infarction (MI) and CHD in a total of 64,297 individuals (including 3898 MI cases, 5465 CHD cases). SNPs that passed an arbitrary threshold of 5×10-6 in Stage I were taken to Stage II for further discovery. Furthermore, in an analysis of prognosis, we studied whether known SNPs from former GWAS were associated with total mortality in individuals who experienced MI during follow-up.ResultsIn Stage I 15 loci passed the threshold of 5×10-6; 8 loci for MI and 8 loci for CHD, for which one locus overlapped and none were reported in previous GWAS meta-analyses. We took 60 SNPs representing these 15 loci to Stage II of discovery. Four SNPs near QKI showed nominally significant association with MI (p-value

The article presents the dynamics of transformation of network characteristics of modern society, related to changes in the quality and structure of communications, which are expanding and differentiating in the public space integrated with the Internet. The ways of development of information and communication technologies in all spheres – social, political, economic, cultural, which are conditioned by the network logic of development of social subjects are analyzed. The analysis of the actual researches concerning problems of formation of the new model of organization of socio-political space in which horizontal network communications dominates and many different actors involved in the transformation of public policy, as well as the role and importance of network structures possessing high potential for self-organization and mobilization. The peculiarities of functioning of the Ukrainian political system, which, on the one hand, reflect the global trends of network public policy formation, are considered; on the other hand, existing social networking practices are not always linked to increasing public resources and developing democratic foundations of politics. The author draws attention to the dominance of informal political communication practices, the imitation of publicity, the formation of clan politics and the patrimonial political system that characterize the destructive potential of social networks. The article provides a theoretical substantiation of the concept of "Internet in public regional policy", which allows to expand the paradigmatic field of political science, as well as to apply the network method to the analysis of Ukrainian public policy, which makes it possible not only to explain new socio-political phenomena, but also to define new vectors development of the modern political system of Ukraine based on the principles of democratic participation and cooperation of the state and civil society. The effects of the Internet of communications through the penetration of network society into public policy and its actions, which is multidimensional in nature and manifested as changes at different levels, causes the emergence of innovative mechanisms that reproduce its new type, namely network public policy.

Strontium ferromolybdate, Sr2FeMoO6, is an important member of the family of double perovskites with the possible technological applications in the field of spintronics and solid oxide fuel cells. Its preparation via a multi-step ceramic route or various wet chemistry-based routes is notoriously difficult. The present work demonstrates that Sr2FeMoO6 can be mechanosynthesized at ambient temperature in air directly from its precursors (SrO, α-Fe, MoO3) in the form of nanostructured powders, without the need for solvents and/or calcination under controlled oxygen fugacity. The mechanically induced evolution of the Sr2FeMoO6 phase and the far-from-equilibrium structural state of the reaction product are systematically monitored with XRD and a variety of spectroscopic techniques including Raman spectroscopy, 57Fe Mössbauer spectroscopy, and X-ray photoelectron spectroscopy. The unique extensive oxidation of iron species (Fe0 → Fe3+) with simultaneous reduction of Mo cations (Mo6+ → Mo5+), occuring during the mechanosynthesis of Sr2FeMoO6, is attributed to the mechanically triggered formation of tiny metallic iron nanoparticles in superparamagnetic state with a large reaction surface and a high oxidation affinity, whose steady presence in the reaction mixture of the milled educts initiates/promotes the swift redox reaction. High-resolution transmission electron microscopy observations reveal that the mechanosynthesized Sr2FeMoO6, even after its moderate thermal treatment at 923 K for 30 min in air, exhibits the nanostructured nature with the average particle size of 21(4) nm. At the short-range scale, the nanostructure of the as-prepared Sr2FeMoO6 is characterized by both, the strongly distorted geometry of the constituent FeO6 octahedra and the extraordinarily high degree of anti-site disorder. The degree of anti-site disorder ASD = 0.5, derived independently from the present experimental XRD, Mössbauer, and SQUID magnetization data, corresponds to the completely random distribution of Fe3+ and Mo5+ cations over the sites of octahedral coordination provided by the double perovskite structure. Moreover, the fully anti-site disordered Sr2FeMoO6 nanoparticles exhibit superparamagnetism with the blocking temperature TB = 240 K and the deteriorated effective magnetic moment μ = 0.055 μB per formula unit.

Background: Proton-pump inhibitors (PPIs) are widely prescribed as acid-suppression therapy. Some observational studies suggest that long-term use of PPIs is potentially associated with certain adverse kidney outcomes. We conducted a systematic literature review to assess potential bias in non-randomized studies reporting on putative associations between PPIs and adverse kidney outcomes (acute kidney injury, acute interstitial nephritis, chronic interstitial nephritis, acute tubular necrosis, chronic kidney disease, and end-stage renal disease). Methods: We searched the medical literature within 10 years of 17 December 2020. Pre-specified criteria guided identification of relevant English language articles for assessment. Risk of bias on an outcome-specific basis was evaluated using the Risk of Bias in Non-randomized Studies of Interventions (ROBINS-I) tool by two independent reviewers. Results: Of 620 initially identified records, 26 studies met a priori eligibility criteria and underwent risk of bias assessment. Nineteen studies were judged as having a moderate risk of bias for reported adverse kidney outcomes, while six studies were judged as having a serious risk of bias (mainly due to inadequate control of confounders and selection bias). We were unable to determine the overall risk of bias in two studies (one of which was assessed as having a moderate risk of bias for a different adverse kidney outcome) due to insufficient information presented. Effect estimates for PPIs in relation to adverse kidney outcomes varied widely (0.24–7.34) but associations mostly showed increased risk. Conclusion: Using ROBINS-I, we found that non-randomized observational studies suggesting kidney harm by PPIs have moderate to serious risk of bias, making it challenging to establish causality. Additional high-quality, real-world evidence among generalizable populations are needed to better understand the relation between PPI treatment and acute and chronic kidney outcomes, accounting for the effects of varying durations of PPI treatment, self-treatment with over-the-counter PPIs, and potential critical confounders.

Purpose: To depict the treatment journey for patients with small cell lung cancer (SCLC) and evaluate health care resource utilization (HCRU) associated with myelosuppression, a complication induced by chemotherapy or chemotherapy plus radiation therapy. Patients and methods: This was a descriptive, retrospective study of patients with SCLC aged ≥65 years, identified from linked Surveillance, Epidemiology, and End Results (SEER)-Medicare data curated between January 2012 and December 2015. Treatment types (chemotherapy, radiation therapy, surgery) were classified as first, second, or third line, depending on the temporal sequence in which regimens were prescribed. For each year, the proportions of patients completing 4- or 6-cycle chemotherapy regimens, with hospital admissions associated with myelosuppression, or who used granulocyte colony–stimulating factors (G-CSFs), blood/platelet transfusions, or erythropoiesis-stimulating agents (ESAs), were calculated. Results: Chemotherapy was administered as initial treatment in 7,807/11,907 (65.6%) patients whose treatment journey was recorded. Approximately one-third (n = 3,985) subsequently received radiation therapy. In total, 5,791 (57.8%) patients completed the guideline-recommended 4–6 cycles of chemotherapy. Among all chemotherapy-treated patients, 10,370 (74.3%) experienced ≥1 inpatient admission associated with myelosuppression (anemia, 7,366 [52.8%]; neutropenia, 4,642 [33.3%]; thrombocytopenia, 2,375 [17.0%]; pancytopenia, 1,983 [14.2%]). Supportive care interventions included G-CSF (6,756 [48.4%] patients), ESAs (1,534 [11.0%]), and transfusions (3,674 [26.3%]). Conclusion: Chemotherapy remains a cornerstone of care for patients with SCLC. Slightly over half of patients completed the recommended number of cycles, underscoring the frailty of patients and aggressiveness of SCLC. HCRU associated with myelosuppression was prominent, suggesting a substantial burden on older patients with SCLC.

Bismuth ferrite (BiFeO3) particles are prepared by a combined mechanochemical−thermal processing of a Bi2O3 + α-Fe2O3 mixture. Structural, magnetic, hyperfine, morphological and chemical properties of the as-prepared BiFeO3 are studied using X-ray diffraction (Rietveld refinement), 57Fe Mössbauer spectroscopy, SQUID magnetometry, electron microscopy and energy dispersive X-ray spectroscopy. It is revealed that the structure of the ferrite exhibits the long-range distortion (significantly tilted FeO6 octahedra) and the short-range disorder (deformed FeO6 octahedra). Consequently, these structural features result in the suppression of a space modulated cycloidal spin arrangement in the material. The latter manifests itself by the appearance of only single spectral component in the 57Fe Mössbauer spectrum of BiFeO3. The macroscopic magnetic behavior of the material is interpreted as a superposition of ferromagnetic and antiferromagnetic contributions with a large coercive field and remanent magnetization. Taking into account the average particle size of the as-prepared BiFeO3 particles (∼98 nm), exceeding the typical period length of cycloid (∼62 nm), both the suppression of the spiral spin structure in the material and its partly ferromagnetic behavior are attributed to the crystal lattice distortion caused by mechanical stress during the preparation procedure.

Diabetic foot (DF) can develop in diabetic patients after organ transplantation (Tx) due to several factors including peripheral arterial disease (PAD), diabetic neuropathy and inappropriate DF prevention. Aim: To assess the occurrence of DF and associated risk factors in transplant patients. Methods: Fifty-seven diabetic patients were enrolled as part of this prospective study. All patients underwent organ Tx (01/2013-12/2015) and were followed up for minimum of 12 months up to a maximum of 50 months. Over the study period we evaluated DF incidence and identified a number of factors likely to influence DF development, including organ function, presence of late complications, PAD, history of DF, levels of physical activity before and after Tx, patient education and standards of DF prevention. Results: Active DF developed in 31.6% (18/57) of patients after organ Tx within 11 months on average (10.7 ± 8 months). The following factors significantly correlated with DF development: diabetes control (p =.0065), PAD (p<0.0001), transcutaneous oxygen pressure (TcPO2;p =.01), history of DF (p =.0031), deformities (p =.0021) and increased leisure-time physical activity (LTPA) before Tx (p =.037). However, based on logistic stepwise regression analysis, the only factors significantly associated with DF during the post-transplant period were: PAD, deformities and increased LTPA. Education was provided to patients periodically (2.6 ± 2.5 times) during the observation period. Although 94.7% of patients regularly inspected their feet (4.5 ± 2.9 times/week), only 26.3% of transplant patients used appropriate footwear. Conclusions: Incidence of DF was relatively high, affecting almost 1/3 of pancreas and kidney/pancreas recipients. The predominant risk factors were: presence of PAD, foot deformities and higher LTPA before Tx. Therefore, we recommend a programme involving more detailed vascular and physical examinations and more intensive education focusing on physical activity and DF prevention in at-risk patients before transplantation. [ABSTRACT FROM AUTHOR]

Infusing pancreatic islets into the portal vein currently represents the preferred approach for islet transplantation, despite considerable loss of islet mass almost immediately after implantation. Therefore, approaches that obviate direct intravascular placement are urgently needed. A promising candidate for extrahepatic placement is the omentum. We aimed to develop an extracellular matrix skeleton from the native pancreas that could provide a microenvironment for islet survival in an omental flap. To that end, we compared different decellularization approaches, including perfusion through the pancreatic duct, gastric artery, portal vein, and a novel method through the splenic vein. Decellularized skeletons were compared for size, residual DNA content, protein composition, histology, electron microscopy, and MR imaging after repopulation with isolated islets. Compared to the other approaches, pancreatic perfusion via the splenic vein provided smaller extracellular matrix skeletons, which facilitated transplantation into the omentum, without compromising other requirements, such as the complete depletion of cellular components and the preservation of pancreatic extracellular proteins. Repeated MR imaging of iron-oxide-labeled pancreatic islets showed that islets maintained their position in vivo for 49 days. Advanced environmental scanning electron microscopy demonstrated that islets remained integrated with the pancreatic skeleton. This novel approach represents a proof-of-concept for long-term transplantation experiments.

Nickel mono- (NiSe) and diselenide (NiSe2) were produced from stoichiometric mixtures of powdered Ni and Se precursors by the one-step, undemanding mechanochemical reactions. The process was carried out by high-energy milling for 30 and 120 min in a planetary ball mill. The kinetics of the reactions were documented, and the products were studied in terms of their crystal structure, morphology, electrical, and optical properties. X-ray powder diffraction confirmed that NiSe has hexagonal and NiSe2 cubic crystal structure with an average crystallite size of 10.5 nm for NiSe and 13.3 nm for NiSe2. Their physical properties were characterized by the specific surface area measurements and particle size distribution analysis. Transmission electron microscopy showed that the prepared materials contain nanoparticles of irregular shape, which are agglomerated into clusters of about 1–2 μm in diameter. The first original values of electrical conductivity, resistivity, and sheet resistance of nickel selenides synthesized by milling were measured. The obtained bandgap energy values determined using UV–Vis spectroscopy confirmed their potential use in photovoltaics. Photoluminescence spectroscopy revealed weak luminescence activity of the materials. Such synthesis of nickel selenides can easily be carried out on a large scale by milling in an industrial mill, as was verified earlier for copper selenide synthesis.

We demonstrated the deposition of the architecture of graphene oxide on stainless steel substrate and its potential environmental application. The synthesis and characterization of graphene oxide were described. The controlled formation of graphene oxide coatings in the form of the homogenous structure on stainless steel is demonstrated by scanning electron microscopy (SEM). The structure, morphology and properties of the material were assessed by Fourier transform infrared (FTIR) spectroscopy, X-ray photoelectron spectroscopy (XPS), Raman spectroscopy, transmission electron microscopy (TEM) and atomic force microscopy (AFM). The morphology and stability of these structures are shown to be particularly related to the pre-treatment of stainless steel substrate before the electrophoretic deposition. This approach opens up a new route to the facile fabrication of advanced electrode coatings with potential use in environmental applications.

The present study deals with the effects of laser surface treatment on microstructure evolution and wear resistance of AISI H11 hot work tool steel in quenched and tempered condition. The most upper laser-affected zone is characterized by re-melted microstructure consisting of dendrite cells with fresh non-tempered martensite, retained austenite and inter-dendritic carbidic network. The subsolidus microstructure just beneath the re-melted zone represents the most laser surface hardened zone consisting of fresh non-tempered martensite with fine and coarse carbides as a result of overheating the original QT substrate microstructure. The highest microhardness values in the range from 775 to 857 HV were measured for the LSH microstructure and the most softened microstructure exhibited the minimum hardness of 530 HV. The laser treated samples showed the improvement of their surface wear resistance by 35%.

Мета роботи – охарактеризувати внутрішні ризики, які виникають під час керування діяльністю фінансового посередника (страхової компанії), визначити їх періодичність та шляхи антикризового управління ними. Метод. Дослідження проведено із застосуванням методів наукової абстракції, структурного і декомпозіціонного аналізу, інструментів причинно-наслідкової комунікації. Результати. Охарактеризовано роль та місце внутрішніх фінансових ризиків в системі ефективності роботи суб’єкта господарювання та клієнтів фінансового посередника. Сформульовано рекомендації для нейтралізації нетипових ризиків, що виникають у фінансових посередників, зокрема страхових компаній, як комплекс антиризових заходів, зокрема, із розвитку діяльності страхової компанії за рахунок прогнозування показників та застосування нефінансових методів регулювання. Практичне значення дослідження. Результати дослідження можна використовувати в керуванні нетиповими видами внутрішніх ризиків страхових компаній та інших фінансових посередників. Оригинальность / ценность / научная новизна исследования. Висвітлено розширену характеристику нетипових внутрішніх ризиків фінансових посередників та сформульовані підходи до часових тенденцій розвитку напрямків діяльності страховика шляхом прогнозування її показників та застосування нефінансових методів регулювання. Перспективи подальших досліджень – удосконалювати механізм управління внутрішніми фінансовими ризиками фінансових посередників у нетиповому середовищі та з урахуванням не тематичних аспектів діяльності. Тип статті – теоретична.