Hyperglycaemia is common in acute illness and more severe hyperglycaemia is associated with worse outcomes in critically ill patients in general and after acute myocardial infarction, stroke, and ...trauma. Normalization of blood glucose by intensive insulin therapy has been shown to reduce morbidity and mortality in one study in surgical intensive care patients; a subsequent study in medical intensive care patients resulted in reduced morbidity but not a reduction in mortality. Multicentre studies and current meta-analyses in the critically ill have not demonstrated improved outcomes when normalization of blood glucose was targeted; furthermore all studies to date have detected an increased risk of hypoglycaemia in patients subjected to intensive insulin therapy. At present, universal treatment guidelines or recommendations to target strict normoglycaemia must be considered premature. Further data will be available after the completion of the NICE-SUGAR study which has recruited 6103 patients; the NICE SUGAR study will add significant power to future meta-analyses and may help define the role of intensive insulin therapy in critically ill patients.
Uniaxial pressure provides an efficient approach to control charge density waves in YBa
Cu
O
. It can enhance the correlation volume of ubiquitous short-range two-dimensional charge-density-wave ...correlations, and induces a long-range three-dimensional charge density wave, otherwise only accessible at large magnetic fields. Here, we use x-ray diffraction to study the strain dependence of these charge density waves and uncover direct evidence for a form of competition between them. We show that this interplay is qualitatively described by including strain effects in a nonlinear sigma model of competing superconducting and charge-density-wave orders. Our analysis suggests that strain stabilizes the 3D charge density wave in the regions between disorder-pinned domains of 2D charge density waves, and that the two orders compete at the boundaries of these domains. No signatures of discommensurations nor of pair density waves are observed. From a broader perspective, our results underscore the potential of strain tuning as a powerful tool for probing competing orders in quantum materials.
This Phase III, uncontrolled, open-label, multicenter study was conducted to investigate the contraceptive efficacy, bleeding pattern, and cycle control of a novel once-a-week contraceptive patch, ...delivering low-dose ethinyl estradiol (EE) and gestodene (GSD) at the same systemic exposure seen after oral administration of a combined oral contraceptive containing 0.02 mg EE/0.06 mg GSD. Participants were women aged 18 to 35 years, all of whom received the EE/GSD patch for 13 cycles each of 21 treatment days (one patch per week for 3 weeks) followed by a 7-day, patch-free interval. The primary efficacy variable was the occurrence of unintended pregnancies during the study period as assessed by life table analysis and the Pearl Index. Secondary efficacy variables were days with bleeding during four 90-day reference periods and during 1 treatment year, bleeding pattern, and cycle control. The Kaplan-Meier probability of contraceptive protection after 364 treatment days was 98.8% and the adjusted Pearl Index was 0.81. The percentage of participants with intracyclic bleeding/spotting decreased over time, from 11.4% to 6.8% in cycles 1 and 12, respectively. Almost all participants (range: 90.8%-97.6%) experienced withdrawal bleeding across the study period. Compliance was very high (mean: 97.9%; median: 100%). The most frequent adverse events were headache (9.5%) and application site reaction (8.5%); no clinically significant safety concerns were observed. Results suggest the EE/GSD patch is highly effective in preventing pregnancy. Menstrual bleeding pattern was favorable and within the ranges expected of a healthy female population. The patch was well tolerated and treatment compliance was high.
ZnO can be regarded as one of the most important metal oxide semiconductors for future applications. Similar to silicon in microelectronics, it is not only important to obtain nanoscale building ...blocks of ZnO, but also extraordinary purity has to be ensured. A new gas‐phase approach to obtain size‐selected, nanocrystalline ZnO particles is presented. The tetrameric alkyl‐alkoxy zinc compound CH3ZnOCH(CH3)24 is chemically transformed into ZnO, and the mechanism of gas‐phase transformation is studied in detail. Furthermore, the morphological genesis of particles via gas‐phase sintering is investigated, and for the first time a detailed model of the gas‐phase sintering processes of ZnO is presented. Various analytical techniques (powder XRD, TEM/energy‐dispersive X‐ray spectroscopy, magic‐angle spinning NMR spectroscopy, FTIR spectroscopy, etc.) are used to investigate the structure and purity of the samples. In particular, the defect structure of the ZnO was studied by photoluminescence spectroscopy.
Pure chance: Chemical vapor synthesis using an organometallic single‐source precursor is applied to the preparation of ultrapure, size‐selected, nanocrystalline ZnO particles (see picture). The morphological genesis of the particles in the gas phase is investigated, and a model of the gas‐phase sintering of ZnO is proposed.
The hydrolysis of small amides has garnered major attention due to its relevance to peptide hydrolysis, one of the most fundamental reactions of biology. Both experimental and theoretical research ...efforts have studied the reaction in different media, and a consensus has been reached regarding the specific acid- and base-catalyzed reaction pathways. Nevertheless, for the water reaction, large discrepancies between theoretical and experimental results are found in the literature. Herein, we report the results of theoretical calculations of formamide and urea hydrolysis at different pH values. Model systems have been built clustering one and two water molecules with the reactive amide. A careful analysis of the reaction pathways at different temperatures has allowed us to accurately reproduce available experimental data and to separate the water reactions from their acid and base counterparts. The relevance of the results in providing an accurate definition of the proficiency of amidohydrolases is discussed.
We use diffuse and inelastic x-ray scattering to study the formation of an incommensurate charge-density-wave (I-CDW) in BaNi_{2}As_{2}, a candidate system for charge-driven electronic nematicity. ...Intense diffuse scattering is observed around the modulation vector of the I-CDW, Q_{I-CDW}. It is already visible at room temperature and collapses into superstructure reflections in the long-range ordered state where a small orthorhombic distortion occurs. A clear dip in the dispersion of a low-energy transverse optical phonon mode is observed around Q_{I-CDW}. The phonon continuously softens upon cooling, ultimately driving the transition to the I-CDW state. The transverse character of the soft-phonon branch elucidates the complex pattern of the I-CDW satellites observed in the current and earlier studies and settles the debated unidirectional nature of the I-CDW. The phonon instability and its reciprocal space position are well captured by our ab initio calculations. These, however, indicate that neither Fermi surface nesting, nor enhanced momentum-dependent electron-phonon coupling can account for the I-CDW formation, demonstrating its unconventional nature.
Danforth's short tail (Sd) mutant mice exhibit defects of the neural tube and other abnormalities, which are similar to the human vertebral anomalies, anal atresia, cardiac defects, tracheosophageal ...fistula and/or esophageal atresia, renal and radial abnormalities, and limb defects (VATER/VACTERL) association, including defects of the hindgut. Sd has been shown to underlie ectopic gene expression of murine Ptf1a, which encodes pancreas-specific transcription factor 1A, due to the insertion of a retrotansposon in its 5′ regulatory domain. In order to investigate the possible involvement of this gene in human VATER/VACTERL association and human neural tube defects (NTDs), a sequence analysis was performed. DNA samples from 103 patients with VATER/VACTERL and VATER/VACTERL-like association, all presenting with anorectal malformations, and 72 fetuses with NTDs, where termination of pregnancy had been performed, were included in the current study. The complete PTF1A coding region, splice sites and 1.5 kb of the 5′ flanking promotor region was sequenced. However, no pathogenic alterations were detected. The results of the present study do not support the hypothesis that high penetrant mutations in these regions of PTF1A are involved in the development of human VATER/VACTERL association or NTDs, although rare mutations may be detectable in larger patient samples.
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