There is a paucity of global data on cardiovascular disease (CVD) prevalence in people with type 2 diabetes (T2D). The primary objective of the CAPTURE study was to estimate the prevalence of ...established CVD and its management in adults with T2D across 13 countries from five continents. Additional objectives were to further characterize the study sample regarding demographics, clinical parameters and medication usage, with particular reference to blood glucose-lowering agents (GLAs: glucagon-like peptide-1 receptor agonists and sodium-glucose co-transporter-2 inhibitors) with demonstrated cardiovascular benefit in randomized intervention trials.
Data were collected from adults with T2D managed in primary or specialist care in Australia, China, Japan, Czech Republic, France, Hungary, Italy, Argentina, Brazil, Mexico, Israel, Kingdom of Saudi Arabia, and Turkey in 2019, using standardized methodology. CVD prevalence, weighted by diabetes prevalence in each country, was estimated for the overall CAPTURE sample and participating countries. Country-specific odds ratios for CVD prevalence were further adjusted for relevant demographic and clinical parameters.
The overall CAPTURE sample included 9823 adults with T2D (n = 4502 from primary care; n = 5321 from specialist care). The overall CAPTURE sample had median (interquartile range) diabetes duration 10.7 years (5.6-17.9 years) and glycated hemoglobin 7.3% (6.6-8.4%) 56 mmol/mol (49-68 mmol/mol). Overall weighted CVD and atherosclerotic CVD prevalence estimates were 34.8% (95% confidence interval CI 32.7-36.8) and 31.8% (95% CI 29.7-33.8%), respectively. Age, gender, and clinical parameters accounted for some of the between-country variation in CVD prevalence. GLAs with demonstrated cardiovascular benefit were used by 21.9% of participants, which was similar in participants with and without CVD: 21.5% and 22.2%, respectively.
In 2019, approximately one in three adults with T2D in CAPTURE had diagnosed CVD. The low use of GLAs with demonstrated cardiovascular benefit even in participants with established CVD suggested that most were not managed according to contemporary diabetes and cardiology guidelines. Study registration NCT03786406 (registered on December 20, 2018), NCT03811288 (registered on January 18, 2019).
The modern orthopaedic implants for applications in hips, knees, shoulders, and spines are composed of hard metal alloys or ceramics and a tribological sub-component that is made of soft materials, ...with good frictional properties—e.g., UHMWPE (Ultra High Molecule Weight Polyethylene). The UHMWPE implants need to be machined into their final shape after the polymerization and consolidation into a blank profile or near net shaped implant. Thus, machining is a crucial technology that can generate an accurate and precise shape of the implant that should comply with the joints’ function. However, the machining technology can affect the topography and integrity of the surface, transmitted stresses, and resistance to wear. Technology, cutting tools, and cutting conditions can have an impact on the physical and mechanical properties of the entire implant and its longevity. This paper shows an effective and competitive technology for acquiring high-quality insert shape, dimensions, and surface, needed especially for customized implants.
The modern orthopaedic implants for applications in hips, knees, shoulders, and spines are composed of hard metal alloys or ceramics. The tribo-logical sub-component is composed of soft materials ...with good tribological properties – e.g. UHMWPE (Ultra High Molecule Weight Polyethylene). The UHMWPE implants need to be machined into their final shape after the polymerization and consolidation into a blank profile or near-net shaped implant.
So machining is a crucial technology that can generate an accurate and precise shape of the implant that should comply with the joints’ function. However, the machining technology can affect the topography and integrity of the surface, and its resistance to wear. The technology, cutting tools, and cutting conditions can impact the physical and mechanical properties of the entire implant, limiting its life span and creating a need to be replaced.
The basic machining technologies are turning and milling (each can be used as roughing or finishing). There are many ways to machine these surfaces. Many problems such as low rigidity of the product, poor thermal properties of the material, high melt viscosities, and sticking of the material to the cutting edge (production of built-up edges) have been solved. UHMWPE can be damaged by excessive heat, feed rate, cutting force, and tool micro-geometry. The shapes and dimensions for the customized implants vary broadly for the humans this complicates the machining technology. No standard programs can be used repeatedly so each joint must be designed and produced individually. However, it results in the longer implant life and a better comfort of patients.
To analyze the impact of polycyclic aromatic hydrocarbons (PAHs) in ambient air at the time of delivery and five years of age on cognitive development in five year old children.
Two cohorts of ...children born in the years 2013 and 2014 from Karvina (Northern Moravia,
= 70) and Ceske Budejovice (Southern Bohemia,
= 99) were studied at the age of five years for their cognitive development related to the exposure to PAHs, determined in the ambient air as the concentration of benzoapyrene (BaP) and OH-PAH (hydroxy-PAH) metabolites in urine of the newborns at the time of delivery. As psychological tests, the Bender Visual Motor Gestalt Test (BG test) and the Raven Colored Progressive Matrices (RCPM test) were used.
Concentrations of BaP in the third trimester of mother's pregnancies were 6.1 ± 4.53 ng/m
in Karvina, and 1.19 ± 1.28 ng/m
(
< 0.001) in Ceske Budejovice. Neither the outcome of the RCPM test nor the BG test differed between children in Karvina vs. Ceske Budejovice, or boys vs. girls. Cognitive development in five year old children was affected by the higher exposure to PM2.5 during the third trimester in girls in Karvina.
We did not observe any significant effect of prenatal PAH exposure on psychological cognitive tests in five year old children.
Polycyclic aromatic hydrocarbons (PAHs) are environmental contaminants produced during incomplete combustion of organic matter. Humans can be exposed to them via several pathways (inhalation, ...digestion, dermal exposure). The aim of this study was to assess the concentration of 11 monohydroxylated metabolites of PAHs (OH-PAHs) in 660 urine samples collected from mothers and their newborns residing in two localities of the Czech Republic — Most and Ceske Budejovice — in 2016 and 2017. After enzymatic hydrolysis, the target analytes were extracted from the urine samples using liquid-liquid extraction, with extraction solvent ethyl acetate and a clean-up step using dispersive solid-phase extraction (d-SPE) with the Z-Sep sorbent. For identification and quantification, ultra-high performance liquid chromatography coupled with tandem mass spectrometry was applied. 2-OH-NAP was the compound present in all of the measured samples and it was also the compound at the highest concentration in both mothers' and newborns' urine samples (median concentration 5.15 μg/g creatinine and 3.58 μg/g creatinine). The total concentrations of OH-PAHs in urine samples collected from mothers were 2 times higher compared to their children. The most contaminated samples were collected in Most in the period October 2016–March 2017 from both mothers (12.59 μg/g creatinine) and their newborns (8.29 μg/g creatinine). The concentrations of OH-PAHs in urine samples, which were collected from both mothers and their newborns as presented in this study, are comparable with those found in our previous study between 2013 and 2014. In addition, they are slightly lower or comparable to other studies from Poland, USA, Germany, China, and Australia. The results might indicate that the population in the previously highly air-polluted mining districts carries some long-term changes (maybe existing changes in genetic information), which also affect the metabolism of PAHs. It could be related to the long-lasting effect, and thus corresponding to the shortened life expectancy.
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•The most frequently detected analyte with the highest concentration was 2-OH-NAP.•6-OH-CHRY and 3-OH-BaP were not detected in any of the analysed samples.•ΣOH-PAHs in children‘s urine samples were1.7× lower compared to their mothers.•ΣOH-PAHs in urine did not correlate with PAHs measured in the ambient air.
Within this study, a new method enabling monitoring of various estrogenic substances potentially occurring in milk and dairy products was proposed. Groups of compounds fairly differing in ...physico-chemical properties and biological activity were analyzed: four natural estrogens, four synthetic estrogens, five mycoestrogens, and nine phytoestrogens. Since they may pass into milk mainly in glucuronated and sulfated forms, an enzymatic hydrolysis was involved prior to the extraction based on the QuEChERS methodology. For the purification of the organic extract, a dispersive solid-phase extraction (d-SPE) with sorbent C18 was applied. The final analysis was performed by ultra-high-performance liquid chromatography (UHPLC) coupled with triple quadrupole tandem mass spectrometry (MS/MS). Method recovery ranged from 70 to 120% with a relative standard deviation (RSD) value lower than 20% and limits of quantification (LOQs) in the range of 0.02–0.60 μg/L (0.2–6.0 μg/kg dry weight) and 0.02–0.90 μg/kg (0.2–6.0 μg/kg dry weight) for milk and yogurt, respectively. The new procedure was applied for the investigation of estrogenic compounds in 11 milk samples and 13 yogurt samples from a Czech retail market. Mainly phytoestrogens were found in the studied samples. The most abundant compounds were equol and enterolactone representing 40–90% of all estrogens. The total content of phytoestrogens (free and bound) was in the range of 149–3870 μg/kg dry weight. This amount is approximately 20 times higher compared to non-bound estrogens.
In this study, a novel analytical approach for the determination of 11 monohydroxylated polycyclic aromatic hydrocarbon metabolites (OH-PAHs) in urine was developed and validated. The rapid, simple ...and high-throughput sample preparation procedure based on ethyl acetate extraction and subsequent purification by dispersive solid-phase extraction (d-SPE) employing a Z-Sep sorbent is used for the first time. For the identification/quantification of target compounds, ultra-high-performance liquid chromatography (U-HPLC) interfaced with tandem mass spectrometry (MS/MS) was applied. The results of validation experiments performed on the Standard Reference Material (SRM) 3673 (organic contaminants in non-smokers’ urine) were in accordance with the certified values. The method recoveries ranged from 77 to 114 % with the relative standard deviation lower than 20 % and the quantification limits in the range of 0.010–0.025 ng mL
−1
(except for benzoapyren-3-ol with 0.9 ng mL
−1
). Within the pilot study, the new method was used for the analysis of OH-PAHs in 50 urine samples. The concentrations of ΣOH-PAHs were in the range of 0.87–63 ng mL
−1
(1600–33,000 ng g
−1
creatinine), with naphthalen-2-ol (2-OH-NAP) and phenanthren-1-ol (1-OH-PHEN) being the most abundant exposure biomarkers detected in all samples.
Graphical abstract
Flow-chart of the analytical method for the determination of major OH-PAHs in urine including the concentrations of detected metabolites in real samples (
n
= 50)
To assess human exposure to hazardous diesters of phthalic acid and their substitute di-iso-nonyl cyclohexane-1,2-dicarboxylate (DINCH), concentrations of their metabolites in urine should be ...determined. For the purpose of this biomonitoring study, a quick and easy sample preparation procedure for the simultaneous determination of eight phthalate and four DINCH metabolites in urine has been implemented and validated. Following the enzymatic hydrolysis and dilution with methanol, the sample is ready for the analysis by ultra-high performance liquid chromatography coupled to tandem mass spectrometry (UHPLC-MS/MS). The limits of quantification of this method ranged from 0.15 to 0.4 ng/mL urine with recoveries of 60–126% and repeatability in the range of 1–11%. The validated method was subsequently used for the analysis of urine samples collected from mothers and their newborn children living in two localities of the Czech Republic (Karvina and Ceske Budejovice, 2013–2014). Median concentrations of all measured metabolites (∑metabolites) were slightly lower in the urine samples collected from children (77.7 ng/mL urine) compared to their mothers (115.3 ng/mL urine), but no correlation was found between the concentrations of target compounds in children's and mothers' urine samples. The analyte with the highest concentration was monobutyl phthalate (MBP), with the median concentration of 32.1 ng/mL urine in the urine samples collected from mothers and 17.2 ng/mL urine in the samples collected from their children. This compound was also found in almost all of the measured samples. On the other hand, mono-isononyl-cyclohexane-1,2-dicarboxylate (MINCH) was not found in any urine sample. The most contaminated samples were collected from children living in the Karvina locality (median ∑metabolites 103.2 ng/mL urine), where the mono (2-ethyl-5-carboxypentyl) phthalate (cx-MEHP) compound contributed 43% to the total content of phthalate metabolites in newborns' urine. The results from our study are comparable with concentrations of the target compounds from Norway and Germany and lower compared to the results concluded in Sweden.
•Use of a simple method for the analysis of phthalate and DINCH urinary metabolites.•The most often detected compound at the highest concentration was MBP.•Concentration of ∑metabolites was lower in newborns' samples compared to mothers'.•DINCH metabolites were found only in 4% of the urine samples.
Esters of phthalic acid (phthalates), mainly used as plasticisers, are well-known ubiquitous contaminants of the environment. Humans can be exposed to these chemicals through various pathways (mainly ...ingestion, dermal absorption or inhalation). After entering the human body, phthalates are rapidly metabolised and excreted via urine. Due to the adverse effects of some phthalates on human health (disruption of the endocrine system and carcinogenicity), they are nowadays being replaced with less harmful substitutes such as di-iso-nonyl cyclohexane-1,2-dicarboxylate (DINCH). The aim of this study was to evaluate concentrations of 18 phthalate and 4 DINCH metabolites in urine samples collected from mothers and their newborns living in 2 locations of the Czech Republic (2016–2017). Sample preparation required only enzymatic hydrolysis and dilution of the hydrolysed sample with methanol. Target compounds were identified and quantified using ultra-high performance liquid chromatography coupled with tandem mass spectrometry (UHPLC–MS/MS). The validated method (recovery 60–126%, repeatability 1–14%, limits of quantification 0.15–0.40 ng/mL urine) was used for the analysis of 315 paired urine samples collected from mothers and their newborns. The overall concentration of target analytes was 2 × lower in urine samples collected from newborns compared to their mothers. Monobutyl phthalate (MBP) was the analyte with the highest concentrations (median 22.1 ng/mL in the mothers′ urine samples; median 21.6 ng/mL in the newborns′ urine samples), followed by mono-iso-butyl phthalate (MiBP) and monoethyl phthalate (MEP). A marked difference between samples from both locations was observed in the concentrations of target analytes in newborns, suggesting that the childcare products used in one of the hospitals might have caused this difference. Primary metabolite of DINCH, MINCH, was not found in any of the tested samples and the secondary metabolites of DINCH (OH-, oxo- and cx-MINCH) were present in only 22–23% of the measured samples collected from mothers and in 4–6% of the urine samples collected from their children at relatively low levels. Similar studies abroad reported MEP to be present at the highest levels whilst our study identified MBP as the most abundant. This result could indicate different exposure sources of phthalates in the Czech population compared to other countries, which should be further investigated.
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