Objective:
The efficacy of angiotensin-converting enzyme inhibitors and angiotensin receptor blockers in reducing cardiovascular outcomes in patients with diabetes and overt nephropathy is still a ...controversial issue.
Methods:
We systematically searched MEDLINE, Embase and Cochrane Library for randomised controlled trials.
Results:
Thirteen trials containing 4638 patients with diabetes and overt nephropathy were included. Compared with controls, angiotensin-converting enzyme inhibitor/angiotensin receptor blocker treatment did not reduce the risk of cardiovascular events (odds ratio 0.94, 95% confidence interval 0.86 to 1.03, P=0.18; I2=0.0%, P=0.75). Angiotensin-converting enzyme inhibitor/angiotensin receptor blocker therapy reduced the odds of heart failure events by 29% (0.71, 0.61 to 0.83, P<0.001; I2=0%, P=0.78). The results indicated no significant differences between the two treatment regimens with regard to the frequency of MI (0.95, 0.76 to 1.19, P=0.64), stroke (1.20, 0.83 to 1.74, P=0.32), cardiovascular death (1.26, 0.96 to 1.65, P=0.09) and all-cause mortality (0.98, 0.86 to 1.12, P=0.73). Among all kinds of adverse effects, angiotensin-converting enzyme inhibitor/angiotensin receptor blocker therapy increased the incidence of hyperkalemia (2.26, 1.42 to 3.61, P=0.001).
Conclusion:
This study demonstrated that angiotensin-converting enzyme inhibitors and angiotensin receptor blockers did not reduce cardiovascular events in patients with diabetes and overt nephropathy.
Aim
This study aimed to explore the level and influencing factors of fatigue in patients with rheumatoid arthritis.
Methods
This cross‐sectional study was conducted in 243 patients with rheumatoid ...arthritis from April 2016 to March 2017. The Bristol Rheumatoid Arthritis Fatigue Multi‐Dimensional Questionnaire, Arthritis Self‐Efficacy Scale‐8, Visual Analogue Scale for pain, physical function subscale of Short Form 36‐Item Health Survey, Hospital Anxiety and Depression Scale, Perceived Social Support Scale, Pittsburgh Sleep Quality Index and a self‐designed demographic and disease‐related information questionnaire were used to collect the data. Stepwise linear multiple regression was used to clarify the impact of statistically significant variables (P < 0.05) in the independent sample t test, one‐way ANOVA and correlation analysis on the level of fatigue.
Results
Stepwise linear multiple regression analyses showed that disease activity, self‐efficacy, physical function, pain, depression, duration of morning stiffness and anxiety were major factors influencing fatigue in patients with rheumatoid arthritis, which explained 59.5% of the total variance.
Conclusion
Our study demonstrated a moderate level of fatigue in Chinese patients with rheumatoid arthritis. In clinical practice, nurses should explore individualized intervention programmes based on related predictors of fatigue to help patients relieve fatigue.
Summary statement
What is already known about this topic?
Fatigue is a common problem in patients with rheumatoid arthritis (RA).
Little research has investigated what factors are associated with fatigue in patients with RA.
Nurses need to understand the factors that potentially influence fatigue in patients with RA, in order to improve the quality of life.
What this paper adds?
Fatigue is moderate in Chinese patients with RA, which is lower than the results of western countries.
Disease activity, self‐efficacy, physical function, pain, depression, duration of morning stiffness and anxiety are important factors affecting fatigue in patients with RA.
The implications of this paper:
Special attention should be paid to the RA patients with high level of fatigue.
The findings of this study highlight the need to develop effective strategies to alleviate fatigue and eventually improve the quality of life in patients with RA.
The electrochemical reduction of CO2 could play an important role in addressing climate-change issues and global energy demands as part of a carbon-neutral energy cycle. Single-atom catalysts can ...display outstanding electrocatalytic performance; however, given their single-site nature they are usually only amenable to reactions that involve single molecules. For processes that involve multiple molecules, improved catalytic properties could be achieved through the development of atomically dispersed catalysts with higher complexities. Here we report a catalyst that features two adjacent copper atoms, which we call an ‘atom-pair catalyst’, that work together to carry out the critical bimolecular step in CO2 reduction. The atom-pair catalyst features stable Cu10–Cu1x+ pair structures, with Cu1x+ adsorbing H2O and the neighbouring Cu10 adsorbing CO2, which thereby promotes CO2 activation. This results in a Faradaic efficiency for CO generation above 92%, with the competing hydrogen evolution reaction almost completely suppressed. Experimental characterization and density functional theory revealed that the adsorption configuration reduces the activation energy, which generates high selectivity, activity and stability under relatively low potentials.Anchored single-atom catalysts have recently been shown to be very active for various processes, however, a catalyst that features two adjacent copper atoms—which we call an atom-pair catalyst—is now reported. The Cu10–Cu1x+ pair structures work together to carry out the critical bimolecular step in CO2 reduction.
Interface engineering is promising but still challenging for developing highly efficient and stable non‐noble‐metal‐based electrocatalysts for water splitting. Herein, partially phosphidated ...core@shell Co@Co–P nanoparticles encapsulated in bamboo‐like N, P co‐doped carbon nanotubes (denoted as Part‐Ph Co@Co–P@NPCNTs) are prepared through a pyrolysis–oxidation–phosphidation strategy. In this structure, each Co nanoparticle is covered with a thin Co–P layer to form a special core@shell heterojunction interface, and the core@shell structure is further encapsulated by N, P co‐doped CNTs that not only protect the Co from corrosion but also guarantee an effective and fast electron transfer on cobalt phosphide. As a bifunctional catalyst for both the hydrogen evolution reaction and oxygen evolution reaction, it exhibits an excellent activity for overall water splitting, and enables long‐term operation without significant degradation. Density functional theory calculations demonstrate that the interface of the Co/Co2P heterojunction could lower the values of ΔGH* (hydrogen adsorption) and ΔGB (water dissociation), which are negatively correlated to the j10, because of the electronic structures of up‐shifted d‐band center. This study not only presents an efficient and stable electrocatalyst for overall water splitting but also provides a special route for the interface engineering of heterostructures.
A composite catalyst comprising partially phosphidated core@shell Co@Co–P nanoparticles encapsulated in bamboo‐like N, P co‐doped carbon nanotubes is prepared through a pyrolysis–oxidation–phosphidation strategy. As a bifunctional catalyst for both the hydrogen evolution reaction and oxygen evolution reaction, it exhibits an excellent activity and stability for water splitting. A special route for the interface engineering of heterostructures is provided.
To identify the molecular mechanisms and novel therapeutic targets of late-onset Alzheimer’s Disease (LOAD), we performed an integrative network analysis of multi-omics profiling of four cortical ...areas across 364 donors with varying cognitive and neuropathological phenotypes. Our analyses revealed thousands of molecular changes and uncovered neuronal gene subnetworks as the most dysregulated in LOAD. ATP6V1A was identified as a key regulator of a top-ranked neuronal subnetwork, and its role in disease-related processes was evaluated through CRISPR-based manipulation in human induced pluripotent stem cell-derived neurons and RNAi-based knockdown in Drosophila models. Neuronal impairment and neurodegeneration caused by ATP6V1A deficit were improved by a repositioned compound, NCH-51. This study provides not only a global landscape but also detailed signaling circuits of complex molecular interactions in key brain regions affected by LOAD, and the resulting network models will serve as a blueprint for developing next-generation therapeutic agents against LOAD.
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•Development of gene network models of four cortical areas affected by LOAD•Identification of region-specific molecular changes and gene subnetworks in LOAD•ATP6V1A is a top key regulator of a neuronal subnetwork most disrupted in LOAD•NCH-51 normalizes neuronal impairment and neurodegeneration caused by ATP6V1A deficit
Employing an integrative network biology approach, Wang et al. identify critical gene subnetworks associated with late-onset Alzheimer’s disease (LOAD) and predict ATP6V1A as a key regulator of a neuron-specific subnetwork most affected by LOAD. ATP6V1A deficit causes neuronal impairment and neurodegeneration, which are normalized by a predicted compound, NCH-51.
Carbon nanotube (CNTs) reinforced cementitious composites have obvious advantages over traditional building materials in strength and impermeable durability. However, the material in question has not ...been widely employed in grouting engineering due to the limitations posed by dispersion issues. This study introduces a novel method of using amino functional groups to coat carbon nanotubes on the surface of fly ash to improve dispersion. The objective is to produce high-quality industrial-grade slurry and facilitate the transition of carbon nanotubes from small-scale research to large-scale engineering applications. The results show that mixing 14.3 wt% fly ash and 0.023 wt% CNTs in cementitious composites can replace an equivalent proportion of cement. Compared to traditional cement-based grouting material, the modified composites exhibit a 21.6 % increase in fluidity, a 7.9 % increase in the 7-day consolidation strength, and an 11.9 % reduction in the porosity of the slurry consolidation. The CNTs with large specific surface area on the fly ash surface provide sites for cement hydration reaction, accelerate cement hydration, and form dense hydration products. Additionally, the interaction between hydration products and CNTs within the microcracks of the cement matrix forms a 'bridging role' that enhances mechanical properties. The effectiveness of incorporating CNTs in reducing micro-damage during the loading process of slurry consolidation, enhancing integrity, and improving the grouting material's resistance to loading was further proved by acoustic emission, scanning electron microscopy, and fractal analysis of the fracture surface.
•Coating method assists the CNT dispersion, strongly connected to the FA surface.•Coating method allows CNTs to concentrate in the ITZ between FA and cement.•Coated CNTs generate nucleation and pore-infilling effects to strengthen the ITZ.•The workability of the CNTs-coated FA-modified cement grouting can be reinforced.
Abstract
Elucidating the synergistic catalytic mechanism between multiple active centers is of great significance for heterogeneous catalysis; however, finding the corresponding experimental evidence ...remains challenging owing to the complexity of catalyst structures and interface environment. Here we construct an asymmetric TeN
2
–CuN
3
double-atomic site catalyst, which is analyzed via full-range synchrotron pair distribution function. In electrochemical CO
2
reduction, the catalyst features a synergistic mechanism with the double-atomic site activating two key molecules: operando spectroscopy confirms that the Te center activates CO
2
, and the Cu center helps to dissociate H
2
O. The experimental and theoretical results reveal that the TeN
2
–CuN
3
could cooperatively lower the energy barriers for the rate-determining step, promoting proton transfer kinetics. Therefore, the TeN
2
–CuN
3
displays a broad potential range with high CO selectivity, improved kinetics and good stability. This work presents synthesis and characterization strategies for double-atomic site catalysts, and experimentally unveils the underpinning mechanism of synergistic catalysis.
Background: Causal evidence of circulating lipids especially the remnant cholesterol with cardiovascular and cerebrovascular disease (CVD) is lacking. This research aimed to explore the causal roles ...of extensive lipid traits especially the remnant lipids in CVD.Methods: Two-sample Mendelian randomization (TSMR) analysis was performed based on large-scale meta-analysis datasets in European ancestry. The causal effect of 15 circulating lipid profiles including 6 conventional lipids and 9 remnant lipids on coronary heart disease (CHD) and ischemic stroke (IS), as well as the subtypes, was assessed.Results: Apolipoprotein B (Apo B), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and triglyceride (TG) were still important risk factors for CHD and myocardial infarction (MI) but not for IS. Apo B is the strongest which increased the CHD and MI risk by 44% and 41%, respectively. The odds ratios (ORs) of total TG on CHD and MI were 1.25 (95% confidence interval CI, 1.13–1.38) and 1.24 (95% CI, 1.11–1.38), respectively. A one standard deviation difference increased TG in medium very-low-density lipoproteins (M.VLDL.TG), TG in small VLDL (S.VLDL.TG), TG in very small VLDL (XS.VLDL.TG), TG in intermediate-density lipoproteins (IDL.TG), TG in very large HDL (XL.HDL.TG), and TG in small HDL (S.HDL.TG) particles also robustly increased the risk of CHD and MI by 9–28% and 9–27%, respectively. TG in very/extremely large VLDL (XXL.VLDL.TG and XL.VLDL.TG) were insignificant or even negatively associated with CHD (in multivariable TSMR), and negatively associated with IS as well.Conclusion: The remnant lipids presented heterogeneity and two-sided effects for the risk of CHD and IS that may partially rely on the particle size. The findings suggested that the remnant lipids were required to be intervened according to specific components. This research confirms the importance of remnant lipids and provides causal evidence for potential targets for intervention.
MiRNAs are important regulators of different biological processes, including tumorigenesis. MiR-210 is a potential prognostic factor for survival in patients with cancer according to previous ...clinical researches. We conducted a systematic review and meta-analysis to summarize the significance of increased miR-210 expression in the prognosis of indicated cancers.
The present systematic review and meta-analysis of 16 researches included 1809 patients with 7 different types of cancers from 7 countries, and aimed to explore the association between miR-210 expression and the survival of cancer patients. Over-expression of miR-210 may predict poor overall survival (OS, HR = 1.33, 95% CI: 0.85-2.09, P = 0.210), but the effect was not significant. While the predictive effect on disease-free survival (DFS, HR = 1.89, 95% CI: 1.30-2.74, P = 0.001), progression-free survival (PFS, HR = 1.20, 95% CI: 1.05-1.38, P = 0.007) and relapse-free survival(RFS, HR = 4.42, 95% CI: 2.14-9.15, P = 0.000) for patients with breast cancer, primary head and neck squamous cell carcinoma (HNSCC), renal cancer, soft-tissue sarcoma, pediatric osteosarcoma, bladder cancer or glioblastoma was certain. Subgroup analysis showed the limited predictive effect of over-expressed miR-210 on breast cancer OS (HR = 1.63, 95% CI: 0.47-5.67, P = 0.443), breast cancer DFS (HR = 2.03, 95% CI: 0.90-4.57, P = 0.088), sarcoma OS (HR = 1.24, 95% CI: 0.20-7.89, P = 0.818) and renal cancer OS (HR = 1.16, 95% CI: 0.27-4.94, P = 0.842).
This systematic review and meta-analysis suggests that miR-210 has a predictive effect on survival of patients with studied cancer types as indexed by disease-free survival, progression-free survival and relapse-free survival. While the predictive effect on overall survival, breast cancer overall survival, breast cancer disease-free survival, sarcoma overall survival and renal cancer overall survival was not statistically significant.
The electrochemical reduction of CO
could play an important role in addressing climate-change issues and global energy demands as part of a carbon-neutral energy cycle. Single-atom catalysts can ...display outstanding electrocatalytic performance; however, given their single-site nature they are usually only amenable to reactions that involve single molecules. For processes that involve multiple molecules, improved catalytic properties could be achieved through the development of atomically dispersed catalysts with higher complexities. Here we report a catalyst that features two adjacent copper atoms, which we call an 'atom-pair catalyst', that work together to carry out the critical bimolecular step in CO
reduction. The atom-pair catalyst features stable Cu
-Cu
pair structures, with Cu
adsorbing H
O and the neighbouring Cu
adsorbing CO
, which thereby promotes CO
activation. This results in a Faradaic efficiency for CO generation above 92%, with the competing hydrogen evolution reaction almost completely suppressed. Experimental characterization and density functional theory revealed that the adsorption configuration reduces the activation energy, which generates high selectivity, activity and stability under relatively low potentials.
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