A versatile characterization of poly(N-isopropylacrylamideco- N,N'-methylene-bis-acrylamide) hydrogels for composition, mechanical strength, and rheology

Poly(N-isopropylacrylamide-co-N,N"-methylene-bisacrylamide) (P(NIPAAm-co-MBA)) hydrogels were prepared in water using redox initiator. The copolymer composition at high conversion (> 95%) was determined indirectly by HPLC (high performance liquid chromatography) analysis of the leaching water and directly by solid state 13C CP MAS NMR (cross polarization magic angle spinning nuclear magnetic resonance) spectroscopy of the dried gels, and was found to be close to that of the feed. The effect of cross-linker (MBA) content in the copolymer was investigated in the concentration range of 1.1–9.1 mol% (R:90–10; R = mol NIPAAm/mol MBA) on the rheological behaviour and mechanical strength of the hydrogels. Both storage and loss modulus decreased with decreasing cross-linker content as revealed by dynamic rheometry. Gels R70 and R90 with very low cross-linker content (1.2–1.5 mol% MBA) have a very loose network structure, which is significantly different from those with higher cross-linker content manifesting in higher difference in storage modulus. The temperature dependence of the damping factor served the most accurate determination of the volume phase transition temperature, which was not affected by the cross-link density in the investigated range of MBA concentration. Gel R10 with highest cross-linker content (9.1 mol% MBA) behaves anomalously due to heterogeneity and the hindered conformation of the side chains of PNIPAAm

PtOx-SnOx-TiO2 catalyst system for methanol photocatalytic reforming: Influence of cocatalysts on the hydrogen production

Effects of modification of PtOx-TiO2 photocatalysts by tin were elucidated by exploring relationships between the structural properties of variously prepared tin-loaded catalysts and their catalytic activity in methanol photocatalytic reforming. Tin free and amorphous tin-oxide decorated TiO2 samples were prepared by sol-gel method from titanium-isopropoxide. In other approach, Sn was loaded onto the sol-gel prepared TiO2 by impregnation followed by calcination. Pt was introduced by impregnation followed by either reduction in H2 at 400 °C or calcination at 300 °C. TEM, XRD and Raman spectroscopic measurements proved that TiO2 existed in the form of aggregates of polycrystalline anatase with primary particle size of 15–20 nm in all samples. Photocatalytic hydrogen production was influenced by the combined effect of many parameters. Both the presence of Sn and the way of Pt co-catalyst formation played important role in the activity of these photocatalysts. The Sn introduction by both sol-gel method and impregnation clearly enhanced the photocatalytic activity. 1H MAS NMR measurements revealed that the Sn introduction reduced the amount of the terminal Ti-OH groups of relatively basic character considered to be unfavorable for the photocatalytic reaction. Presence of SnOx decreased the signal of the undesirable vacancies observed by ESR. Furthermore surface SnOx enhanced the dispersion of Pt. Formation of the Pt co-catalyst by calcination was more favorable than by H2 treatment. In case of the calcined samples in situ reduction of the Pt nanoparticles at the beginning of the photocatalytic reaction was found to be favorable for the hydrogen production. The relatively modest photocatalytical activity obtained after high temperature H2 treatment could be related to at least two processes in this system: (i) creation of unfavorable oxygen vacancies and (ii) segregation of SnOx to the surface of the Pt cocatalyst as the result of the air exposure of the alloy type Pt-Sn nanoparticles formed during the H2 treatment, resulting in a decreased number of active sites for reduction of H+

Pregnancy outcomes of women with untreated ‘mild’ gestational diabetes (gestational diabetes by the WHO 2013 but not by the WHO-1999 diagnostic criteria) – A population-based cohort study

AIMS: We compared pregnancy outcomes of untreated 'mild' GDM (GDM by WHO 2013 but not by WHO-1999) to normal glucose tolerant women (NGT). METHODS: In a universal screening program 4333 pregnant women had a 3-point 75 g OGTT in Hungary in 2009-2013. By WHO-2013 untreated NGT was diagnosed in n = 3303, 'mild' GDM in n = 336 cases. RESULTS: 'Mild' GDM women were older (mean difference, SE: 1.4, 0.3 yrs), had higher fasting (1.0, 0.02), 60-minute (1.0, 0.09), and 120-minute (0.4, 0.06 mmol/l) blood glucose, and blood pressure (2.6, 0.5/2.0, 0.5 mmHg). Weight gain was similar in both groups (-0.3, 0.3 kg). GDM newborns were heavier (142, 50 g) and were more frequently macrosomic (>4000 g, OR 1.85, 95 %CI 1.35-2.54). Hypertension during pregnancy was more prevalent in the GDM group (OR 1.55, 95 %CI 1.05-2.28), as well as induced (OR 1.38, 95 %CI 1.10-1.74) and instrumental delivery (OR 1.34, 95 %CI 1.07-1.68), and acute caesarean section (OR 1.32, 95 %CI 1.04-1.64). Most of these differences substantially attenuated or became non-significant after adjustment for pre-pregnancy BMI. CONCLUSIONS: Pregnancy outcomes of 'mild' GDM were worse compared to normal glucose tolerant women however these differences were explained by the pre-pregnancy BMI difference between groups

Comparison of the efficacy and safety of commercially available fixed ratio combinations of insulin degludec/liraglutide (IDegLira) and insulin glargine/lixisenatide (iGlarLixi) - a network meta-analysis

AIMS: To compare the efficacy and safety of commercially available fixed ratio combinations (FRC) of glucagon-like peptide 1 receptor agonists (GLP-1RA) and basal insulins by a network meta-analysis (NMA) of randomised controlled trials (RCT) of type 2 diabetes patients. METHODS: We report a systematic review and network meta-analyses of RCTs of type 2 diabetes patients randomized to FRCs or to their components for ≥24-weeks reported in PubMed or ClinicalTrials.gov until 28/FEB/2022. Primary outcome was attained HbA1c. Secondary outcomes included fasting plasma glucose, change in body weight, and incident hypoglycaemia. Treatment effects were estimated as mean differences and standard errors (MD; [SE]) or odds ratios (OR) with 95% confidence intervals (95%CI) using iGlarLixi as reference. RESULTS: We included 29 RCTs of the 1404 papers identified. No direct comparison between FRCs were found. After excluding some insulin capped trials to reach model consistency, both FRCs were more efficacious regarding HbA1c than their components, however no difference between FRCs were found (MD: -0.10 [SE: 0.10]%). The effect of IDegLira (-0.47 [0.24] mmol/l) and basal insulins was similar to that of iGlarLixi (ref.) on fasting glucose, while GLP-1RA had lower efficacy than iGlarLixi. Weight gain was lower with GLP-1RAs and IDegLira (-0.72 [0.32] kg) than iGlarLixi (ref.) and higher with basal insulins. Incident hypoglycemia (based on different definitions) was least frequent with GLP-1RAs followed by IDegLira (OR 0.78 95%CI 0.39-1.57), iGlarLixi (ref.) and basal insulins. CONCLUSIONS: Regarding HbA1c, both FRCs were more efficacious over their individual components with similar efficacies of the two FRCs

Trend of pregnancy outcomes in type 1 diabetes compared to control women: a register-based analysis in 1996-2018

INTRODUCTION: In 1989, the St Vincent declaration aimed to approximate pregnancy outcomes of diabetes to that of healthy pregnancies. We aimed to compare frequency and trends of outcomes of pregnancies affected by type 1 diabetes and controls in 1996-2018. METHODS: We used anonymized records of a mandatory nation-wide registry of all deliveries between gestational weeks 24 and 42 in Hungary. We included all singleton births (4,091 type 1 diabetes, 1,879,183 controls) between 1996 and 2018. We compared frequency and trends of pregnancy outcomes between type 1 diabetes and control pregnancies using hierarchical Poisson regression. RESULTS: The frequency of stillbirth, perinatal mortality, large for gestational age, caesarean section, admission to neonatal intensive care unit (NICU), and low Appearance, Pulse, Grimace, Activity, and Respiration (APGAR) score was 2-4 times higher in type 1 diabetes compared to controls, while the risk of congenital malformations was increased by 51% and SGA was decreased by 42% (all p<0.05). These observations remained significant after adjustment for confounders except for low APGAR scores. We found decreasing rate ratios comparing cases and controls over time for caesarean sections, low APGAR scores (p<0.05), and for NICU admissions (p=0.052) in adjusted models. The difference between cases and controls became non-significant after 2009. No linear trends were observed for the other outcomes. CONCLUSIONS: Although we found that the rates of SGA, NICU care, and low APGAR score improved in pregnancies complicated by type 1 diabetes, the target of the St Vincent Declaration was only achieved for the occurrence of low APGAR scores

Comparison of clinical characteristics of patients with pandemic SARS-CoV-2-related and community-acquired pneumonias in Hungary – a pilot historical case-control study

The distinction between severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)–related and community-acquired pneumonias poses significant difficulties, as both frequently involve the elderly. This study aimed to predict the risk of SARS-CoV-2-related pneumonia based on clinical characteristics at hospital presentation. Case-control study of all patients admitted for pneumonia at Semmelweis University Emergency Department. Cases (n = 30) were patients diagnosed with SARS-CoV-2-related pneumonia (based on polymerase chain reaction test) between 26 March 2020 and 30 April 2020; controls (n = 82) were historical pneumonia cases between 1 January 2019 and 30 April 2019. Logistic models were built with SARS-CoV-2 infection as outcome using clinical characteristics at presentation. Patients with SARS-CoV-2-related pneumonia were younger (mean difference, 95% CI: 9.3, 3.2–15.5 years) and had a higher lymphocyte count, lower C-reactive protein, presented more frequently with bilateral infiltrate, less frequently with abdominal pain, diarrhoea, and nausea in age- and sex-adjusted models. A logistic model using age, sex, abdominal pain, C-reactive protein, and the presence of bilateral infiltrate as predictors had an excellent discrimination (AUC 0.88, 95% CI: 0.81–0.96) and calibration (p = 0.27–Hosmer-Lemeshow test). The clinical use of our screening prediction model could improve the discrimination of SARS-CoV-2 related from other community-acquired pneumonias and thus help patient triage based on commonly used diagnostic approaches. However, external validation in independent datasets is required before its clinical use

The effect of COVID-19 vaccination status on all-cause mortality in patients hospitalised with COVID-19 in Hungary during the delta wave of the pandemic

The high mortality of patients with coronavirus disease 2019 (COVID-19) is effectively reduced by vaccination. However, the effect of vaccination on mortality among hospitalised patients is under-researched. Thus, we investigated the effect of a full primary or an additional booster vaccination on in-hospital mortality among patients hospitalised with COVID-19 during the delta wave of the pandemic. This retrospective cohort included all patients (n = 430) admitted with COVID-19 at Semmelweis University Department of Medicine and Oncology in 01/OCT/2021–15/DEC/2021. Logistic regression models were built with COVID-19-associated in-hospital/30 day-mortality as outcome with hierarchical entry of predictors of vaccination, vaccination status, measures of disease severity, and chronic comorbidities. Deceased COVID-19 patients were older and presented more frequently with cardiac complications, chronic kidney disease, and active malignancy, as well as higher levels of inflammatory markers, serum creatinine, and lower albumin compared to surviving patients (all p < 0.05). However, the rates of vaccination were similar (52–55%) in both groups. Based on the fully adjusted model, there was a linear decrease of mortality from no/incomplete vaccination (ref) through full primary (OR 0.69, 95% CI: 0.39–1.23) to booster vaccination (OR 0.31, 95% CI 0.13–0.72, p = 0.006). Although unadjusted mortality was similar among vaccinated and unvaccinated patients, this was explained by differences in comorbidities and disease severity. In adjusted models, a full primary and especially a booster vaccination improved survival of patients hospitalised with COVID-19 during the delta wave of the pandemic. Our findings may improve the quality of patient provider discussions at the time of admission