Serious adverse events and deaths in PCSK9 inhibitor trials reported on ClinicalTrials.gov:a systematic review

Background: Previous reviews of PCSK9 inhibitor trials are limited by a focus on composite cardiovascular outcomes. ClinicalTrials.gov provides trial results for individual clinical outcomes. Aim of this systematic review was to assess the effect of PCSK9 inhibitors on the risk of myocardial infarction, stroke/TIA, heart failure, diabetes mellitus, neurocognitive events, all-cause serious adverse events (SAE), and all-cause deaths as registered on ClinicalTrials.gov. Methods: PubMed, regulatory reports, ClinicalTrials.gov, and company websites were used to search studies. Randomized trials comparing PCSK9 inhibitor with placebo in participants with hypercholesterolemia were eligible. Study characteristics, risk of bias, and numbers of participants with the outcomes of interest were collected. Results: We identified 33 lipid-lowering and 4 clinical outcomes trials with results on ClinicalTrials.gov (n = 16,958 and n = 73,836, respectively). Risk of bias was generally high. PCSK9 inhibitors did not affect the risk of any of the investigated outcomes in either type of trial. However, in clinical outcomes studies, alirocumab decreased the risk of all-cause SAE (OR 0.92; 95% CI 0.86–0.98), and evolocumab probably increased the risk of mortality (OR 1.12; 95% CI 1.00–1.25). Conclusions: Our meta-analysis of clinical events registered on ClinicalTrials.gov did not show that PCSK9 inhibitors improve cardiovascular health. Evolocumab increased the risk of all-cause mortality

Precisely Engineered Supported Gold Clusters as a Stable Catalyst for Propylene Epoxidation

Designing a stable and selective catalyst with high H2 utilisation is of pivotal importance for the direct gas-phase epoxidation of propylene. This work describes a facile one-pot methodology to synthesise ligand-stabilised sub-nanometre gold clusters immobilised onto a zeolitic support (TS-1) to engineer a stable Au/TS-1 catalyst. A non-thermal O2 plasma technique is used for the quick removal of ligands with limited increase in particle size. Compared to untreated Au/TS-1 catalysts prepared using the deposition precipitation method, the synthesised catalyst exhibits improved catalytic performance, including 10 times longer lifetime (>20 days), increased PO selectivity and hydrogen efficiency in direct gas phase epoxidation. The structure-stability relationship of the catalyst is illustrated using multiple characterisation techniques, such as XPS, 31P MAS NMR, DR-UV/VIS, HRTEM and TGA. It is hypothesised that the ligands play a guardian role in stabilising the Au particle size, which is vital in this reaction. This strategy is a promising approach towards designing a more stable heterogeneous catalyst

Charge Transport and Rectification in Arrays of SAM-Based Tunneling Junctions

This paper describes a method of fabrication that generates small arrays of tunneling junctions based on self-assembled monolayers (SAMs); these junctions have liquid-metal top-electrodes stabilized in microchannels and ultraflat (template-stripped) bottom-electrodes. The yield of junctions generated using this method is high (70−90%). The junctions examined incorporated SAMs of alkanethiolates having ferrocene termini (11-(ferrocenyl)-1-undecanethiol, SC$_{11}$Fc); these junctions rectify currents with large rectification ratios (R), the majority of which fall within the range of 90−180. These values are larger than expected (theory predicts R ≤ 20) and are larger than previous experimental measurements. SAMs of n-alkanethiolates without the Fc groups (SC$_{n−1}$CH$_3$, with n = 12, 14, 16, or 18) do not rectify (R ranged from 1.0 to 5.0). These arrays enable the measurement of the electrical characteristics of the junctions as a function of chemical structure, voltage, and temperature over the range of 110−293 K, with statistically large numbers of data (N = 300−800). The mechanism of rectification with Fc-terminated SAMs seems to be charge transport processes that change with the polarity of bias: from tunneling (at one bias) to hopping combined with tunneling (at the opposite bias).Chemistry and Chemical Biolog

A randomised trial of honey barrier cream versus zinc oxide ointment

In this single-blind multicentre, intervention study, 31 patients with symmetrical intertrigo in large skin folds were included to study the clinical effect of two topical treatments, i.e. standard therapy with zinc oxide ointment versus honey barrier cream. Patients were treated twice daily for 21 days, and the severity of intertrigo was scored in an observation period of 21 days. Patients were used as their own controls by treating symmetrical skin folds, on the left and right side. There was no significant difference in treatment effect between intervention groups. For the majority of patients, both treatments were effective. However, the use of honey barrier cream showed lower pruritus complaints (12.9% versus 29.0%). Honey barrier cream is a suitable alternative in the treatment of intertrigo, and promotes patient comfort

Gold nanoparticles with tailored size through ligand modification for catalytic applications

The active sites of catalysts can be tuned by using appropriate organic moieties. Here, we describe a facile approach to synthesise gold nanoparticles (AuNPs) using various Au(I) precursors. The core size of these AuNPs can be precisely tailored by varying the steric hindrance imposed by bound ligands. An interesting relationship is deduced that correlates the steric hindrance around the metal to the final size of the nanoparticles. The synthesised AuNPs are immobilised onto TS-1 zeolite (Au/TS-1) with minimal change in the final size of the AuNPs. The catalytic performance of Au/TS-1 catalyst is evaluated for the direct gas phase epoxidation of propylene with hydrogen and oxygen, an environmentally friendly route to produce propylene oxide. The results indicate that smaller AuNPs exhibit enhanced catalytic activity and selectivity. Furthermore, this synthetic approach is beneficial when tailored synthesis of gold nanoparticles of specific sizes is required

AC Loss in the Superconducting Cables of the CERN Fast Cycled Magnet Prototype

Fast Cycled Superconducting Magnets (FCM's) are an option of interest for the long-term consolidation and upgrade plan of the LHC accelerator complex. The economical advantage of FCM's in the range of 2 T bore field, continuously cycled at 0.5 Hz repetition rate, depends critically on the AC loss property of strand and cable. In this paper we report the results of the AC loss measurements that we have performed both on strands and cables manufactured for the CERN FCM prototype program

Statistical Tools for Analyzing Measurements of Charge Transport

This paper applies statistical methods to analyze the large, noisy data sets produced in measurements of tunneling current density (J) through self-assembled monolayers (SAMs) in large-area junctions. It describes and compares the accuracy and precision of procedures for summarizing data for individual SAMs, for comparing two or more SAMs, and for determining the parameters of the Simmons model (β and J0). For data that contain significant numbers of outliers (i.e., most measurements of charge transport), commonly used statistical techniques—e.g., summarizing data with arithmetic mean and standard deviation and fitting data using a linear, least-squares algorithm—are prone to large errors. The paper recommends statistical methods that distinguish between real data and artifacts, subject to the assumption that real data (J) are independent and log-normally distributed. Selecting a precise and accurate (conditional on these assumptions) method yields updated values of β and J0 for charge transport across both odd and even n-alkanethiols (with 99% confidence intervals) and explains that the so-called odd–even effect (for n-alkanethiols on Ag) is largely due to a difference in J0 between odd and even n-alkanethiols. This conclusion is provisional, in that it depends to some extent on the statistical model assumed, and these assumptions must be tested by future experiments.Chemistry and Chemical BiologyEngineering and Applied Science