Origin of Polarization in Bismuth Sodium Titanate-Based Ceramics.

The classical view of the structural changes that occur at the ferroelectric transition in perovskite-structured systems, such as BaTiO3, is that polarization occurs due to the off-center displacement of the B-site cations. Here, we show that in the bismuth sodium titanate (BNT)-based composition 0.2(Ba0.4Sr0.6TiO3)-0.8(Bi0.5Na0.5TiO3), this model does not accurately describe the structural situation. Such BNT-based systems are of interest as lead-free alternatives to currently used materials in a variety of piezo-/ferroelectric applications. A combination of high-resolution powder neutron diffraction, impedance spectroscopy, and ab initio calculations reveals that Ti4+ contributes less than a third in magnitude to the overall polarization and that the displacements of the O2- ions and the A-site cations, particularly Bi3+, are very significant. The detailed examination of the ferroelectric transition in this system offers insights applicable to the understanding of such transitions in other ferroelectric perovskites, particularly those containing lone pair elements

An ab initio study of oxide ion dynamics in type-II Bi3NbO7

Oxide ion dynamics in the type-II phase of Bi3NbO7have been studied using a series of DFT molecular dynamics calculations.</p

Structural and electrical behaviour in Bi14YO22.5

National Science Centre Poland for project grant numbers 2012/05/E/ ST3/02767 and 2013/09/N/ST3/0432

Ações de Prevenção da Deficiência Mental, dirigidas a Gestantes e Recém-Nascidos, no âmbito da Saúde Pública da Grande Vitória-ES

The accomplishment of prevention in Public Health requires a systematized knowledge for the proposition of a program and its evaluation. When it comes to the prevention of Mental Deficiency, which afflicts around 10% of the population, little is known in Brazil. By adopting a methodology for cataloging MD preventive actions in hospitals and health units, with pregnant women and newborns, it was possible to describe and analyze the actions of the public health system in Greater Vitoria/ES, indicating the levels of prevention which were most covered. Preventive actions (PA) of five large public hospitals, nine health units and six health offices, from 1996 to 1997 were studied. Data from 25 interviews show that these places made 51.5% of the 433 possible PA (57.4% of primary prevention and 45.5% of the secondary). Along with the particularization of the action of each municipality and place researched, the obtained data was useful for analyses and possible changes in maternal-infantile health indicators.Faire de la prévention dans la santé publique est conditionné par une très bonne connaissance afin de proposer des programmes et les évaluer. Au Brésil, on sait peu de choses sur la prévention de la déficience mentale, qui atteint pourtant 10 % de la population. Adoptant une méthodologie et pour faire un catalogue des actions préventives de déficience mentale dans les hôpitaux et les unités de santé, pour les femmes enceintes et les nouveau-nés, on a pu décrire et analyser les actions de santé publique dans la ville de Grande Vitoria (État du Espirito Santo), indiquant le niveau de prévention les plus couverts. On a regroupé les actions de prévention de cinq hôpitaux publics importants, neuf (31 %) unités de santé et six bureaux centralisateurs, entre 1996 et 97. Les données de vingt-cinq entrevues montrent que ces locaux réalisent 51,5 % des 433 actions de prévention possibles (57,4 % de prévention primaire et 45,5 % de secondaire). En détaillant les réalisations de chaque municipalité et local étudié, les chiffres fournissent des ressources pour des analyses et les modifications possibles dans les indicateurs de santé maternelle et infantile.Fazer prevenção em Saúde Pública implica em conhecimento sistematizado para a proposição de programas e sua avaliação. Quanto à prevenção de Deficiência Mental, que atinge cerca de 10% da população, pouco se conhece no país. Adotando uma metodologia para levantamento de ações preventivas de DM em hospitais e unidades de saúde, junto a gestantes e recém-nascidos, fo i possível descrever e analisar a atuação da rede pública de saúde da Grande Vitória/ES, indicando os níveis de prevenção mais atendidos. Foram levantadas as ações de prevenção (AP) de cinco hospitais públicos de grande porte, nove (31%) unidades de saúde e seis secretarias de saúde, entre 1996-97. Os dados de 25 entrevistas mostram que esses locais realizavam 51,5% das 433 AP possíveis (57,4% da prevenção primária e 45,5% da secundária). Particularizando a atuação de cada município e local pesquisado, os dados fornecem subsídios para análises e possíveis mudanças nos indicadores de saúde materno-infantil

Effect of SGLT2 inhibitors on stroke and atrial fibrillation in diabetic kidney disease: Results from the CREDENCE trial and meta-analysis

BACKGROUND AND PURPOSE: Chronic kidney disease with reduced estimated glomerular filtration rate or elevated albuminuria increases risk for ischemic and hemorrhagic stroke. This study assessed the effects of sodium glucose cotransporter 2 inhibitors (SGLT2i) on stroke and atrial fibrillation/flutter (AF/AFL) from CREDENCE (Canagliflozin and Renal Events in Diabetes With Established Nephropathy Clinical Evaluation) and a meta-Analysis of large cardiovascular outcome trials (CVOTs) of SGLT2i in type 2 diabetes mellitus. METHODS: CREDENCE randomized 4401 participants with type 2 diabetes mellitus and chronic kidney disease to canagliflozin or placebo. Post hoc, we estimated effects on fatal or nonfatal stroke, stroke subtypes, and intermediate markers of stroke risk including AF/AFL. Stroke and AF/AFL data from 3 other completed large CVOTs and CREDENCE were pooled using random-effects meta-Analysis. RESULTS: In CREDENCE, 142 participants experienced a stroke during follow-up (10.9/1000 patient-years with canagliflozin, 14.2/1000 patient-years with placebo; hazard ratio [HR], 0.77 [95% CI, 0.55-1.08]). Effects by stroke subtypes were: ischemic (HR, 0.88 [95% CI, 0.61-1.28]; n=111), hemorrhagic (HR, 0.50 [95% CI, 0.19-1.32]; n=18), and undetermined (HR, 0.54 [95% CI, 0.20-1.46]; n=17). There was no clear effect on AF/AFL (HR, 0.76 [95% CI, 0.53-1.10]; n=115). The overall effects in the 4 CVOTs combined were: Total stroke (HRpooled, 0.96 [95% CI, 0.82-1.12]), ischemic stroke (HRpooled, 1.01 [95% CI, 0.89-1.14]), hemorrhagic stroke (HRpooled, 0.50 [95% CI, 0.30-0.83]), undetermined stroke (HRpooled, 0.86 [95% CI, 0.49-1.51]), and AF/AFL (HRpooled, 0.81 [95% CI, 0.71-0.93]). There was evidence that SGLT2i effects on total stroke varied by baseline estimated glomerular filtration rate (P=0.01), with protection in the lowest estimated glomerular filtration rate (45 mL/min/1.73 m2]) subgroup (HRpooled, 0.50 [95% CI, 0.31-0.79]). CONCLUSIONS: Although we found no clear effect of SGLT2i on total stroke in CREDENCE or across trials combined, there was some evidence of benefit in preventing hemorrhagic stroke and AF/AFL, as well as total stroke for those with lowest estimated glomerular filtration rate. Future research should focus on confirming these data and exploring potential mechanisms

Canagliflozin and Cardiovascular and Renal Outcomes in Type 2 Diabetes Mellitus and Chronic Kidney Disease in Primary and Secondary Cardiovascular Prevention Groups

Background: Canagliflozin reduces the risk of kidney failure in patients with type 2 diabetes mellitus and chronic kidney disease, but effects on specific cardiovascular outcomes are uncertain, as are effects in people without previous cardiovascular disease (primary prevention). Methods: In CREDENCE (Canagliflozin and Renal Events in Diabetes With Established Nephropathy Clinical Evaluation), 4401 participants with type 2 diabetes mellitus and chronic kidney disease were randomly assigned to canagliflozin or placebo on a background of optimized standard of care. Results: Primary prevention participants (n=2181, 49.6%) were younger (61 versus 65 years), were more often female (37% versus 31%), and had shorter duration of diabetes mellitus (15 years versus 16 years) compared with secondary prevention participants (n=2220, 50.4%). Canagliflozin reduced the risk of major cardiovascular events overall (hazard ratio [HR], 0.80 [95% CI, 0.67-0.95]; P=0.01), with consistent reductions in both the primary (HR, 0.68 [95% CI, 0.49-0.94]) and secondary (HR, 0.85 [95% CI, 0.69-1.06]) prevention groups (P for interaction=0.25). Effects were also similar for the components of the composite including cardiovascular death (HR, 0.78 [95% CI, 0.61-1.00]), nonfatal myocardial infarction (HR, 0.81 [95% CI, 0.59-1.10]), and nonfatal stroke (HR, 0.80 [95% CI, 0.56-1.15]). The risk of the primary composite renal outcome and the composite of cardiovascular death or hospitalization for heart failure were also consistently reduced in both the primary and secondary prevention groups (P for interaction &gt;0.5 for each outcome). Conclusions: Canagliflozin significantly reduced major cardiovascular events and kidney failure in patients with type 2 diabetes mellitus and chronic kidney disease, including in participants who did not have previous cardiovascular disease

Canagliflozin and Renal Outcomes in Type 2 Diabetes and Nephropathy

BACKGROUND Type 2 diabetes mellitus is the leading cause of kidney failure worldwide, but few effective long-term treatments are available. In cardiovascular trials of inhibitors of sodium–glucose cotransporter 2 (SGLT2), exploratory results have suggested that such drugs may improve renal outcomes in patients with type 2 diabetes. METHODS In this double-blind, randomized trial, we assigned patients with type 2 diabetes and albuminuric chronic kidney disease to receive canagliflozin, an oral SGLT2 inhibitor, at a dose of 100 mg daily or placebo. All the patients had an estimated glomerular filtration rate (GFR) of 30 to 300 to 5000) and were treated with renin–angiotensin system blockade. The primary outcome was a composite of end-stage kidney disease (dialysis, transplantation, or a sustained estimated GFR of <15 ml per minute per 1.73 m 2), a doubling of the serum creatinine level, or death from renal or cardiovascular causes. Prespecified secondary outcomes were tested hierarchically. RESULTS The trial was stopped early after a planned interim analysis on the recommendation of the data and safety monitoring committee. At that time, 4401 patients had undergone randomization, with a median follow-up of 2.62 years. The relative risk of the primary outcome was 30% lower in the canagliflozin group than in the placebo group, with event rates of 43.2 and 61.2 per 1000 patient-years, respectively (hazard ratio, 0.70; 95% confidence interval [CI], 0.59 to 0.82; P=0.00001). The relative risk of the renal-specific composite of end-stage kidney disease, a doubling of the creatinine level, or death from renal causes was lower by 34% (hazard ratio, 0.66; 95% CI, 0.53 to 0.81; P<0.001), and the relative risk of end-stage kidney disease was lower by 32% (hazard ratio, 0.68; 95% CI, 0.54 to 0.86; P=0.002). The canagliflozin group also had a lower risk of cardiovascular death, myocardial infarction, or stroke (hazard ratio, 0.80; 95% CI, 0.67 to 0.95; P=0.01) and hospitalization for heart failure (hazard ratio, 0.61; 95% CI, 0.47 to 0.80; P<0.001). There were no significant differences in rates of amputation or fracture. CONCLUSIONS In patients with type 2 diabetes and kidney disease, the risk of kidney failure and cardiovascular events was lower in the canagliflozin group than in the placebo group at a median follow-up of 2.62 years

Elucidation of the Nature of Structural Relaxation in Glassy d -Sorbitol

The nature and origin of the glass transition is one of the great unsolved problems of condensed-matter science. With the rapid increase of viscosity upon cooling the liquid near the glass-transition temperature, a range of dynamical motifs are observed, revealing the sheer complexity of interactions between the amorphous units. Yet, the causal link between those motifs and the solidification process remains unclear. Here, we apply a novel approach for exploring nontrivial interactions between structural units in d-sorbitol, a canonical example of a hydrogen-bonded organic glass, by introducing a dihedral-rearrangement-indicator analysis to shed light on relaxation processes and dynamical heterogeneity, which are known for their association with the stability of a glass. We find that both α- and β-relaxation processes are governed by cooperative and heterogeneous changes in hydrogen-bond dynamics that can be described by spatial and dihedral-angle-rearrangement indicators. The methodology and findings are of general applicability to other glass-forming systems

Trapping of oxide ions in delta-Bi3YO6

National Science Centre Poland for project grant numbers 2012/05/E/ST3/02767 and 2013/09/N/ST3/04326