Efficacy and safety of insulin glargine 300 units/mL vs insulin degludec in patients with type 1 and type 2 diabetes: a systematic review and meta-analysis

BackgroundUltra-long-acting insulin analogs [insulin degludec (IDeg) and insulin glargine 300 units/mL (IGla-300)] offer a longer duration of action with less risk of hypoglycemia compared to other long-acting insulins. However, data about the comparative efficacy and safety are inconsistent.MethodsWe searched CENTRAL, PubMed, Embase, ICTRP Search Portal, and ClinicalTrials.gov on 7 October 2022. Randomized controlled trials (RCTs) comparing the safety and efficacy of IDeg (100 or 200 units/mL) and IGla-300 in patients with type 1 or type 2 diabetes were included. Three review authors independently selected trials, assessed the risk of bias, extracted data, and evaluated the overall certainty of the evidence using GRADE. The primary outcomes were the change in glycated hemoglobin (HbA1c) and any hypoglycemia; the secondary outcomes were the change in fasting plasma glucose (FPG) and severe and nocturnal hypoglycemia.ResultsFour open-label RCTs were included (2727 participants), 3 parallel and 1 cross-over. Overall, the risk of bias assessment yielded some concern or high risk. There was a comparable change in HbA1c from baseline to the end of treatment, a mean difference of 0.07% (95% confidence interval (CI) 0.06 – 0.19; p = 0.29; 3 trials; 2652 patients; very low-certainty evidence), and a comparable rate of any hypoglycemia, rate ratio 1.02 (95% CI 0.8 – 1.3; p = 0.87; 3 trials; 2881 patients; very low-certainty evidence). IDeg resulted in more reduction in FPG compared to IGla-300, mean difference of 10.27 mg/dL (95% CI 7.25 – 13.29; p < 0.001; 3 trials; 2668 patients; low-certainty evidence). Similar rates of nocturnal and severe hypoglycemia were observed, rate ratio of 1.13 (95% CI 0.72 – 1.78; p = 0.54; 3 trials; 2668 patients; very low-certainty evidence) and 1.4 (95% CI 0.41 – 4.73; p = 0.59; 2 trials; 1952 patients; very low-certainty evidence), respectively.ConclusionThere is no evidence of a difference between IDeg and IGla-300 in the mean change in HbA1c and the risk of anytime, nocturnal, and severe hypoglycemia. IDeg appeared to cause a higher reduction in FPG compared to IGla-300. However, this finding should be interpreted with caution due to the small number of trials included and their high risk of bias.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022364891, identifier CRD42022364891

PROCESSING AND CHARACTERIZATION OF TUBULAR CERAMIC SUPPORT FOR MICROFILTRATION MEMBRANE PREPARED FROM PYROPHYLLITE CLAY

Tubular macroporous support for ceramic microfiltration membranes were prepared by extrusion followed by sintering of the low cost pyrophyllite clay. Clay powders mixed with some organic additives can be extruded to form a porous tubular support. The average pore size of the membrane is observed to increase from 5 µm to 10.8 µm when sintering temperature increase from 900 °C to 1200 °C. However, with the increase in temperature from 900 °C to 1200 °C, the support porosity is reduced from 47% to 30% and flexural strength is increased from 4 MPa to 17 MPa. The fabricated macro-porous supports are expected to have potential applications in the pre-treatment and also can be used like support for membranes of ultra-filtration

An overview of hepatitis B virus surface antigen mutant in the Asia Pacific

Hepatitis B virus infection is a serious health problem worldwide, and more than 350 million people are chronic carriers, constituting a major global threat. Southeast Asia and the Western Pacific have the highest levels of endemicity in the world, with an estimated seroprevalence ranging between 2% and 31%. Mutations in the hepatitis B surface antigen (HBsAg) have been reported in many parts of the world but are most common in Asian infants; such mutants have several clinical effects, such as the development of hepatocellular carcinoma. Diagnostic failures by commercial assays have reduced the diagnostic effectiveness of HBsAg detection. For example the substitution of an amino acid in the major hydrophilic region of the S gene reduces the binding of hepatitis B surface antibodies leading to immune escape. The safety of blood transfusion may be compromised by current screening tests due to escape from being neutralised by antibodies induced by HBsAg mutants, and undetectable levels of viral surface protein. Data on the epidemiology of HBsAg mutation in Asia Pacific are scant; however, this manuscript has reviewed the available information on the epidemiology of HBsAg mutation in Asia Pacific

Occult hepatitis B infection among vaccinated cohort

BACKGROUND: Occult hepatitis B is characterized by undetectable levels of surface antigen, but detectable levels of viral DNA and is becoming a major global threat due to: (i) the effect on the health of children born to carrier mothers despite the presence of passive immunoglobulin at birth (ii) immune escape of current vaccines; and (iii) spread through blood and blood products in post transfusion infection, organ donation, and sexual transmission. The aim of this study is to investigate occult hepatitis B virus among vaccines. METHOD: Four hundred and eight, vaccinee were recruited for this study. All samples were tested for hepatitis B surface antigen, hepatitis B surface and core antibodies using enzyme-linked immunosorbent assay kit (DRG International Inc., USA). Positive samples were re-tested to exclude false positive results. Molecular technique using a nested polymerase chain reaction was done using primers specific to the surface gene. RESULTS: Persistence of hepatitis B surface antibodies (≥10 IU/L) was found in 62.5% (255/408) with 37.5% (153/408) having anti-HBs<10 IU/L in circulation. Hepatitis B core antibodies among vaccinated cohort were found to be 5.0% (20/408). Of which 80% (16/20) of the hepatitis B core antibodies positive, have positive hepatitis B surface antibodies (≥10 IU/L) while 20% (4/20) are negative (<10 IU/L). The former is indicating immunity as a result of previous infection and the latter group are referred to as isolated anti-core, as described in previous studies (1). However none of the samples is hepatitis B surface antigen positive. Hepatitis B viral DNA was detected in all the core antigen positive individuals, contrary to studies in Turkey and Taiwan and in line with other similar studies(2). Occult hepatitis B infections have significant clinical importance since they can become reactivated when the immune system is suppressed and can be transmitted through blood or blood product transfusion, organs transplant, and sexual intercourse. CONCLUSION: The result of this study shows occult chronic HBV infection among adults who were vaccinated against hepatitis B vaccine at infant. The anti-HBs produced were induced by the vaccine they received but do not provide protection against the mutant’s variant suggesting primary infection with mutant’s hepatitis B virus

A thiazolo[5,4-: D] thiazole-bridged porphyrin organic framework as a promising nonlinear optical material

Porphyrin-based porous organic frameworks are an important group of materials gaining interest due to their structural diversity and distinct opto-electronic properties. However, these materials are seldom explored for nonlinear optical (NLO) applications. In this work, we investigate a thiazolo[5,4-d]thiazole-bridged porous, porphyrin framework (Por-TzTz-POF) with promising NLO properties. The planar TzTz moiety coupled with integrated porphyrin units enables efficient π-conjugation and charge distribution in the Por-TzTz-POF resulting in a high nonlinear absorption coefficient (β = 1100 cm GW-1) with figure of merit (FoM) σ1/σ0 = 5571, in contrast to analogous molecules and material counterparts e.g. metal-organic frameworks (MOFs; β = ∼0.3-0.5 cm GW-1), molecular porphyrins (β = ∼100-400 cm GW-1), graphene (β = 900 cm GW-1), and covalent organic frameworks (Por-COF-HH; β = 1040 cm GW-1 and FoM = 3534). This journal is © The Royal Society of Chemistry

Influence of temperature, salinity and Mg:Ca ratio on microbially-mediated formation of Mg-rich carbonates by Virgibacillus strains isolated from a sabkha environment.

Studies have demonstrated that microbes facilitate the incorporation of Mg into carbonate minerals, leading to the formation of potential dolomite precursors. Most microbes that are capable of mediating Mg-rich carbonates have been isolated from evaporitic environments in which temperature and salinity are higher than those of average marine environments. However, how such physicochemical factors affect and concur with microbial activity influencing mineral precipitation remains poorly constrained. Here, we report the results of laboratory precipitation experiments using two mineral-forming Virgibacillus strains and one non-mineral-forming strain of Bacillus licheniformis, all isolated from the Dohat Faishakh sabkha in Qatar. They were grown under different combinations of temperature (20°, 30°, 40 °C), salinity (3.5, 7.5, 10 NaCl %w/v), and Mg:Ca ratios (1:1, 6:1 and 12:1). Our results show that the incorporation of Mg into the carbonate minerals is significantly affected by all of the three tested factors. With a Mg:Ca ratio of 1, no Mg-rich carbonates formed during the experiments. With a Mg:Ca ratios of 6 and 12, multivariate analysis indicates that temperature has the highest impact followed by salinity and Mg:Ca ratio. The outcome of this study suggests that warm and saline environments are particularly favourable for microbially mediated formation of Mg-rich carbonates and provides new insight for interpreting ancient dolomite formations

Influenza vaccination among Malaysian healthcare workers: a survey of coverage and attitudes

Background: Healthcare workers (HCWs) are at increased risk of getting influenza than the general population, therefore putting patients at risk of nosocomial infection. Influenza vaccination coverage among HCWs is low despite the availability of a safe and effective vaccine. However, the reasons for such a poor uptake are not well reported in Malaysia. This study aimed at assessing the rate of influenza vaccination uptake, knowledge and attitude of healthcare workers regarding influenza, and employers’ policy on influenza vaccination. Methods: A cross-sectional questionnaire survey was conducted in three hospitals in the Klang Valley. Mann–Whitney test was used to assess possible differences in knowledge and attitude towards flu vaccination and the χ 2 was used for categorical variables. Analyses were performed with SPSS 22.0. Results: A total of 690 questionnaires were distributed; 527 were returned (giving a response rate of 76.4%. The vaccine uptake was 51.4% with the majority (83.5%) of those believing they were vaccinated to protect themselves. Higher proportion of vaccinated HCWs (p <0.05) agreeing to the fact that influenza is a serious threat to their health, however, 10% were not sure of its safety. Eighty-three (15.7%) claimed their employers did not have a vaccination policy, while 43.3% were not sure if their employers have vaccination policy. Conclusion: This study has demonstrated more than half of the healthcare workers were vaccinated, with a significant proportion of the healthcare workers believed they were vaccinated to protect themselves, while most of those that were not vaccinated claimed they are worried about the safety of the vaccine. Most employers did not have a flu vaccination policy in place. Hence, the need for government to enforce such policy and make annual flu vaccination free and compulsory for all healthcare workers

Hepatitis E virus isolated from chronic hepatitis B patients in Malaysia: Sequences analysis and genetic diversity suggest zoonotic origin

Background: Zoonotically acquired HEV has been described as one of the most successful zoonotic viral infections in human history.Aim: In this study we characterized HEV comparative genomic analysis as it relates to swine HEV.Materials and methods: A total of 82 chronic hepatitis B patients were recruited from May 2015 to May 2016 for this study. We conducted a serological and molecular investigation of HEV among these patients. The detected HEV were sequenced and the genomes and deduced amino acids were characterized using molecular evolutionary genetic analysis software version 7.Results: Of the 82 chronic hepatitis B patients that were tested, 9.8% (8/82) were found to be HEV positive. Phylogenetic analysis of the HEV RNA sequences showed they are of genotype 4 and demonstrated high sequence identity with a swine isolate from China, with variation in amino acids at position 22, where leucine was present in the Malaysian human isolate while phenylalanine was present in the China swine isolate.Conclusion: Comparative analysis of the human HEV ORF-2 nucleotide sequence suggest zoonotic origin.Keywords: Co-infection, Chronic hepatitis B, Hepatitis E virus, Zoonotic HEV, Malaysian HEV isolat

Correlation between cell surface physicochemical properties of bacterial strains and their chromium removal potential

Physicochemical characterization of microbes has gained recently a great interest by scientific community. It is proved of extreme importance in several fields of science and technology applications such as bioremediation. In this work, we investigated the establishment of a possible correlation between chromium removal capacity of seven bacterial strains isolated from contaminated sites with industrial wastes including tanning processing and their cell surface physicochemical properties. Thus, hydrophobicity and donor/acceptor electrons character were obtained using contact angle measurements. Statistical analysis showed a high significant positive correlation between hexavalent chromium (Cr(VI)) removal by the strains and their acceptor electron character γ+(r = 0.90). While significant negative correlation between the Cr(VI) removal potential and the ΔGiwi value (r = −0.844) and also with their donor electron character γ− (r = −0.746) were observed. These results may contribute to determine a selectrion criteria of bacteria that can be operated in bioremediation applications