38 research outputs found
Micromechanical Properties of Injection-Molded StarchâWood Particle Composites
The micromechanical properties of injection molded starchâwood particle composites were investigated as a function of particle content and humidity conditions.
The composite materials were characterized by scanning electron microscopy and X-ray diffraction methods. The microhardness
of the composites was shown to increase notably with the concentration of the wood particles. In addition,creep behavior under the indenter and temperature dependence
were evaluated in terms of the independent contribution of the starch matrix and the wood microparticles to the hardness value. The influence of drying time on the density
and weight uptake of the injection-molded composites was highlighted. The results revealed the role of the mechanism of water evaporation, showing that the dependence of water uptake and temperature was greater for the starchâwood composites than for the pure starch sample. Experiments performed during the drying process at 70°C indicated that
the wood in the starch composites did not prevent water loss from the samples.Peer reviewe
Prevention of contrast-induced acute kidney injury in patients undergoing cardiovascular procedures : a systematic review and network meta-analysis
BACKGROUND: Interventional diagnostic and therapeutic procedures requiring intravascular iodinated contrast steadily increase patient exposure to the risks of contrast-induced acute kidney injury (CIAKI), which is associated with death, nonfatal cardiovascular events, and prolonged hospitalization. The aim of this study was to investigate the efficacy of pharmacological and non-pharmacological treatments for CIAKI prevention in patients undergoing cardiovascular invasive procedures with iodinated contrast.METHODS AND FINDINGS: MEDLINE, Google Scholar, EMBASE and Cochrane databases as well as abstracts and presentations from major cardiovascular and nephrology meetings were searched, up to 22 April 2016. Eligible studies were randomized trials comparing strategies to prevent CIAKI (alone or in combination) when added to saline versus each other, saline, placebo, or no treatment in patients undergoing cardiovascular invasive procedures with administration of iodinated contrast. Two reviewers independently extracted trial-level data including number of patients, duration of follow-up, and outcomes. Eighteen strategies aimed at CIAKI prevention were identified. The primary outcome was the occurrence of CIAKI. Secondary outcomes were mortality, myocardial infarction, dialysis and heart failure. The data were pooled using network meta-analysis. Treatment estimates were calculated as odds ratios (ORs) with 95% credible intervals (CrI). 147 RCTs involving 33,463 patients were eligible. Saline plus N-acetylcysteine (OR 0.72, 95%CrI 0.57-0.88), ascorbic acid (0.59, 0.34-0.95), sodium bicarbonate plus N-acetylcysteine (0.59, 0.36-0.89), probucol (0.42, 0.15-0.91), methylxanthines (0.39, 0.20-0.66), statin (0.36, 0.21-0.59), device-guided matched hydration (0.35, 0.12-0.79), prostaglandins (0.26, 0.08-0.62) and trimetazidine (0.26, 0.09-0.59) were associated with lower odds of CIAKI compared to saline. Methylxanthines (0.12, 0.01-0.94) or left ventricular end-diastolic pressure-guided hydration (0.09, 0.01-0.59) were associated with lower mortality compared to saline.CONCLUSIONS: Currently recommended treatment with saline as the only measure to prevent CIAKI during cardiovascular procedures may not represent the optimal strategy. Vasodilators, when added to saline, may significantly reduce the odds of CIAKI following cardiovascular procedures
Roxadustat for the Maintenance Treatment of Anemia in Patients with End-Stage Kidney Disease on Stable Dialysis: A European Phase 3, Randomized, Open-Label, Active-Controlled Study (PYRENEES)
Introduction: Roxadustat is an orally administered hypoxia-inducible factor prolyl hydroxylase inhibitor being developed for the treatment of anemia of chronic kidney disease (CKD). This European, phase 3, randomized, open-label, active-controlled study investigated efficacy and safety of roxadustat in patients with end-stage kidney disease on dialysis for at least 4 months. Methods: Patients were randomized to switch from an erythropoiesis-stimulating agent (ESA) (epoetin alfa or darbepoetin alfa) to roxadustat three times/week or to continue their previous ESA. Roxadustat and ESA doses were adjusted to maintain hemoglobin within 10.0â12.0 g/dL during the treatment period (day 1 up to 52â104 weeks). Primary endpoints were hemoglobin change from baseline (CFB) to the average of weeks 28â36 without rescue therapy and hemoglobin CFB to the average of weeks 28â52 regardless of rescue therapy. Treatment-emergent adverse events (TEAEs) were assessed descriptively. Results: Of 1081 screened patients, 836 were randomized and received treatment (roxadustat, n = 415; ESA, n = 421). The least squares means (95% CI) of the treatment difference (roxadustat â ESA) for hemoglobin CFB to weeks 28â36 (without rescue therapy) and CFB to weeks 28â52 (regardless of rescue therapy) were 0.235 (0.132, 0.339) g/dL and 0.171 (0.082, 0.261) g/dL, respectively, demonstrating non-inferiority of roxadustat to ESA (non-inferiority margin of â 0.75 g/dL). The proportions of patients who achieved target hemoglobin without rescue therapy during weeks 28â36 were 84.2% (roxadustat) and 82.4% (ESA). Roxadustat was superior to ESA in decreasing LDL cholesterol from baseline to the average of weeks 12â28. Serious TEAEs occurred in 50.7% (roxadustat) and 45.0% (ESA) of patients. Common TEAEs in both treatment groups included hypertension, arteriovenous fistula thrombosis, headache, and diarrhea. Conclusion: Roxadustat was non-inferior to ESAs in maintaining hemoglobin levels in this cohort of patients with anemia of CKD on dialysis for at least 4 months who were previously treated with ESAs. Observed TEAEs were consistent with previous studies
Roxadustat for the treatment of anemia in chronic kidney disease patients not on dialysis: a Phase 3, randomized, double-blind, placebo-controlled study (ALPS)
BACKGROUND: Roxadustat is an orally active hypoxia-inducible factor prolyl hydroxylase inhibitor for the treatment of chronic kidney disease (CKD) anemia. METHODS: This Phase 3, multicenter, randomized, double-blind, placebo-controlled study examined patients with Stages 3-5 CKD, not on dialysis (NCT01887600). Patients were randomized (2:1) to oral roxadustat or placebo three times weekly for 52-104âweeks. This study examined two primary efficacy endpoints: European Union (European Medicines Agency)-hemoglobin (Hb) response, defined as Hbââ„11.0âg/dL that increased from baseline (BL) by â„1.0âg/dL in patients with Hbâ>8.0âg/dL or â„2.0âg/dL in patients with BL Hbââ€8.0âg/dL, without rescue therapy, during the first 24âweeks of treatment; US Food and Drug Administration-change in Hb from BL to the average Hb level during Weeks 28-52, regardless of rescue therapy. Secondary efficacy endpoints and safety were examined. RESULTS: A total of 594 patients were analyzed (roxadustat: 391; placebo: 203). Superiority of roxadustat versus placebo was demonstrated for both primary efficacy endpoints: Hb response [odds ratio = 34.74, 95% confidence interval (CI) 20.48-58.93] and change in Hb from BL [roxadustat - placebo: +1.692 (95% CI 1.52-1.86); both Pâ<â0.001]. Superiority of roxadustat was demonstrated for low-density lipoprotein cholesterol change from BL, and time to first use of rescue medication (both Pâ<â0.001). The incidences of treatment-emergent adverse events were comparable between groups (roxadustat: 87.7%, placebo: 86.7%). CONCLUSIONS: Roxadustat demonstrated superior efficacy versus placebo in terms of both Hb response rate and change in Hb from BL. The safety profiles of roxadustat and placebo were comparable
Continuous Erythropoietin Receptor Activator (CERA) administered at extended administration intervals corrects anaemia in patients with chronic kidney disease on dialysis: a randomised, multicentre, multiple-dose, phase II study
This dose-finding, open-label study examined the potential of subcutaneous Continuous Erythropoietin Receptor Activator (C.E.R.A.) to correct anaemia at extended administration intervals in 61 erythropoiesis-stimulating agent-naive patients with chronic kidney disease (CKD) on dialysis. After a 4-week run-in, patients were randomised to C.E.R.A. 0.15, 0.30 and 0.45 mu g/kg/week. Within these dose groups, patients were further randomised to once weekly, once every 2 weeks or once every 3 weeks treatment. Mean changes in haemoglobin (Hb) increased with increasing C.E.R.A. dose during a period of 6 weeks where no dose adjustments were permitted. The effect was independent of administration schedule. Erythropoietic responses were sustained until the end of the study (12 weeks) in all groups. In total, 90% of patients in the 0.30 mu g/kg/week group and 79% in the 0.45 mu g/kg/week group responded to treatment (Hb increase >= 1.0 g/dl), compared with 72% in the 0.15 mu g/kg/week group. Faster median response time was associated with increasing dose (51, 38 and 31 days, respectively) and response was unrelated to administration frequency. C.E.R.A. was generally well tolerated. Our results suggest that 0.60 mu g/kg twice monthly would be a suitable starting dose of C.E.R.A. for the initiation of anaemia correction in patients with CKD on dialysis. Phase III studies will confirm the feasibility of using C.E.R.A. at extended administration intervals in patients with CKD and anaemia
Are botanical pesticides not toxic to non-target organisms: Studying the effects of azadirachtin on soil microbes using advanced culture-independent approaches
Azadirachtin is probably the most popular botanical
insecticide registered for use in conventional and organic
farming. It is characterized by low toxicity to mammals and
low environmental persistence. The biological origin of
azadirachtin has created a general perception that is safe for
not-target organisms including soil microbes. However this
remains to be verified by experimental data. In order to fill
this gap, a microcosm study was employed where an
agricultural soil was exposed to four dose levels of
azadirachtin (x0, x1, x10 and x100 the recommended dose).
The impact of the insecticides to soil microbial activity was
determined via high throughput enzyme activity screening
while diversity effects were determined via Illumina-based
assay of the 16S rRNA bacterial gene. In parallel the
dissipation of azadricahtin was also determined. The
degradation of azadirachtin in soil was quite rapid, with DT50
of 1.3 days at the x100 dose rate. Azadirachtin had a
significant positive effect on the activities of betaglucosidase, chitinase, phosphomonoesterase, leucineaminopeptidase
and on potential nitrification (PN), with the
latter two parameters showing the most significant
correlations. Distance based redundancy analysis indicated a
small but significant effect of the applied dose rate on
microbial activities with dose level, as a main factor,
explaining 9.3 % of the total observed variance. This was
mainly due to differences between the non-treated (x0) and
the treated sample (x1, x10 and x100), with PN contributing
mostly to these differences. The latter showed a rapid (4-7
days) positive response to azadirachtin applications at all
dose levels. Diversity assessment of the bacterial
communities is on the way and the complete dataset will be
presented during the conference