Aluminium oxide-hydroxides obtained by hydrothermal synthesis: influence of thermal treatment on phase composition and textural characteristics

Aluminium oxide-hydroxides obtained by means of the hydrothermal synthesis of aluminium nanopowder are of great interest in terms of the potential supports for heterogeneous catalysts due its high specific surface area (200...300 m2/g) and pore size of 4...17 nm. In this work the influence of thermal treatment (150...1300 °C) on structural and phase composition, specific surface area and porosity of aluminium oxide-hydroxides has been investigated. Nanostructured γ-Al2O3 (T=400 °C) was found to have the specific surface area of 328 m2/g and average pore size of ~9 nm. The thermal treatment of aluminium oxide- hydroxides at the temperature of higher and lower than 400 °C has caused the reduction of specific surface area and overall pore volume

Cr2O3/Al-Al2O3 composite catalysts for hydrocarbons dehydrogenation prepared from aluminum nanopowder

Aluminum nanopowder (10–150 nm) was treated hydrothermally in mild conditions (60–95 °C, at atmospheric pressure), and an aluminum-alumina composite with high porosity and specific surface area was obtained. Cr2O3/Al-Al2O3 catalysts were prepared using the aluminum-alumina composite by impregnation techniques and tested in dehydrogenation of C4-hydrocarbons. It was shown that aluminum-alumina composites had high chemical and phase purity, specific surface area of 150–350 m2/g and the average pore size of 8–13 nm, that is favorable for application as support for catalysts. Cr2O3/Al-Al2O3 catalysts had high activity and selectivity in dehydrogenation of n- and i-butane (conversion of 44–80 mol.% and selectivity >85% at temperatures of 540–610 °C), that is comparable ones for commercial catalysts for CATOFIN, STAR processes

Influence of ultrafine particles on structure, mechanical properties, and strengthening of ductile cast iron

Integrated assessment of the influence of an ultrafine mixture TiO2 + ZrO2 + Na3AlF6 on the formation of the structure, mechanical properties, and strengthening of ductile cast iron was made in the paper. The structural-phase composition of ductile cast iron was studied by means of scanning electron microscopy and a transmission electron microscope. Plastic deformation was determined during testing of uniaxial compression. The change in the structural state of the alloy and in its mechanical properties was observed. Quantitative assessment of contributions of separate physical mechanisms to strengthening characteristics of unmodified and modified ductile cast iron was made

Outcome in patients perceived as receiving excessive care across different ethical climates: a prospective study in 68 intensive care units in Europe and the USA

Purpose: Whether the quality of the ethical climate in the intensive care unit (ICU) improves the identification of patients receiving excessive care and affects patient outcomes is unknown. Methods: In this prospective observational study, perceptions of excessive care (PECs) by clinicians working in 68 ICUs in Europe and the USA were collected daily during a 28-day period. The quality of the ethical climate in the ICUs was assessed via a validated questionnaire. We compared the combined endpoint (death, not at home or poor quality of life at 1 year) of patients with PECs and the time from PECs until written treatment-limitation decisions (TLDs) and death across the four climates defined via cluster analysis. Results: Of the 4747 eligible clinicians, 2992 (63%) evaluated the ethical climate in their ICU. Of the 321 and 623 patients not admitted for monitoring only in ICUs with a good (n = 12, 18%) and poor (n = 24, 35%) climate, 36 (11%) and 74 (12%), respectively were identified with PECs by at least two clinicians. Of the 35 and 71 identified patients with an available combined endpoint, 100% (95% CI 90.0–1.00) and 85.9% (75.4–92.0) (P = 0.02) attained that endpoint. The risk of death (HR 1.88, 95% CI 1.20–2.92) or receiving a written TLD (HR 2.32, CI 1.11–4.85) in patients with PECs by at least two clinicians was higher in ICUs with a good climate than in those with a poor one. The differences between ICUs with an average climate, with (n = 12, 18%) or without (n = 20, 29%) nursing involvement at the end of life, and ICUs with a poor climate were less obvious but still in favour of the former. Conclusion: Enhancing the quality of the ethical climate in the ICU may improve both the identification of patients receiving excessive care and the decision-making process at the end of life

Albiglutide and cardiovascular outcomes in patients with type 2 diabetes and cardiovascular disease (Harmony Outcomes): a double-blind, randomised placebo-controlled trial

Background: Glucagon-like peptide 1 receptor agonists differ in chemical structure, duration of action, and in their effects on clinical outcomes. The cardiovascular effects of once-weekly albiglutide in type 2 diabetes are unknown. We aimed to determine the safety and efficacy of albiglutide in preventing cardiovascular death, myocardial infarction, or stroke. Methods: We did a double-blind, randomised, placebo-controlled trial in 610 sites across 28 countries. We randomly assigned patients aged 40 years and older with type 2 diabetes and cardiovascular disease (at a 1:1 ratio) to groups that either received a subcutaneous injection of albiglutide (30–50 mg, based on glycaemic response and tolerability) or of a matched volume of placebo once a week, in addition to their standard care. Investigators used an interactive voice or web response system to obtain treatment assignment, and patients and all study investigators were masked to their treatment allocation. We hypothesised that albiglutide would be non-inferior to placebo for the primary outcome of the first occurrence of cardiovascular death, myocardial infarction, or stroke, which was assessed in the intention-to-treat population. If non-inferiority was confirmed by an upper limit of the 95% CI for a hazard ratio of less than 1·30, closed testing for superiority was prespecified. This study is registered with ClinicalTrials.gov, number NCT02465515. Findings: Patients were screened between July 1, 2015, and Nov 24, 2016. 10 793 patients were screened and 9463 participants were enrolled and randomly assigned to groups: 4731 patients were assigned to receive albiglutide and 4732 patients to receive placebo. On Nov 8, 2017, it was determined that 611 primary endpoints and a median follow-up of at least 1·5 years had accrued, and participants returned for a final visit and discontinuation from study treatment; the last patient visit was on March 12, 2018. These 9463 patients, the intention-to-treat population, were evaluated for a median duration of 1·6 years and were assessed for the primary outcome. The primary composite outcome occurred in 338 (7%) of 4731 patients at an incidence rate of 4·6 events per 100 person-years in the albiglutide group and in 428 (9%) of 4732 patients at an incidence rate of 5·9 events per 100 person-years in the placebo group (hazard ratio 0·78, 95% CI 0·68–0·90), which indicated that albiglutide was superior to placebo (p<0·0001 for non-inferiority; p=0·0006 for superiority). The incidence of acute pancreatitis (ten patients in the albiglutide group and seven patients in the placebo group), pancreatic cancer (six patients in the albiglutide group and five patients in the placebo group), medullary thyroid carcinoma (zero patients in both groups), and other serious adverse events did not differ between the two groups. There were three (<1%) deaths in the placebo group that were assessed by investigators, who were masked to study drug assignment, to be treatment-related and two (<1%) deaths in the albiglutide group. Interpretation: In patients with type 2 diabetes and cardiovascular disease, albiglutide was superior to placebo with respect to major adverse cardiovascular events. Evidence-based glucagon-like peptide 1 receptor agonists should therefore be considered as part of a comprehensive strategy to reduce the risk of cardiovascular events in patients with type 2 diabetes. Funding: GlaxoSmithKline

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 <90 ml per minute per 1.73 m2 of body-surface area and albuminuria (ratio of albumin [mg] to creatinine [g], >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 m2), 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

Design and baseline characteristics of the finerenone in reducing cardiovascular mortality and morbidity in diabetic kidney disease trial

Background: Among people with diabetes, those with kidney disease have exceptionally high rates of cardiovascular (CV) morbidity and mortality and progression of their underlying kidney disease. Finerenone is a novel, nonsteroidal, selective mineralocorticoid receptor antagonist that has shown to reduce albuminuria in type 2 diabetes (T2D) patients with chronic kidney disease (CKD) while revealing only a low risk of hyperkalemia. However, the effect of finerenone on CV and renal outcomes has not yet been investigated in long-term trials. Patients and Methods: The Finerenone in Reducing CV Mortality and Morbidity in Diabetic Kidney Disease (FIGARO-DKD) trial aims to assess the efficacy and safety of finerenone compared to placebo at reducing clinically important CV and renal outcomes in T2D patients with CKD. FIGARO-DKD is a randomized, double-blind, placebo-controlled, parallel-group, event-driven trial running in 47 countries with an expected duration of approximately 6 years. FIGARO-DKD randomized 7,437 patients with an estimated glomerular filtration rate >= 25 mL/min/1.73 m(2) and albuminuria (urinary albumin-to-creatinine ratio >= 30 to <= 5,000 mg/g). The study has at least 90% power to detect a 20% reduction in the risk of the primary outcome (overall two-sided significance level alpha = 0.05), the composite of time to first occurrence of CV death, nonfatal myocardial infarction, nonfatal stroke, or hospitalization for heart failure. Conclusions: FIGARO-DKD will determine whether an optimally treated cohort of T2D patients with CKD at high risk of CV and renal events will experience cardiorenal benefits with the addition of finerenone to their treatment regimen. Trial Registration: EudraCT number: 2015-000950-39; ClinicalTrials.gov identifier: NCT02545049

Effect of ultrafine powders on the structural formation processes and mechanical properties of Al7%Si alloy

The multi-component system interaction mechanisms associated with ultrafine powders (TiO2 and ZrO2) and fluorine-containing salts (K2ZrF6, Na3AlF6 and Na5Al3F14) with the Al–7%Si melt are studied. The formation of a multi-phase system with a high concentration of crystallization centres (N ≈ 7 · 1012 U/cm3) was identified. We experimentally show that the injection of an ultrafine powders modifying mixture containing refractory metal oxides and fluorine-containing salts into a Al–7%Si melt leads to a significant reduction in the a silicon plate size (by 1.5 times) and the Fe-containing phases (by 4 times). An equal distribution of the eutectic phase (α-Al + β-Si) is established in the Al– 7%Si alloy. As a result of microstructural changes when the modifying mixture was injected, a factor of 2 increase in the Al–7%Si alloy ductility was observed

Effect of ultrafine powders on the structural formation processes and mechanical properties of Al7%Si alloy

The multi-component system interaction mechanisms associated with ultrafine powders (TiO2 and ZrO2) and fluorine-containing salts (K2ZrF6, Na3AlF6 and Na5Al3F14) with the Al–7%Si melt are studied. The formation of a multi-phase system with a high concentration of crystallization centres (N ≈ 7 · 1012 U/cm3) was identified. We experimentally show that the injection of an ultrafine powders modifying mixture containing refractory metal oxides and fluorine-containing salts into a Al–7%Si melt leads to a significant reduction in the a silicon plate size (by 1.5 times) and the Fe-containing phases (by 4 times). An equal distribution of the eutectic phase (α-Al + β-Si) is established in the Al– 7%Si alloy. As a result of microstructural changes when the modifying mixture was injected, a factor of 2 increase in the Al–7%Si alloy ductility was observed

Fine structure and phase composition of Fe–14Mn–1.2C steel: influence of a modified mixture based on refractory metals

The effect of TiO2, ZrO2 and Na3AlF6 ultrafine powders on the fine structure and the phase composition of Fe–14Mn–1.2C steel was investigated. The introduction of the ultrafine powders into the melt influenced the grain size, the quantity, and the character of distribution of nonmetallic inclusions in the railroad frogs. The microstructure of castings was improved significantly because of the refinement of the grain structure and an increase of the grain-boundary area. After the modifying mixture was introduced into the melt, either the microtwins of one or two intersecting systems or the precipitations of ε-martensite of different types, or simultaneously the microtwins and wafers of ε-martensite, were present in each grain