Effects of empagliflozin on progression of chronic kidney disease: a prespecified secondary analysis from the empa-kidney trial

BACKGROUND

Sodium-glucose co-transporter-2 (SGLT2) inhibitors reduce progression of chronic kidney disease and the risk of cardiovascular morbidity and mortality in a wide range of patients. However, their effects on kidney disease progression in some patients with chronic kidney disease are unclear because few clinical kidney outcomes occurred among such patients in the completed trials. In particular, some guidelines stratify their level of recommendation about who should be treated with SGLT2 inhibitors based on diabetes status and albuminuria. We aimed to assess the effects of empagliflozin on progression of chronic kidney disease both overall and among specific types of participants in the EMPA-KIDNEY trial.

METHODS

EMPA-KIDNEY, a randomised, controlled, phase 3 trial, was conducted at 241 centres in eight countries (Canada, China, Germany, Italy, Japan, Malaysia, the UK, and the USA), and included individuals aged 18 years or older with an estimated glomerular filtration rate (eGFR) of 20 to less than 45 mL/min per 1·73 m2, or with an eGFR of 45 to less than 90 mL/min per 1·73 m2 with a urinary albumin-to-creatinine ratio (uACR) of 200 mg/g or higher. We explored the effects of 10 mg oral empagliflozin once daily versus placebo on the annualised rate of change in estimated glomerular filtration rate (eGFR slope), a tertiary outcome. We studied the acute slope (from randomisation to 2 months) and chronic slope (from 2 months onwards) separately, using shared parameter models to estimate the latter. Analyses were done in all randomly assigned participants by intention to treat. EMPA-KIDNEY is registered at ClinicalTrials.gov, NCT03594110.

FINDINGS

Between May 15, 2019, and April 16, 2021, 6609 participants were randomly assigned and then followed up for a median of 2·0 years (IQR 1·5-2·4). Prespecified subgroups of eGFR included 2282 (34·5%) participants with an eGFR of less than 30 mL/min per 1·73 m2, 2928 (44·3%) with an eGFR of 30 to less than 45 mL/min per 1·73 m2, and 1399 (21·2%) with an eGFR 45 mL/min per 1·73 m2 or higher. Prespecified subgroups of uACR included 1328 (20·1%) with a uACR of less than 30 mg/g, 1864 (28·2%) with a uACR of 30 to 300 mg/g, and 3417 (51·7%) with a uACR of more than 300 mg/g. Overall, allocation to empagliflozin caused an acute 2·12 mL/min per 1·73 m2 (95% CI 1·83-2·41) reduction in eGFR, equivalent to a 6% (5-6) dip in the first 2 months. After this, it halved the chronic slope from -2·75 to -1·37 mL/min per 1·73 m2 per year (relative difference 50%, 95% CI 42-58). The absolute and relative benefits of empagliflozin on the magnitude of the chronic slope varied significantly depending on diabetes status and baseline levels of eGFR and uACR. In particular, the absolute difference in chronic slopes was lower in patients with lower baseline uACR, but because this group progressed more slowly than those with higher uACR, this translated to a larger relative difference in chronic slopes in this group (86% [36-136] reduction in the chronic slope among those with baseline uACR <30 mg/g compared with a 29% [19-38] reduction for those with baseline uACR ≥2000 mg/g; ptrend<0·0001).

INTERPRETATION

Empagliflozin slowed the rate of progression of chronic kidney disease among all types of participant in the EMPA-KIDNEY trial, including those with little albuminuria. Albuminuria alone should not be used to determine whether to treat with an SGLT2 inhibitor.

FUNDING

Boehringer Ingelheim and Eli Lilly.

Impact of primary kidney disease on the effects of empagliflozin in patients with chronic kidney disease: secondary analyses of the EMPA-KIDNEY trial

BACKGROUND

The EMPA-KIDNEY trial showed that empagliflozin reduced the risk of the primary composite outcome of kidney disease progression or cardiovascular death in patients with chronic kidney disease mainly through slowing progression. We aimed to assess how effects of empagliflozin might differ by primary kidney disease across its broad population.

METHODS

EMPA-KIDNEY, a randomised, controlled, phase 3 trial, was conducted at 241 centres in eight countries (Canada, China, Germany, Italy, Japan, Malaysia, the UK, and the USA). Patients were eligible if their estimated glomerular filtration rate (eGFR) was 20 to less than 45 mL/min per 1·73 m2, or 45 to less than 90 mL/min per 1·73 m2 with a urinary albumin-to-creatinine ratio (uACR) of 200 mg/g or higher at screening. They were randomly assigned (1:1) to 10 mg oral empagliflozin once daily or matching placebo. Effects on kidney disease progression (defined as a sustained ≥40% eGFR decline from randomisation, end-stage kidney disease, a sustained eGFR below 10 mL/min per 1·73 m2, or death from kidney failure) were assessed using prespecified Cox models, and eGFR slope analyses used shared parameter models. Subgroup comparisons were performed by including relevant interaction terms in models. EMPA-KIDNEY is registered with ClinicalTrials.gov, NCT03594110.

FINDINGS

Between May 15, 2019, and April 16, 2021, 6609 participants were randomly assigned and followed up for a median of 2·0 years (IQR 1·5-2·4). Prespecified subgroupings by primary kidney disease included 2057 (31·1%) participants with diabetic kidney disease, 1669 (25·3%) with glomerular disease, 1445 (21·9%) with hypertensive or renovascular disease, and 1438 (21·8%) with other or unknown causes. Kidney disease progression occurred in 384 (11·6%) of 3304 patients in the empagliflozin group and 504 (15·2%) of 3305 patients in the placebo group (hazard ratio 0·71 [95% CI 0·62-0·81]), with no evidence that the relative effect size varied significantly by primary kidney disease (pheterogeneity=0·62). The between-group difference in chronic eGFR slopes (ie, from 2 months to final follow-up) was 1·37 mL/min per 1·73 m2 per year (95% CI 1·16-1·59), representing a 50% (42-58) reduction in the rate of chronic eGFR decline. This relative effect of empagliflozin on chronic eGFR slope was similar in analyses by different primary kidney diseases, including in explorations by type of glomerular disease and diabetes (p values for heterogeneity all >0·1).

INTERPRETATION

In a broad range of patients with chronic kidney disease at risk of progression, including a wide range of non-diabetic causes of chronic kidney disease, empagliflozin reduced risk of kidney disease progression. Relative effect sizes were broadly similar irrespective of the cause of primary kidney disease, suggesting that SGLT2 inhibitors should be part of a standard of care to minimise risk of kidney failure in chronic kidney disease.

FUNDING

Boehringer Ingelheim, Eli Lilly, and UK Medical Research Council.

Incorporation of graphene oxide/titanium dioxide with different polymer materials and its effects on methylene blue dye rejection and antifouling ability

Exposure of synthetic dye, such as methylene blue (MB), in water bodies led to a serious threat to living things because they are toxic and non-degradable. Amongst the introduced dye removal methods, membrane separation process can be considered a powerful technique for treating dye contamination. However, this method commonly suffered from drawbacks, such as short membrane lifetime, low permeability and selectivity. To overcome these issues, graphene oxide (GO) and titanium dioxide (TiO₂) were used as additives to fabricate polyethersulfone (PES)- and polyvinylidene fluoride (PVDF)-based hybrid membranes via non-solvent-induced phase separation method. Prior to membrane fabrication, GO was synthesised via electrochemical exfoliation method assisted by customised triple-tail surfactant. The potential of PES- and PVDF-based hybrid membranes for wastewater treatment has been discussed widely. However, direct comparison between these two polymeric membranes is not critically discussed for MB dye separation application yet. Therefore, this study is aimed at evaluating the performance of different types of polymers (e.g. PES and PVDF) in terms of membrane morphology, properties, dye rejection and antifouling ability. Results showed that the incorporation of GO and TiO₂ alters the morphology of the fabricated membranes and affects dye rejection further, as well as their antifouling performance. In contrast with pristine membrane, PES-GO/TiO₂ and PVDF-GO/TiO₂ possessed high hydrophilicity, as indicated by their low contact angle (67.38° and 62.12°, respectively). Based on this study, PVDF-GO/TiO₂ showed higher porosity value (94.88%), permeability (87.32 L/m²hMPa) and MB rejection rate (92.63%), as well as flux recovery ratio value of > 100% as compared with others. Overall, the incorporation of GO and TiO₂ with PVDF polymer are proven to be effective hybrid materials of membrane fabrication for dye rejection application in the near future. The polymer material's intrinsic properties can affect the attributes of the fabricated membrane.

Formation of a Nanorod-Assembled TiO2 Actinomorphic-Flower-like Microsphere Film via Ta Doping Using a Facile Solution Immersion Method for Humidity Sensing

This study fabricated tantalum (Ta)-doped titanium dioxide with a unique nanorod-assembled actinomorphic-flower-like microsphere structured film. The Ta-doped TiO₂ actinomorphic-flower-like microsphere (TAFM) was fabricated via the solution immersion method in a Schott bottle with a home-made improvised clamp. The samples were characterised using FESEM, HRTEM, XRD, Raman, XPS, and Hall effect measurements for their structural and electrical properties. Compared to the undoped sample, the rutile-phased TAFM sample had finer nanorods with an average 42 nm diameter assembled to form microsphere-like structures. It also had higher oxygen vacancy sites, electron concentration, and mobility. In addition, a reversed double-beam photoacoustic spectroscopy measurement was performed for TAFM, revealing that the sample had a high electron trap density of up to 2.5 μmolg^-1. The TAFM showed promising results when employed as the resistive-type sensing film for a humidity sensor, with the highest sensor response of 53,909% obtained at 3 at.% Ta doping. Adding rGO to 3 at.% TAFM further improved the sensor response to 232,152%.

Thermoelectric Power-Factor of Ag-Doped TiO2 Thin Film

The thermoelectric power-factor of two types of rutile-phased nanostructured-TiO₂ thin films doped with Ag was investigated at room temperature, by measuring their Seebeck coefficient and electrical conductivity. The thin films, consisting of a nanorod structure (single layer) and nanorod and nanoflower structure (bilayer) of TiO_2, with the addition of different wt.% of AgNO₃ were synthesized on an F:SnO₂-coated glass substrate. The evaluated thermoelectric power-factor was observed to increase with an increasing wt.% of AgNO₃ for both structures, with the bilayer structure increasing three times more than the undoped bilayer-structure, with a value of 148 μWm-¹K^-2 at 0.15 wt.%. This enhancement was due to the increase in electrical conductivity, which compensated for the small changes in the Seebeck coefficient, which were likely due to the increase in carrier concentration. Consequently, an enhancement in the thermoelectric conversion-efficiency of TiO₂ thin film may be observed by Ag doping, without influencing the layer structure and material phase.

Evaluating Different TiO2 Nanoflower-Based Composites for Humidity Detection

Unique three-dimensional (3D) titanium dioxide (TiO₂) nanoflowers (TFNA) have shown great potential for humidity sensing applications, due to their large surface area-to-volume ratio and high hydrophilicity. The formation of a composite with other materials could further enhance the performance of this material. In this work, the effect of different types of composites on the performance of a TNFA-based humidity sensor was examined. NiO, ZnO, rGO, and PVDF have been explored as possible composite pairing candidates with TiO₂ nanoflowers, which were prepared via a modified solution immersion method. The properties of the composites were examined using field emission electron spectroscopy (FESEM), X-ray diffractometry (XRD), transmission electron microscopy (TEM), X-ray photoelectron spectroscopy (XPS), current-voltage (I-V) analysis, Hall effect measurement, and contact angle measurement. The performance of the humidity sensor was assessed using a humidity sensor measurement system inside a humidity-controlled chamber. Based on the result, the combination of TiO₂ with rGO produced the highest sensor response at 39,590%. The achievement is attributed to the increase in the electrical conductivity, hydrophilicity, and specific surface area of the composite.

Carbon nanotubes from waste cooking palm oil as adsorbent materials for the adsorption of heavy metal ions

In this work, waste cooking palm oil (WCPO)-based carbon nanotubes (CNTs) with encapsulated iron (Fe) nanoparticles have been successfully produced via modified thermal chemical vapor deposition method. Based on several characterizations, the dense WCPO-based CNT was produced with high purity of 89% and high crystallinity proven by low I_D/I_G ratio (0.43). Moreover, the ferromagnetic response of CNTs showed that the average coercivity and magnetization saturation were found to be 551.5 Oe and 13.4 emu/g, respectively. These produced WCPO-based CNTs were further used as heavy metal ions adsorbent for wastewater treatment application. Some optimizations, such as the effect of different adsorbent dosage, varied initial pH solution, and various heavy metal ions, were investigated. The adsorption studies showed that the optimum adsorbent dosage was 1.8 g/L when it was applied to 100 mg/L Cu (II) solution at neutral pH (pH 7). Further measurement then showed that high Cu (II) ion removal percentage (~80%) was achieved when it was applied at very acidic solution (pH 2). Last measurement confirmed that the produced WCPO-based CNTs successfully removed different heavy metal ions in the following order: Fe (II) > Zn (II) ≈ Cu (II) with the removal percentage in the range of 99.2 to 99.9%. The adsorption isotherm for Cu (II) was better fitted by Langmuir model with a correlation coefficient of 0.82751. WCPO-based CNTs can be a potential material to be applied as adsorbent in heavy metal ion removal.

Cytotoxicity of MXene-based nanomaterials for biomedical applications: A mini review

MXene based nanomaterial is an uprising two-dimensional material gaining tremendous scientific attentions due to its versatile properties for the applications in electronic devices, power generation, sensors, drug delivery, and biomedicine. However, the cytotoxic effects of MXene still remained a huge concern. Therefore, stringent analysis of biocompatibility of MXene is an essential requirement before introduction to human physiological system. Several in vitro and in vivo toxicological studies have been reported to investigate the interactions between MXenes with living organisms such as microbes, mammalian cells and animal models. The biological response and cytotoxicity reported were dependent on the physicochemical properties of MXene. The biocompatibility and cytotoxicity of MXene were dependent on size, dose, and surface coating. This review demystifies the in vitro and in vivo biocompatibility studies associated with MXene. Various methods proposed to mitigate the cytotoxicity of MXene for in vivo applications were revealed. The machine learning methods were developed to predict the cytotoxicity of experimentally synthesized MXene compounds. Finally, we also discussed the current research gaps of applying MXenes in biomedical interventions.

Fabrication and application of composite adsorbents made by one-pot electrochemical exfoliation of graphite in surfactant ionic liquid/nanocellulose mixtures

Previously, surfactant-assisted exfoliated graphene oxide (sEGO) formed with the triple-chain surfactant TC14 (sodium 1,4-bis(neopentyloxy)-3-(neopentylcarbonyl)-1,4-dioxobutane-2-sulfonate) was applied in wastewater treatment. The extent of dye-removal and the adsorption capacity of the sEGO formed with this triple-chain surfactant outperformed those of two other systems, namely, the di-chain version of TC14 (AOT14; sodium 1,2-bis-(2,2-dimethyl-propoxycarbonyl)-ethanesulfonate) and the single-chain surfactant sodium n-dodecylsulfate. In the present study, to further optimise the surfactant chemical structure, the sodium ion of TC14 was substituted with 1-butyl-3-methyl-imidazolium (BMIM) generating surfactant ionic liquids (SAILs; 1-butyl-3-imidazolium 1,4-bis(neopentyloxy)-3-(neopentyloxycarbonyl)-1,4-dioxobutane-2-sulfonate), hereafter denoted as BMIM-TC14. This SAIL, together with nanofibrillated kenaf cellulose (NFC), was used to electrochemically exfoliate graphite, yielding BMIM-TC14 sEGO/NFC composites. These highly hydrophobic polymer composites were then used for the removal of methylene blue (MB) from aqueous solution. ¹H NMR spectroscopy was used to elucidate the structure of the synthesised SAILs. The morphologies of the resulting nanocomposites were investigated using Raman spectroscopy, field-emission scanning electron microscopy, and high-resolution transmission electron microscopy. Analysis using small-angle neutron scattering was performed to examine the aggregation behaviour of sEGO and custom-made SAILs. Zeta potential, surface tension, and dynamic light-scattering measurements were used to study the aqueous properties and colloidal stability of the suspension. Amongst the surfactants tested, BMIM-TC14 sEGO/NFC exhibited the highest MB adsorption ability, achieving 99% dye removal under optimum conditions. These results highlight the importance of modifying the hydrophilic moieties of amphiphilic compounds to improve the performance of sEGO/NFC composites as effective adsorbents for wastewater treatment.

Photocatalytic performance improvement by utilizing GO_MWCNTs hybrid solution on sand/ZnO/TiO2-based photocatalysts to degrade methylene blue dye

In this work, sand/zinc oxide (ZnO)/titanium dioxide (TiO₂)-based photocatalysts were hybridized with graphene oxide (GO) and GO_multi-walled carbon nanotubes (MWCNTs) hybrid solution. The novel hybrid was then used in photocatalysis to degrade dye contamination. The nanocomposite photocatalyst was initially fabricated by growing ZnO nanorods (NRs) via sol-gel immersion followed by synthesizing TiO₂ NRs for different times (5 and 20 h) using a hydrothermal method on sand as a substrate. Prior to the hybridization, the initial GO was synthesized using electrochemical exfoliation and further mixed with 1 wt% MWCNTs to form GO_MWCNTs hybrid solution. The synthesized GO and GO_MWCNTs hybrid solution were then incorporated onto sand/ZnO/TiO₂ nanocomposite-based photocatalysts through immersion. Various sand/ZnO/TiO₂-based photocatalysts were then tested for methylene blue (MB) dye degradation within 3 days. On the basis of UV-Vis measurement, the highest MB degradation was achieved by using sand/ZnO NRs/TiO₂ NRs (5 h)/GO_MWCNTs (92.60%). The high surface area and high electrical conductivity of GO_MWCNTs prolonged the lifetime of electron/hole separation and thus enhanced the photocatalytic performance.

Highly branched triple-chain surfactant-mediated electrochemical exfoliation of graphite to obtain graphene oxide: colloidal behaviour and application in water treatment

The generation of surfactant-assisted exfoliated graphene oxide (sEGO) by electrochemical exfoliation is influenced by the presence of surfactants, and in particular the hydrophobic tail molecular-architecture. Increasing surfactant chain branching may improve the affinity for the graphite surfaces to provide enhanced intersheet separation and stabilisation of exfoliated sheets. The resulting sEGO composites can be readily used to remove of a model pollutant, the dye, methylene blue (MB), from aqueous solutions by providing abundant sites for dye adsorption. This article explores relationships between surfactant structure and the performance of sEGO for MB adsorption. Double-branched and highly branched triple-chain graphene-compatible surfactants were successfully synthesised and characterised by ¹H NMR spectroscopy. These surfactants were used to produce sEGO via electrochemical exfoliation of graphite, and the sEGOs generated were further utilised in batch adsorption studies of MB from aqueous solutions. The properties of these synthesised surfactants were compared with those of a common single-chain standard surfactant, sodium dodecyl-sulfate (SDS). The structural morphology of sEGO was assessed using Raman spectroscopy and field emission scanning electron microscopy (FESEM). To reveal the links between the hydrophobic chain structure and the sEGO adsorption capacity, UV-visible spectroscopy, zeta potential, and air-water (a/w) surface tension measurements were conducted. The aggregation behaviour of the surfactants was studied using small-angle neutron scattering (SANS). The highly branched triple-chain surfactant sodium 1,4-bis(neopentyloxy)-3-(neopentylcarbonyl)-1,4-dioxobutane-2-sulfonate (TC14) displayed enhanced exfoliating efficiency compared to those of the single-and double-chain surfactants, leading to ∼83% MB removal. The findings suggest that highly branched triple-chain surfactants are able to offer more adsorption sites, by expanding the sEGO interlayer gap for MB adsorption, compared to standard single-chain surfactants.

Electrochemical exfoliation of graphite in nanofibrillated kenaf cellulose (NFC)/surfactant mixture for the development of conductive paper

The effect of incorporating common dodecyl anionic and cationic surfactants such as dodecyltrimethylammonium bromide (DTAB), dodecylethyldimethylammonium bromide (DDAB), and sodium dodecylsulfate (SDS) in nanocomposites of reduced graphene oxide and nanocellulose are described. The stabilization and electrical properties of the nanocomoposites of reduced graphene oxide (RGO) and nanofibrillated kenaf cellulose (NFC) were characterized using four-point probe electrical conductivity measurements. Raman spectroscopy, field emission scanning electron microscopy, and high-resolution transmission electron microscopy were used to investigate dispersion morphology and the quality of RGO inside the NFC matrices. Small-angle neutron scattering (SANS) was used to study the aggregation behavior of the aqueous surfactant systems and RGO dispersions. The cationic surfactant DTAB proved to be the best choice for stabilization of RGO in NFC, giving enhanced electrical conductivity five orders of magnitude higher than the neat NFC. The results highlight the effects of hydrophilic surfactant moieties on the structure, stability and properties of RGO/NFC composites.

Electrochemical-Based Biosensors on Different Zinc Oxide Nanostructures: A Review

Electrochemical biosensors have shown great potential in the medical diagnosis field. The performance of electrochemical biosensors depends on the sensing materials used. ZnO nanostructures play important roles as the active sites where biological events occur, subsequently defining the sensitivity and stability of the device. ZnO nanostructures have been synthesized into four different dimensional formations, which are zero dimensional (nanoparticles and quantum dots), one dimensional (nanorods, nanotubes, nanofibers, and nanowires), two dimensional (nanosheets, nanoflakes, nanodiscs, and nanowalls) and three dimensional (hollow spheres and nanoflowers). The zero-dimensional nanostructures could be utilized for creating more active sites with a larger surface area. Meanwhile, one-dimensional nanostructures provide a direct and stable pathway for rapid electron transport. Two-dimensional nanostructures possess a unique polar surface for enhancing the immobilization process. Finally, three-dimensional nanostructures create extra surface area because of their geometric volume. The sensing performance of each of these morphologies toward the bio-analyte level makes ZnO nanostructures a suitable candidate to be applied as active sites in electrochemical biosensors for medical diagnostic purposes. This review highlights recent advances in various dimensions of ZnO nanostructures towards electrochemical biosensor applications.

Preparation of conductive cellulose paper through electrochemical exfoliation of graphite: The role of anionic surfactant ionic liquids as exfoliating and stabilizing agents

A facile electrochemical exfoliation method was established to efficiently prepare conductive paper containing reduced graphene oxide (RGO) with the help of single chain anionic surfactant ionic liquids (SAILs). The surfactant ionic liquids are synthesized from conventional organic surfactant anions and a 1-butyl-3-methyl-imidazolium cation. For the first time the combination of SAILs and cellulose was used to directly exfoliate graphite. The ionic liquid 1-butyl-3-methyl-imidazolium dodecylbenzenesulfonate (BMIM-DBS) was shown to have notable affinity for graphene, demonstrating improved electrical properties of the conductive cellulose paper. The presence of BMIM-DBS in the system promotes five orders of magnitude enhancement of the paper electrical conductivity (2.71 × 10^-5 S cm^-1) compared to the native cellulose (1.97 × 10^-10 S cm^-1). A thorough investigation using electron microscopy and Raman spectroscopy highlights the presence of uniform graphene incorporated inside the matrices. Studies into aqueous aggregation behavior using small-angle neutron scattering (SANS) point to the ability of this compound to act as a bridge between graphene and cellulose, and is responsible for the enhanced exfoliation level and stabilization of the resulting dispersion. The simple and feasible process for producing conductive paper described here is attractive for the possibility of scaling-up this technique for mass production of conductive composites containing graphene or other layered materials.

Significant effect of concentration ratio in synthesizing titania nanoflowers (TNF) powder for various application as additive

The significant effect of concentration (TBut/HCl) ratio in synthesizing titania nanoflowers (TNF) towards powder morphologies, crystallographic phases, surface area and band gap were investigated. Various synthesized titania nanostructure were prepared via facile hydrothermal method using titanium butoxide (TBut) and hydrochloric acid (HCl) as a mixing composition. The morphologies of synthesizing titania powder was analyzed by using FE-SEM to observe the shape and geometry of the synthesized powder. XRD was used to determine the crystallographic phases of synthesized powder at 2θ angles of 25° to 75°. Each samples were then investigated under BET analyzer to observe the particles surface morphology and UV-Vis analyzer to determine the band gap. The results demonstrated that the concentration of TBut/HCl ratio gave a very significant effect in transforming the mixing solution into geometrical shape of microspheres, nanoflowers and nanorods of titania as increasing the ratio. At TN0.5, the synthesized powder was clearly showed a circle geometrical shape of particles. The shape was suddenly change into round nanoflowers form consist of tiny nanorods at TN1. At TN1.5, the powder morphologies shows the nanoflowers started to form in irregular pattern. As the TBut/HCl ratio increased, the nanoflowers form disappeared and nanorods begin to clumps. In addition, all synthesized powder was in rutile phases guided by XRD peaks and band gap value reported from previous works. The particles surface area was also different for each samples since the geometrical shape of powder was change by increasing the concentration (TBut/HCl) ratio. Thus, concentration ratio of the mixing composition plays a major role in transforming the overall morphologies and structures of hydrothermally titania synthesized particles.

Comparison of biophysical properties characterized for microtissues cultured using microencapsulation and liquid crystal based 3D cell culture techniques

Growing three dimensional (3D) cells is an emerging research in tissue engineering. Biophysical properties of the 3D cells regulate the cells growth, drug diffusion dynamics and gene expressions. Scaffold based or scaffoldless techniques for 3D cell cultures are rarely being compared in terms of the physical features of the microtissues produced. The biophysical properties of the microtissues cultured using scaffold based microencapsulation by flicking and scaffoldless liquid crystal (LC) based techniques were characterized. Flicking technique produced high yield and highly reproducible microtissues of keratinocyte cell lines in alginate microcapsules at approximately 350 ± 12 pieces per culture. However, microtissues grown on the LC substrates yielded at lower quantity of 58 ± 21 pieces per culture. The sizes of the microtissues produced using alginate microcapsules and LC substrates were 250 ± 25 μm and 141 ± 70 μm, respectively. In both techniques, cells remodeled into microtissues via different growth phases and showed good integrity of cells in field-emission scanning microscopy (FE-SEM). Microencapsulation packed the cells in alginate scaffolds of polysaccharides with limited spaces for motility. Whereas, LC substrates allowed the cells to migrate and self-stacking into multilayered structures as revealed by the nuclei stainings. The cells cultured using both techniques were found viable based on the live and dead cell stainings. Stained histological sections showed that both techniques produced cell models that closely replicate the intrinsic physiological conditions. Alginate microcapsulation and LC based techniques produced microtissues containing similar bio-macromolecules but they did not alter the main absorption bands of microtissues as revealed by the Fourier transform infrared spectroscopy. Cell growth, structural organization, morphology and surface structures for 3D microtissues cultured using both techniques appeared to be different and might be suitable for different applications.

Approximation solution for system of generalized ordered variational inclusions with ⊕ operator in ordered Banach space

The resolvent operator approach is applied to address a system of generalized ordered variational inclusions with ⊕ operator in real ordered Banach space. With the help of the resolvent operator technique, Li et al. (J. Inequal. Appl. 2013:514, 2013; Fixed Point Theory Appl. 2014:122, 2014; Fixed Point Theory Appl. 2014:146, 2014; Appl. Math. Lett. 25:1384-1388, 2012; Fixed Point Theory Appl. 2013:241, 2013; Eur. J. Oper. Res. 16(1):1-8, 2011; Fixed Point Theory Appl. 2014:79, 2014; Nonlinear Anal. Forum 13(2):205-214, 2008; Nonlinear Anal. Forum 14: 89-97, 2009) derived an iterative algorithm for approximating a solution of the considered system. Here, we prove an existence result for the solution of the system of generalized ordered variational inclusions and deal with a convergence scheme for the algorithms under some appropriate conditions. Some special cases are also discussed.

Evaluation of Oxidative Stress and Antioxidant Status in Chronic Obstructive Pulmonary Disease

Chronic obstructive pulmonary disease (COPD) is a common respiratory condition involving the airways and characterized by airflow limitation. Gaseous and noxious particles play an important role in this process. Antioxidants are the substances that may protect cells from the damage caused by unstable molecules known as free radicals. The increased oxidative stress in patients with COPD is the result of an increased burden of inhaled oxidants, as well as increased amounts of reactive oxygen species (ROS) generated by various inflammatory, immune and epithelial cells of the airways. A total of 150 subjects with COPD and 100 healthy controls subjects were enrolled in this study from the period October 2015 to January 2016. The investigation included measurements of plasma superoxide dismutase activity (SOD), catalase activity (CAT), glutathione content (GSH) reduced form, (GPx) glutathione peroxidase, glutathione reductase (GR) and lipid peroxidation (LPO). Absorbance was measured by UV spectrophotometer. The estimated values of SOD, catalase, GPx, GSH and GR were found to be significantly (P = 0.0001) lower among the cases compared with controls. But, the levels of MDA were higher (P = 0.0001) in cases as compared to control group and there was significant difference in the oxidative stress parameters among the various stages of COPD. The post hoc analysis revealed that SOD was significantly (P < 0.01) lower among the mild, moderate and severe patients compared with very severe patients. The catalase was also observed to be significantly (P = 0.01) lower among mild, moderate and severe patients than very severe patients. The GPx was found to be significantly (P = 0.002) lower among the mild, moderate and severe patients compared with very severe patients. MDA was observed to be significantly higher in mild, moderate and severe patients compared with very severe (P = 0.001). GR was significantly (P = 0.003) lower among mild, moderate and severe patients than very severe patients. However, there was no significant difference in GSH among severity of COPD patients. This study suggests that oxidant and antioxidant imbalance plays an important role in various stages of severity of COPD. These results revealed the presence of an oxidative stress in subjects with COPD, and it is proportionate to the severity of disease.

Study of oxidative stress biomarkers in chronic obstructive pulmonary disease and their correlation with disease severity in north Indian population cohort

Background:

Oxidant-antioxidant imbalance forms a prime component in pathogenesis of chronic obstructive pulmonary disease (COPD). Studies of oxidative stress markers in South Asians were sparse.

Methods:

One hundred and eighty COPD patients and eighty healthy nonsmokers were enrolled in the study. Serum malondialdehyde (MDA) and iron levels were estimated for oxidative stress. Three antioxidant markers evaluated-catalase, superoxide dismutase (SOD), and serum copper. Patients on antioxidant therapy and with sepsis and chronic illness were excluded from the study.

Results:

The mean age of COPD patients was 59.29 ± 10.3 years. Serum levels of MDA and iron were significantly higher in COPD patients compared to controls (5.21 ± 1.9 vs. 0.71 ± 0.29 nmol MDA/ml, P = 0.0001 and 69.85 ± 85.49 vs. 79.32 ± 24.39 μg/dl, P = 0.0001, respectively). Mean level of all antioxidant enzymes catalase, SOD, and copper were significantly diminished in cases when compared to control population (P = 0.001). Levels of MDA and iron were found to be significantly elevated in higher Global Initiative for Chronic Obstructive Lung Disease (GOLD) classes (III, IV) when compared to lower GOLD Classes (I, II). The levels of serum antioxidants were significantly depleted in higher GOLD grades too. COPD patients who were male and smoked had significantly higher levels of oxidants and depleted antioxidant levels compared to female and nonsmoking compatriots. Serum MDA levels negatively correlated with forced expiratory volume 1 s and forced vital capacity (r = −0.19 and r = −0.21, P ≤ 0.01). The presence of a cough significantly correlated with higher levels of MDA and iron (P = 0.001). The levels of MDA negatively correlated with SOD and catalase levels.

Conclusion:

Oxidative markers (MDA and iron) are higher whereas antioxidants (catalase, copper, and SOD) are significantly reduced in patients of COPD. Serum MDA levels correlate with lung functions and disease severity.

A scaffoldless technique for self-generation of three-dimensional keratinospheroids on liquid crystal surfaces

We describe a new scaffold-free three-dimensional (3D) cell culture model using cholesteryl ester based lyotropic liquid crystal (LC) substrates. Keratinocytes were deposited randomly on the LC surface where they self-assembled into 3D microtissues or keratinospheroids. The cell density required to form spheroids was optimized. We investigated cell viability using dead/live cell assays. The adhesion characteristics of cells within the microtissues were determined using histological sectioning and immunofluorescence staining. Fourier transform infrared spectroscopy (FTIR) was used to characterize the biochemistry of the keratinospheroids. We found that both cells and microtissues could migrate on the LC surface. The viability study indicated approximately 80% viability of cells in the microtissues up to 20 days of culture. Strong intercellular adhesion was observed in the stratification of the multi-layered microspheroids using field emission-scanning electron microscopy (FE-SEM) and histochemical staining. The cytoskeleton and vinculins of the cells in the microtissues were expressed diffusely, but the microtissues were enriched with lipids and nucleic acids, which indicates close resemblance to the conditions in vivo. The basic 3D culture model based on LC may be used for cell and microtissue migration studies in response to cytochemical treatment.