Walk before you run: Feasibility challenges and lessons learned from the PROCLAIM study, a multicenter randomized controlled trial of misoprostol for prevention of recurrent Clostridioides difficile during COVID-19

We analyzed our challenging experience with a randomized controlled trial of misoprostol for prevention of recurrent C. difficile. Despite careful prescreening and thoughtful protocol modifications to facilitate enrollment, we closed the study early after enrolling just 7 participants over 3 years. We share lessons learned, noting the importance of feasibility studies, inclusion of biomarker outcomes, and dissemination of such findings to inform future research design and implementation successes.

Nickel oxide decorated MoS2nanosheet-based non-enzymatic sensor for the selective detection of glucose

Understanding blood glucose levels in our body can be a key part in identifying and diagnosing prediabetes. Herein, nickel oxide (NiO) decorated molybdenum disulfide (MoS₂) nanosheets have been synthesized via a hydrothermal process to develop a non-enzymatic sensor for the detection of glucose. The surface morphology of the NiO/MoS₂ nanocomposite was comprehensively investigated by field-emission scanning electron microscopy (FE-SEM), high-resolution transmission electron microscopy (HR-TEM), powder X-ray diffraction (PXRD), X-ray photoelectron spectroscopy (XPS) and Brunauer–Emmett–Teller (BET) analysis. The electro-catalytic activity of the as-prepared NiO/MoS₂ nanocomposite towards glucose oxidation was investigated by cyclic voltammetry, electrochemical impedance spectroscopy (EIS) and amperometry in 0.1 M NaOH. The NiO/MoS₂ nanocomposite-based sensor showed outstanding electrocatalytic activity for the direct electro-oxidation of glucose due to it having more catalytic active sites, good conductivity, excellent electron transport and high specific surface area. Meanwhile, the NiO/MoS₂ modified glassy carbon electrode (GCE) showed a linear range of glucose detection from 0.01 to 10 mM by amperometry at 0.55 V. The effect of other common interferent molecules on the electrode response was also tested using alanine, l-cysteine, fructose, hydrogen peroxide, lactose, uric acid, dopamine and ascorbic acid. These molecules did not interfere in the detection of glucose. Moreover, this NiO/MoS₂/GCE sensor offered rapid response (2 s) and a wide linear range with a detection limit of 1.62 μM for glucose. The reproducibility, repeatability and stability of the sensor were also evaluated. The real application of the sensor was tested in a blood serum sample in the absence and presence of spiked glucose and its recovery values (96.1 to 99.8%) indicated that this method can be successfully applied to detect glucose in real samples.

This study reported that NiO/MoS₂ based nanocomposite can be used as an electrocatalytic material to detect glucose with high selectivity in a blood serum.

Polyimide foams derived from poly(4,4'-oxydiphenylpyromellitimide) and poly(α-methylstyrene)

An alternative route for the synthesis of high- Tg thermally stable polymer foams with pore sizes substantially smaller than those produced by other methods is described, using compositionally asymmetric microphase-separated block copolymers where the minor component, poly(α-methylstyrene), is thermally labile and the major component, a polyimide derived from poly(4,4'-oxydiphenylpyromellitimide), is thermally stable. Upon thermal treatment, the thermally unstable block can unzip to the monomer, leaving behind pores, the size and shape of which should, in principle, be identical to the initial block copolymer morphology. Triblock copolymers were prepared where the imide component was derived from poly(amic alfkyl ester) precursor using either the meta- or para-isomers with 4,4'-oxydianiline, and the α-methylstyrene component comprising the outside block of the ABA architecture. Dynamic mechanica] analysis confirmed microphase-separated morphologies for each of the copolymers. The decomposition of the α-methylstyrene block was studied by thermogravimetric, dynamic mechanical and thermomechanical analysis. Mild decomposition conditions were required to avoid rapid depolymerization of the α-methylstyrene and subsequent plasticization of the imide block. The resulting foams showed the expected reduction in density with pore sizes ranging from ∼200Å to ∼1 µm in size, depending on the synthetic route and processing conditions employed.

Preparation, characterization andin vitrorelease properties of ibuprofen-loaded microspheres based on polylactide, poly(϶-caprolactone) and their copolymers

In this paper, ibuprofen was encapsulated into microspheres by oil-in-water (o/w) emulsion solvent evaporation method. Biodegradable polymers with certain compositions and characteristics such as polylactide (PLA), poly(epsilon-caprolactone) (PCL) and their block copolymer were used to prepare the microspheres. The results indicate that, under the same processing conditions, the drug entrapment efficiency was similar (approximately 80%) for microspheres prepared with PLA and P(LA-b-CL) (78.7/21.3 by mole), but it was only 25.4% for PCL microspheres. The in vitro drug release rate decreased in the order of PCL, P(LA-b-CL) (78.7/21.3 by mole) and PLA microspheres. PCL microspheres showed more serious burst release during the first day (almost 80%) than P(LA-b-CL) (50%) and PLA microspheres (18%). The complete ibuprofen release duration from the last two kinds of microspheres exceeded 1 month. Characterization of the microspheres by differential scanning calorimetry (DSC), scanning electron microscopy (SEM) and polarized optical microscope (POM) revealed that ibuprofen was amorphous in PCL microspheres and partially crystalline in P(LA-b-CL) and PLA microspheres. The different release behaviour of ibuprofen from the three kinds of microspheres could be attributed to the different crystallinity of the studied polymers and drug dispersion state in polymer matrices. All the above results suggest that the copolymer with a certain ratio of lactide to -caprolactone could have potential applications for long-term ibuprofen release.