Background: Glucagon-like peptide 1 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. Methods: We randomly assigned patients with type 2 diabetes and cardiovascular disease to the addition of once-weekly subcutaneous injection of albiglutide (30 mg to 50 mg) or matching placebo to standard care. We hypothesized that albiglutide would be noninferior to placebo for the primary outcome of first occurrence of cardiovascular death, myocardial infarction, or stroke. If noninferiority was confirmed by an upper limit of the 95% confidence interval for the hazard ratio of less than 1.30, closed-testing for superiority was prespecified. Findings: Overall, 9463 participants were followed for a median of 1.6 years. The primary composite outcome occurred in 338 of 4731 patients (7.1%; 4.6 events per 100 person-years) in the albiglutide group and in 428 of 4732 patients (9.0%; 5.9 events per 100 person-years) in the placebo group (hazard ratio, 0.78; 95% confidence interval [CI ], 0.68 to 0.90), indicating that albiglutide, was superior to placebo (P<0.0001 for noninferiority, P=0.0006 for superiority). The incidence of acute pancreatitis (albiglutide 10 patients and placebo 7 patients), pancreatic cancer (6 and 5), medullary thyroid carcinoma (0 and 0), and other serious adverse events did not differ significantly between the two groups. Interpretation: In patients with type 2 diabetes and cardiovascular disease, albiglutide was superior to placebo with respect to major adverse cardiovascular events. (Funded by GlaxoSmithKline; Harmony Outcomes ClinicalTrials.gov number, NCT02465515.) noninferiority; P = 0.06 for superiority). There seems to be variation in the results of existing trials with GLP-1 receptor agonists, which if correct, might reflect drug structure or duration of action, patients studied, duration of follow-up or other factors.

No abstract

No abstract

The workability of fresh Portland cement (PC) concrete critically depends on the reaction of the cubic tricalcium aluminate (CA) phase in Ca- and S-rich pH >12 aqueous solution, yet its rate-controlling mechanism is poorly understood. In this article, the role of adsorption phenomena in CA dissolution in aqueous Ca-, S-, and polynaphthalene sulfonate (PNS)-containing solutions is analyzed. The zeta potential and pH results are consistent with the isoelectric point of CA occurring at pH ∼12 and do not show an inversion of its electric double layer potential as a function of S or Ca concentration, and PNS adsorbs onto CA, reducing its zeta potential to negative values at pH >12. The S and Ca K-edge X-ray absorption spectroscopy (XAS) data obtained do not indicate the structural incorporation or specific adsorption of SO on the partially dissolved CA solids analyzed. Together with supporting X-ray ptychography and scanning electron microscopy results, a model for CA dissolution inhibition in hydrated PC systems is proposed whereby the formation of an Al-rich leached layer and the complexation of Ca-S ion pairs onto this leached layer provide the key inhibiting effect(s). This model reconciles the results obtained here with the existing literature, including the inhibiting action of macromolecules such as PNS and polyphosphonic acids upon CA dissolution. Therefore, this article advances the understanding of the rate-controlling mechanism in hydrated CA and thus PC systems, which is important to better controlling the workability of fresh PC concrete.

The interaction of the l-lactate ion ( l-CH3CH(OH)COO(-), lact(-1)) with hematite (alpha-Fe2O3) nanoparticles (average diameter 11 nm) in the presence of bulk water at pH 5 and 25 degrees C was examined using a combination of (1) macroscopic uptake measurements, (2) in situ attenuated total reflectance-Fourier transform infrared (ATR-FTIR) spectroscopy, and (3) density functional theory modeling at the B3LYP/6-31+G* level. Uptake measurements indicate that increasing [ lact(-1)]aq results in an increase in lact(-1) uptake and a concomitant increase in Fe(III) release as a result of the dissolution of the hematite nanoparticles. The ATR-FTIR spectra of aqueous lact(-1) and lact(-1) adsorbed onto hematite nanoparticles at coverages ranging from 0.52 to 5.21 micromol/m2 showed significant differences in peak positions and shapes of carboxyl group stretches. On the basis of Gaussian fits of the spectra, we conclude that lact(-1) is present as both outer-sphere and inner-sphere complexes on the hematite nanoparticles. No significant dependence of the extent of lact(-1) adsorption on background electrolyte concentration was found, suggesting that the dominant adsorption mode for lact(-1) is inner sphere under these conditions. On the basis of quantum chemical modeling, we suggest that inner-sphere complexes of lact(-1) adsorbed on hematite nanoparticles occur dominantly as monodentate, mononuclear complexes with the hydroxyl functional group pointing away from the Fe(III) center.