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.

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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.

Sorption of Zn(II)(aq) on hematite (alpha-Fe2O3) nanoparticles (average diameter 10.5 nm) and microparticles (average diameter 550 nm) has been examined over a range of total Zn(II)(aq) concentrations (0.4-7.6 mM) using Zn K-edge EXAFS spectroscopy and selective chemical extractions. When ZnCl2 aqueous solutions were reacted with hematite nanoparticles (HN) at pH 5.5, Zn(II) formed a mixture of four- and six-coordinated surface complexes [Zn(O,OH)4 and Zn(O,OH)6] with an average Zn-O distance of 2.04+/-0.02 A at low sorption densities (Gammaor=3.38 micromol/m2), we observed the formation of Zn(O,OH)6 surface complexes, with an average Zn-O distance of 2.09+/-0.02 A, a Zn-Zn distance of 3.16+/-0.02 A, and a linear multiple-scattering feature at 6.12+/-0.06 A. Formation of a Zn(OH)2(am) precipitate for the higher sorption density samples (Gamma>or=3.38 micromol/m2) is suggested on the basis of comparison of the EXAFS spectra of the sorption samples with that of synthetic Zn(OH)2am. In contrast, EXAFS spectra of Zn(II) sorbed on hematite microparticles (HM) under similar experimental conditions showed no evidence of surface precipitates even at the same total [Zn(II)(aq)] that resulted in precipitate formation in the nanoparticle system. Instead, Zn(O,OH)6 octahedra (d(Zn-O)=2.10+/-0.02 A) were found to sorb dominantly in an inner-sphere, bidentate, edge-sharing fashion on Fe3+(O,OH)6 octahedra at hematite microparticle surfaces, based on an EXAFS-derived Zn-Fe3+ distance of 3.44+/-0.02 A. CaCl2 selective extraction experiments showed that 10-15% of the sorbed Zn(II) was released from Zn/HN sorption samples, and about 40% was released from a Zn/HM sorption sample. These fractions of Zn(II) are interpreted as weakly bound, outer-sphere adsorption complexes. The combined EXAFS and selective chemical extraction results indicate that (1) both Zn(O,OH)4 and Zn(O,OH)6 adsorption complexes are present in the Zn/HN system, whereas dominantly Zn(O,OH)6 adsorption complexes are present in the Zn/HM system; (2) a higher proportion of outer-sphere Zn(II) surface complexes is present in the Zn/HM system; and (3) Zn-containing precipitates similar to Zn(OH)2(am) form in the nanoparticle system but not in the microparticle system, suggesting a difference in reactivity of the hematite nanoparticles vs microparticles with respect to Zn(II)(aq).

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Tricalcium aluminate (cement clinker phase), gypsum, katoite, ettringite, and calcium monosulfoaluminate hydrate (abbreviated as kuzelite) are the major minerals in the hydration reaction of tricalcium aluminate in the presence of gypsum and have critical impacts on the kinetics and thermodynamics of early-age cement hydration mechanisms. Here, spectroscopic analysis of these minerals is conducted using scanning transmission X-ray microscopy (STXM). Their Ca L 2,3-edge near edge X-ray absorption fine structure (NEXAFS) spectra are measured and correlated to the known Ca coordination environments. The results indicate that these minerals have unique Ca environments that can be differentiated from one another based on the intensities and positions of the absorption peaks at 346.5-348.5 and 350.5-351.5 eV. It is concluded that Ca in tricalcium aluminate (cubic and orthorhombic polymorphs) and katoite is in cubic-like coordination with negative 10Dq, whereas Ca is in an octahedral-like coordination with positive 10Dq in ettringite, gypsum, and kuzelite. For tricalcium aluminate, the Ca atoms in both polymorphs are in similar chemical environments with slightly more distortion in the orthorhombic polymorph. As a common issue in STXM experiments, absorption saturation of NEXAFS spectra is also investigated. It is demonstrated that the optical density difference between pre-and post-edge absorption levels provides a reliable indication of the sample thickness in the systems studied. The present work provides a reference for the STXM study of the calcium (sulfo)aluminate reactions in cement hydration and natural aqueous environments, and in the former case, provides a more complete understanding of a system that may serve as a low-C alternative to Portland cement.