New Approach to Shape Memory Polymer Composite Production Using Alkaline Lignin-Reinforced Epoxy-Based Shape Memory Polymers.

In the past few decades, there has been continued interest in shape memory polymers (SMPs), and tremendous efforts have been made to develop multifunctional composites of these SMPs to enhance the existing properties of SMPs. Although fossil-based sources are widely used in the production of shape memory polymer composites (SMPCs), the depletion of fossil-based resources and associated environmental problems increase interest toward renewable biobased products synthesized from natural resources. This study aims to produce alkaline lignin-reinforced SMPCs by using alkaline lignin in the SMP matrix. Thermo-mechanical, morphological, and shape memory tests are performed in order to reveal the effect of alkaline lignin usage in the SMP matrix on SMPC production. Differential scanning calorimetry analysis results show that adding alkaline lignin into the SMP matrix with 1 and 3% ratios led to an increase in T g values, while raising the alkaline lignin ratio to 5% decreased the T g value. According to the DMA results, increasing the alkaline lignin ratios caused an increase in the storage modulus of SMPCs, and the best storage modulus value was obtained at the 5% alkaline lignin ratio. The results of the three-point bending test also confirmed the results obtained from the DMA analysis, showing that an increasing alkaline lignin ratio caused an increase in the bending modulus. Scanning electron microscopy analysis showed a rough structure in 1 and 3% alkaline lignin supplementation, while a smoother structure was observed in 5% alkaline lignin supplementation. The smoother structure of the sample containing 5% alkaline lignin indicates that alkaline lignin supplementation exhibits a smoother surface by showing a plasticizing effect. As a result, it was observed that increasing the lignin ratio increased the polymer/alkaline lignin interaction, resulting in a harder structure and an increase in the flexural modulus value.

Overt hypogonadism is a cardiovascular risk factor in type 2 diabetic males: An observational study.

We aimed to evaluate the effects of hypogonadism on metabolic and chronic complications in type 2 diabetic males. 261 nonobese males with type 2 diabetes aged 18-70 were involved in the study. Hypononadal males were divided into 2 groups as overt hypogonadism (total testosterone≤230 ng/dl) and borderline hypogonadism (230-345 ng/dl). The control group involved eugonadal diabetic males. Micro-macrovascular complications were recorded. 101 patients had hypogonadism (38.7%), and 160 patients were eugonadal (61.3%). Microvascular complication rate was not different, but macrovascular complication rate was significantly higher in hypogonadal males (42.6%/31.3%, p = 0.042). Optimal glycosylated haemoglobin (HbA1c) achievement(<7%) was significantly lower in hypogonadal patients (20.8%/31.3%, p = 0.043). Poor glycaemic control (HbA1c≥7%), presence of microvascular complication and increased triglyceride levels were independent risk factors for hypogonadism (OR: 1.5, p = 0.044;OR:3.89,p = 0.025 and OR: 1.0, p = 0.016 respectively). Overt hypogonadism, hypertension, hypercholesterolaemia and severe hypoglycaemia were independent risk factors for macrovascular complications (OR: 1.0, p = 0.027; OR:2.6, p = 0.002; OR: 1.8, p = 0.047 and OR: 1.0, p = 0.007 respectively), diabetes duration (≥5 years) and poor glycaemic control for microvascular complication (OR: 1.0, p = 0.031 and OR:2.0, p = 0.028). As a result, hypogonadism is frequent among diabetic males and poor glycaemic control may be an important contributing factor. Furthermore overt hypogonadism is an important cardiovascular risk marker. Therefore, ensuring eugonadism in diabetic patients may positively affect both glycaemic control and complications.

Does neutrophyl to lymphocyte ratio really predict chronic kidney disease progression?

PURPOSE: Chronic kidney disease (CKD) is an inflammatory process. In addition to increased morbidity and mortality, inflammation also contributes to the progression of CKD. Neutrophil/lymphocyte ratio (NLR) is a marker of inflammation. Some recent data suggest that NLR may predict the progression of CKD. METHODS: In this study, 5-year data of 740 patients with stage 2-4 CKD were reviewed retrospectively. Demographic data, NLR, CRP, albumin, the amount of proteinuria were recorded. At the beginning and the end of follow-up the glomerular filtration rate (GFR) and the annual GFR decline rate were calculated. Patients were divided to high and low NLR group according to median value of their baseline NLR. Reaching stage 5 CKD or initiation of renal replacement therapy was determined as end-point for follow-up. RESULTS: The mean age was 62.8 ± 0.57 years, eGFR 40 ml/min/1.73 m2, median NLR was 2.76. NLR increased as the CKD-stage increased. Mean follow-up time was 51.2 ± 30 months and 21.4% of patients reached the end-point. NLR was significantly increased at follow-up (from 3.22 to 5.68, p < 0.001). Annual GFR loss and baseline CRP were higher but baseline albumin and GFR were lower of patients with high NLR. The percent of patients reaching the end-point was not different between the groups with high and low baseline NLR. Kaplan Meier analysis showed that patients with high NLR had significantly lower mean renal survival (86.5 months) than patients with low NLR (105 months) (p < 0.001). In the Cox-regression analysis NLR was not an independent predictor in reaching the end-point but presence of diabetes mellitus, younger age and low baseline eGFR were found effective. CONCLUSIONS: NLR is an indicator of inflammation in chronic kidney disease. It may not be an independent predictor of CKD progression except that the CKD is in a more advanced stage and reflects the associated inflammation. Classical risk factors such as DM and lower GFR are more powerful predictors of progression.