Interaction Sites Research Articles

Alpha-glucosidase Inhibitory Effects of Flavonoids, Phenolic Acids and Iridoids Isolated From Vinca soneri: In vitro and in silico Perspectives.

Various Vinca species have been traditionally used for their antihypertensive, sedative, and hemostatic properties, as well as for treating diabetes. In this study, some flavonoids, phenolic acids and iridoids were isolated from an endemic Vinca species, Vinca soneri for the first time. α-Glucosidase inhibitory effects of the isolates were tested and kaempferol-3-O-α-rhamnopyranosyl (1→6) β-galactopyranoside (1) was found to be the most active one with an IC50 value of 285.73 ± 7.35 µM. Enzyme kinetic assay revealed that it inhibited α-glucosidase in competitive manner. Molecular geometry of 1 was predicted and Frontier molecular orbital analysis was performed using Density Functional Theory (DFT) calculations. Molecular docking and MM-GBSA calculations predicted good fit for 1 in the enzyme active site and key interactions with the catalytic residues. As a result, current study identifies 1 as a promising competitive α-glucosidase inhibitor to be developed as a potential antidiabetic drug candidate.

Safety and Effectiveness of COVID-19 Vaccines During Pregnancy: A Living Systematic Review and Meta-analysis.

Pregnant persons are susceptible to significant complications following COVID-19, even death. However, worldwide COVID-19 vaccination coverage during pregnancy remains suboptimal. This study assessed the safety and effectiveness of COVID-19 vaccines administered to pregnant persons and shared this evidence via an interactive online website. We followed Cochrane methods to conduct this living systematic review. We included studies assessing the effects of COVID-19 vaccines in pregnant persons. We conducted searches every other week for studies until October 2023, without restrictions on language or publication status, in ten databases, guidelines, preprint servers, and COVID-19 websites. The reference lists of eligible studies were hand searched to identify additional relevant studies. Pairs of review authors independently selected eligible studies using the web-based software COVIDENCE. Data extraction and risk of bias assessment were performed independently by pairs of authors. Disagreements were resolved by consensus. We performed random-effects meta-analyses of adjusted relative effects for relevant confounders of comparative studies and proportional meta-analyses to summarize frequencies from one-sample studies using R statistical software. We present the GRADE certainty of evidence from comparative studies. Findings are available on an interactive living systematic review webpage, including an updated evidence map and real-time meta-analyses customizable by subgroups and filters. We included 177 studies involving 638,791 participants from 41 countries. Among the 11 types of COVID-19 vaccines identified, the most frequently used platforms were mRNA (154 studies), viral vector (51), and inactivated virus vaccines (17). Low to very low-certainty evidence suggests that vaccination may result in minimal to no important differences compared to no vaccination in all assessed maternal and infant safety outcomes from 26 fewer to 17 more events per 1000 pregnant persons, and 13 fewer to 9 more events per 1000 neonates, respectively. We found statistically significant reductions in emergency cesarean deliveries (9%) with mRNA vaccines, and in stillbirth (75-83%) with mRNA/viral vector vaccines. Low to very low-certainty evidence suggests that vaccination during pregnancy with mRNA vaccines may reduce severe cases or hospitalizations in pregnant persons with COVID-19 (72%; 95% confidence interval [CI] 42-86), symptomatic COVID-19 (78%; 95% CI 21-94), and virologically confirmed SARS-CoV-2 infection (82%; 95% CI 39-95). Reductions were lower with other vaccine types and during Omicron variant dominance than Alpha and Delta dominance. Infants also presented with fewer severe cases or hospitalizations due to COVID-19 and laboratory-confirmed SARS-CoV-2 infection (64%; 95% CI 37-80 and 66%; 95% CI 37-81, respectively). We found a large body of evidence supporting the safety and effectiveness of COVID-19 vaccines during pregnancy. While the certainty of evidence is not high, it stands as the most reliable option available, given the current absence of pregnant individuals in clinical trials. Results are shared in near real time in an accessible and interactive format for scientists, decision makers, clinicians, and the general public. This living systematic review highlights the relevance of continuous vaccine safety and effectiveness monitoring, particularly in at-risk populations for COVID-19 impact such as pregnant persons, during the introduction of new vaccines. PROSPERO: CRD42021281290.

Enhancing Efficiency and Durability of Perovskite Solar Cells with Chlorine‐Functionalized Fully Conjugated Porous Aromatic Framework

Non‐radiative recombination, caused by trap states, significantly hampers the efficiency and stability of perovskite solar cells (PSCs). The emerging porous organic polymers (POPs) show promise as a platform for designing novel defect passivation agents due to their rigid and porous structure. However, the POPs reported so far lack either sufficient stability or clear sites of interactions with the defects. Herein, two chlorine‐functionalized, fully conjugated porous aromatic frameworks (PAFs) were constructed via a decarbonylation reaction. The chlorinated PAFs feature unique long‐range conjugated networks bearing multiple chlorine atoms, significantly improving the photovoltaic performance and stability of doped solar cells. Combined experimental and theoretical analyses confirmed the strong passivation effects of conjugated structure to the defect through Cl sites. Specifically, PAF‐159, bearing a triphenylamine moiety, demonstrated stronger Cl‐Pb bonding and higher passivation efficiency due to the presence of π* anti‐bonding orbitals, which elevate the HOMO energy level and facilitate Cl‐Pb charge transfer. Consequently, we obtained high‐performance PAF‐159‐doped devices with advanced PCE (24.3%), good storage stability (retaining 86% after 3000 hours), and good long‐term operational stability (retaining 92% after 350 hours)

Enhancing Efficiency and Durability of Perovskite Solar Cells with Chlorine-Functionalized Fully Conjugated Porous Aromatic Framework.

Non-radiative recombination, caused by trap states, significantly hampers the efficiency and stability of perovskite solar cells (PSCs). The emerging porous organic polymers (POPs) show promise as a platform for designing novel defect passivation agents due to their rigid and porous structure. However, the POPs reported so far lack either sufficient stability or clear sites of interactions with the defects. Herein, two chlorine-functionalized, fully conjugated porous aromatic frameworks (PAFs) were constructed via a decarbonylation reaction. The chlorinated PAFs feature unique long-range conjugated networks bearing multiple chlorine atoms, significantly improving the photovoltaic performance and stability of doped solar cells. Combined experimental and theoretical analyses confirmed the strong passivation effects of conjugated structure to the defect through Cl sites. Specifically, PAF-159, bearing a triphenylamine moiety, demonstrated stronger Cl-Pb bonding and higher passivation efficiency due to the presence of π* anti-bonding orbitals, which elevate the HOMO energy level and facilitate Cl-Pb charge transfer. Consequently, we obtained high-performance PAF-159-doped devices with advanced PCE (24.3%), good storage stability (retaining 86% after 3000 hours), and good long-term operational stability (retaining 92% after 350 hours).

Spin-Spin Coupling Constant Based on Reference Interaction Site Model Self-Consistent Field with Constrained Spatial Electron Density.

A method for computing spin-spin coupling constants (SSCCs) using the reference interaction site model self-consistent field with constrained spatial electron density (RISM-SCF-cSED) is proposed for the first time. Describing solvents using integral equation theory allows us to reflect solvent effects at atomic resolution in SSCCs while accounting for thermal fluctuations at a low computational cost. Applying the method to water, 1,1-difluoroethylene, and 1-methylaminomethylene-2-naphthalenone revealed that the solvent shift was evaluated to a greater extent than in the continuum solvent model. The origin of this phenomenon was analyzed in terms of the physical mechanisms underlying SSCCs.

An extended interaction site determines binding between AP180 and AP2 in clathrin mediated endocytosis

The early phases of clathrin mediated endocytosis are organized through a highly complex interaction network mediated by clathrin associated sorting proteins (CLASPs) that comprise long intrinsically disordered regions (IDRs). AP180 is a CLASP exclusively expressed in neurons and comprises a long IDR of around 600 residues, whose function remains partially elusive. Using NMR spectroscopy, we discovered an extended and strong interaction site within AP180 with the major adaptor protein AP2, and describe its binding dynamics at atomic resolution. We find that the 70 residue-long site determines the overall interaction between AP180 and AP2 in a dynamic equilibrium between its bound and unbound states, while weaker binding sites contribute to the overall affinity at much higher concentrations of AP2. Our data suggest that this particular interaction site might play a central role in recruitment of adaptors to the clathrin coated pit, whereas more transient and promiscuous interactions allow reshaping of the interaction network until cargo uptake inside a coated vesicle.

Removal and detection of phenols through an SPE-HPLC method using microporous organic networks as adsorbent.

The design and development of a facile synthesis approach to construct novel materials for the rapid adsorption and removal of environmental pollutants are of significant interest. In this work, we report the rational design and facile synthesis of magnetic core-shell-based microporous organic networks, Fe3O4@MON-TBPT-TEB (TTMON, achieved by reacting 2,4,6-tris(p-bromophenyl) triazine and 1,3,5-triethynylbenzene) and Fe3O4@MON-TBPM-DEBP (TDMON, achieved by reacting tetrakis (4-bromophenyl) methane and 4-4'-diethynylbiphenyl). These MONs possessed excellent dispersity, electrostatic attraction as well as plenty of π-π and hydrophobic interaction sites enabled them to efficiently absorb targeted environmental pollutants. TTMON and TDMON exhibited excellent adsorption capacities of 440 and 510 mg g-1, respectively, at 25 °C for 2,4,6-trichlorophenol (TCP). TCP, 2,4-dichlorophenol (DCP), 2-naphthol (2-NT) and 4-nitrophenol (4-NP) from aqueous solution were treated by both MONs, followed by their analysis with high-performance liquid chromatography (HPLC). For TDMON, the proposed SPE-HPLC-UV method showed an LOD of 0.03 μg L-1, LOQ of 0.11 μg L-1, and a wide linear range of 1-1000 μg L-1 for TCP. The adsorption kinetics, thermodynamics, isotherms, effect of pH and humic acid (HA), ionic strength, regeneration, and reusability of the MONs were also studied. The results revealed that the novel-designed MONs have potential applications as efficient adsorbents in sample pretreatment.

Bexagliflozin: a comprehensive review of a recently approved SGLT2 inhibitor for the treatment of type 2 diabetes mellitus

AbstractType 2 diabetes mellitus (T2DM) remains a major global health threat, claiming millions of lives annually. Despite recent advancements in managing T2DM, the need for innovative treatment options persists. Sodium-glucose cotransporter 2 (SGLT2) inhibition has proven to be an effective therapeutic strategy against T2DM, offering benefits in lowering hemoglobin A1c (HbA1c) and plasma glucose levels as well as treatment for patients with diabetes who develop chronic kidney disease (CKD). Bexagliflozin is a recently approved, orally administered SGLT2 inhibitor for treating T2DM and exhibits promise in combating CKD stages 3a and 3b. Structurally, bexagliflozin differs from other SGLT2 inhibitors in that it has a cyclopropyloxyethoxy group at the para position of the peripheral phenyl ring. This review article provides an overview of bexagliflozin’s discovery, mechanism of action, binding site interactions, metabolism, pharmacokinetics, and clinical applications. Emphasis is placed on the significant contribution of SGLT2 inhibitors, particularly bexagliflozin in glycemic control and treating associated comorbidities such as heart failure and chronic kidney disease in T2DM patients.

Binding of IscU and TusA to different but competing sites of IscS influences the activity of IscS and directs sulfur to the respective biomolecular synthesis pathway.

All sulfur transfer pathways generally have in common an l-cysteine desulfurase as the initial sulfur-mobilizing enzyme, which serves as a sulfur donor for the biosynthesis of numerous sulfur-containing biomolecules in the cell. In Escherichia coli, the housekeeping l-cysteine desulfurase IscS functions as a hub for sulfur transfer through interactions with several partner proteins, which bind at different sites on IscS. So far, the interaction sites of IscU, Fdx, CyaY, and IscX involved in iron sulfur (Fe-S) cluster assembly, TusA, required for molybdenum cofactor biosynthesis and mnm5s2U34 transfer RNA (tRNA) modifications, and ThiI, involved in both the biosynthesis of thiamine and s4U8 tRNA modifications, have been mapped. Previous studies have suggested that IscS partner proteins bind only one at a time, with the exception of Fe-S cluster assembly, which involves the formation of a ternary complex involving IscS, IscU, and one of CyaY, Fdx, or IscX. Here, we show that the affinity of TusA for IscS is similar to but lower than that of IscU and that these proteins compete for binding to IscS. We show that heterocomplexes involving the IscS dimer and single IscU and TusA molecules are readily formed and that binding of both TusA and IscU to IscS affects its l-cysteine desulfurase activity. A model is proposed in which the delivery of sulfur to different sulfur-requiring pathways is controlled by sulfur acceptor protein levels, IscS-binding affinities, and acceptor protein-modulated IscS desulfurase activity.IMPORTANCEIron-sulfur clusters are evolutionarily ancient prosthetic groups. The housekeeping l-cysteine desulfurase IscS functions as a central core for sulfur transfer through interactions with several partner proteins, which bind at different sites on each IscS monomer with different affinities and partially overlapping binding sites. We show that heterocomplexes involving the IscS dimer and single IscU and TusA molecules at each site of the dimer are formed, thereby influencing the activity of IscS.

3D Porous Polymer Scaffold-Conjugated KGF-Mimetic Peptide Promotes Functional Skin Regeneration in Chronic Diabetic Wounds.

The re-epithelialization process gets severely dysregulated in chronic nonhealing diabetic foot ulcers/wounds. Keratinocyte growth factor (KGF or FGF-7) is the major modulator of the re-epithelialization process, which regulates the physiological phenotypes of cutaneous keratinocytes. The existing therapeutic strategies of growth factor administration have several limitations. To overcome these, we have designed a KGF-mimetic peptide (KGFp, 13mer) based on the receptor interaction sites in murine KGF. KGFp enhanced migration and transdifferentiation of mouse bone marrow-derived MSCs toward keratinocyte-like cells (KLCs). A significant increase in the expression of skin-specific markers Bnc1 (28.5-fold), Ck5 (14.6-fold), Ck14 (26.1-fold), Ck10 (187.7-fold), and epithelial markers EpCam (23.3-fold) and Cdh1 (64.2-fold) was associated with the activation of ERK1/2 and STAT3 molecular signaling in the KLCs. Further, to enhance the stability of KGFp in the wound microenvironment, it was conjugated to biocompatible 3D porous polymer scaffolds without compromising its active binding sites followed by chemical characterization using Fourier transform infrared spectroscopy, field-emission scanning electron microscopy, dynamic mechanical analysis, and thermogravimetry. In vitro evaluation of the KGFp-conjugated 3D polymer scaffolds revealed its potential for transdifferentiation of MSCs into KLCs. Transplantation of allogeneic MSCGFP using KGFp-conjugated 3D polymer scaffolds in chronic nonhealing type 2 diabetic wounds (db/db transgenic, 50-52 weeks old male mice) significantly enhanced re-epithelialization-mediated wound closure rate (79.3%) as compared to the control groups (Untransplanted -22.4%, MSCGFP-3D polymer scaffold -38.5%). Thus, KGFp-conjugated 3D porous polymer scaffolds drive the fate of the MSCs toward keratinocytes that may serve as potential stem cell delivery platform technology for tissue engineering and transplantation.

Digitalization of the national economy as a driver of virtualization of communications among dairy market stakeholders

Theoretical and methodological approaches to the study of key trends in the digitalisation of the national economy, which act as a driver of virtualisation of communications of dairy market stakeholders, have been studied and substantiated. It is established the different speed and slow implementation of digital accounting technologies in the conditions of differentiation of requests of interested organisations and customers, providing time saving, and communication costs are calculated. On the one hand, the involvement of local computer networks in the internal activities of national organisations, the internet – in the environment of virtual external interaction, rather with suppliers than with consumers, and e-mail, websites – in all spheres of their virtual activity is predominantly developed. On the other hand, there is a big lag in the implementation of such key elements of digital technologies as “big data”, “internet of things”, artificial intelligence models, radio-frequency identification, “digital twins”. The feasibility of creating a web showcase site for virtual interactions between innovatively active dairy enterprises and customers is substantiated.

Conversion of sugars into methyl lactate over poly (ionic liquid)s functionalized Sn/beta zeolites

Methyl lactate (MLA) is a versatile high value platform chemical prepared from biomass carbohydrates, with widely application in the pharmaceutical, food, pesticide, and cosmetics. The current study presented a one-pot catalytic conversion of sugars to MLA over poly (ionic liquid)s functionalized Sn/Beta zeolites under mild conditions. The Sn/Beta zeolites were prepared by an impregnation method, followed by modification with poly (vinyl imidazole) ([PVIM]) via an in-situ free radical polymerization method. Dosages of polymer and Sn, calcination temperature, reaction temperature, catalyst amount, substrate concentration, and reaction times were optimized. Results showed that an MLA yield of 61.4 % was obtained over 3[PVIM]-Sn/Beta with complete conversion of fructose at 140 °C for 8 h. The physicochemical properties were characterized by XRD, BET, FTIR, CO-DRIFTS, NH3-TPD and pyridine-FTIR analysis, indicating the coexistence of Lewis and Brønsted acid sites. Finally, a possible reaction mechanism was proposed that the weak Lewis acidity of imidazole rings of [PVIM] effectively regulated the local microenvironment of active sites, thus promoting the interaction of the active sites with electronegative oxygens of sugars. This study can provide as a reference for the development of solid acid catalysts for the catalytic conversion of biomass to platform chemicals.

Design of substituted tetrahydrofuran derivatives for HIV-1 protease inhibitors: synthesis, biological evaluation, and X-ray structural studies.

Substituted tetrahydrofuran derivatives were designed and synthesized to serve as the P2 ligand for a series of potent HIV-1 protease inhibitors. Both enantiomers of the tetrahydrofuran derivatives were synthesized stereoselectivity in optically active forms using lipase-PS catalyzed enzymatic resolution as the key step. These tetrahydrofuran derivatives are designed to promote hydrogen bonding and van der Waals interactions with the backbone atoms in the S2 subsite of the HIV-1 protease active site. Several inhibitors displayed very potent HIV-1 protease inhibitory activity. A high-resolution X-ray crystal structure of an inhibitor-bound HIV-1 protease provided important insight into the ligand binding site interactions in the active site.

Alternative molecular mechanisms for force transmission at adherens junctions via β-catenin-vinculin interaction

Force transmission through adherens junctions (AJs) is crucial for multicellular organization, wound healing and tissue regeneration. Recent studies shed light on the molecular mechanisms of mechanotransduction at the AJs. However, the canonical model fails to explain force transmission when essential proteins of the mechanotransduction module are mutated or missing. Here, we demonstrate that, in absence of α-catenin, β-catenin can directly and functionally interact with vinculin in its open conformation, bearing physiological forces. Furthermore, we found that β-catenin can prevent vinculin autoinhibition in the presence of α-catenin by occupying vinculin´s head-tail interaction site, thus preserving force transmission capability. Taken together, our findings suggest a multi-step force transmission process at AJs, where α-catenin and β-catenin can alternatively and cooperatively interact with vinculin. This can explain the graded responses needed to maintain tissue mechanical homeostasis and, importantly, unveils a force-bearing mechanism involving β-catenin and extended vinculin that can potentially explain the underlying process enabling collective invasion of metastatic cells lacking α-catenin.

A Foldaxane-based Supramolecular Muscle-Like Switch.

[cn]daisy chain molecular muscle architectures are self-assemblies of hermaphrodite monomers, which usually contain a macrocycle unit linked to a molecular thread that contains sites of interactions - i. e. molecular stations - for the macrocycle. In these multiply threaded structures, altering with control the affinity between macrocycles and stations allows for contraction and extension of the molecule, which is reminiscent of the operation of a muscle. Besides, the field that consists of combining helix and template-containing rods to design foldaxane supramolecular assemblies is still underexplored. By using foldamer units as surrogates for macrocycles, Gan et al. reported the first supramolecular muscle-like foldamer-containing switch that can adopt, after chemical stimulus, either a contracted co-conformational state or a degenerate-like state for which a slow exchange occurred between the contracted and the stretched state.

Identification of Benzothiazoles Bearing 1,3,4-Thiadiazole as Antiproliferative Hybrids Targeting VEGFR-2 and BRAF Kinase: Design, Synthesis, BIO Evaluation and In Silico Study.

Cancer remains a leading cause of death worldwide, often resulting from uncontrolled growth in various organs. Protein kinase inhibitors represent an important class of targeted cancer therapies. Recently, the kinases BRAF and VEGFR-2 have shown synergistic effects on tumor progression. Seeking to develop dual BRAF/VEGFR-2 inhibitors, we synthesized 18 amino-benzothiazole derivatives with structural similarities to reported dual inhibitors. Four compounds-4a, 4f, 4l, and 4r-demonstrated remarkable cytotoxicity, with IC50 values ranging from 3.58 to 15.36 μM, against three cancer cell lines. Furthermore, these compounds showed IC50 values of 38.77-66.22 μM in the case of a normal cell line, which was significantly safer than the reference, sorafenib. Subsequent investigation revealed that compound 4f exhibited the capacity to inhibit the BRAF and VEGFR-2 enzymes, with IC50 values similar to sorafenib (0.071 and 0.194 μM, respectively). Moreover, compound 4f caused G2-M- and S-phase cycle arrest. Molecular modeling demonstrated binding patterns compatible with inhibition for both targets, where 4f exerted the critical interactions in the BRAF site and interacted in the VEGFR-2 site in a manner akin to sorafenib, demonstrating affinity similar to dabrafenib.

Site‐Selective MoS2‐Based Sensor for Detection and Discrimination of Triethylamine from Volatile Amines Using Kinetic Analysis and Machine Learning

AbstractDetection and discrimination of volatile organic compounds (VOCs) is important to provide a more realistic assessment of their potential implication in complex environments and medical diagnostics based on volatile biomarkers. Herein, chemiresistive sensors are fabricated using stacked MoS2 nanoflakes with defects and exposed‐edge sites. The sensor is found to be extremely selective to triethylamine (TEA) over polar, non‐polar VOCs and atmospheric gases. The sensor exhibits a sensitivity of 1.72% ppm−1, fast response/recovery (19 s/39 s) to 100 ppm TEA at room temperature, low limit of detection (64 ppb), device reproducibility, humidity tolerance (RH 90%) and stability tested up to 60 days. The kinetic analysis of sensing curves reveals two discrete adsorption sites corresponding to edge and basal sites of interaction, with a higher rate constant of association and dissociation for TEA. The Density Functional Theory (DFT) studies support higher adsorption energy of TEA on MoS2 surface with respect to other volatile amines. The sensor demonstrates TEA recognition and composition estimation capability in a binary mixture of a similar class of VOCs using Machine Learning driven analysis with 95% accuracy. The ability to discriminate amines in binary mixture of other volatile amines paves the way for the advancement of next‐generation devices in the field of disease diagnosis.

Induced Chirality in Sulfasalazine by Complexation With Albumins: Theoretical and Experimental Study.

Through molecular recognition, drugs can interact and complex with macromolecules circulating in the body. The serum albumin transport protein, found in several mammals, has several interaction sites where these molecules can be located. The drug sulfasalazine (SSZ) is known in the literature to complex at drug site 1 (DS1) in human serum (HSA) and bovine serum (BSA) proteins. This complexation can be studied using various spectroscopic techniques. With the techniques used in this work, absorption in the ultraviolet and visible regions (UV-Vis) and electronic circular dichroism (ECD), a significant difference was observed in the results involving HSA and BSA. The application of theoretical methodologies, such as TD-DFT and molecular docking, suggests that the conformation that SSZ assumes in DS1 of the two proteins is different, which exposes it to different amino acid residues and different hydrophobicities. This difference in conformation may be related to the location of DS1 where the drug interacts or to the possibility of SSZ moving in the BSA site, due to its larger size, and moving less freely in HSA.

Metal ionic liquid-based hybrid membranes for ammonia separation through moderate interaction sites and cooperative transport channels

The combination ionic liquids (ILs) with membranes is a potential method for direct NH3 separation. In particular, ILs can modulate the interactions with NH3 and construct pathways in membranes for preferential NH3 transport, which is expected to overcome the trade-off effect and achieve a desirable separation performance. In this work, four metal ILs (MILs) with different metal centres and hydrogen bond donating ability, including [2-Mim][Li(NTf2)2], [Eim][Li(NTf2)2], [Bmim]2[Co(NCS)4], and [Bim]2[Co(NCS)4], were incorporated into sulfonated block copolymers to prepare MIL-based hybrid membranes for NH3 separation. The investigation of structure–performance relationships suggested that the interaction sites and transport channels could be tuned by the MIL type, which greatly affects the NH3 separation performance of the membranes. The Nexar/2-Mim-Li-10 membrane exhibits NH3 permeability of 735.6 Barrer with NH3/N2 selectivity of 844.5 and NH3/H2 selectivity of 154.7, which is higher than other MIL-based hybrid membranes owing to self-assembled transport channels and moderate complexation. Increasing the MIL content and feed pressure significantly improved NH3 separation performance.

Medical Assistant Health Coaching for Type 2 Diabetes in Primary Care: Results From a Pragmatic Cluster Randomized Controlled Trial.

This cluster (clinic-level) randomized controlled trial (RCT) compared medical assistant (MA) health coaching (MAC) with usual care (UC) among at-risk adults with type 2 diabetes in two diverse real-world primary care environments: a federally qualified health center (FQHC; Neighborhood Healthcare) and a large nonprofit private insurance-based health system (Scripps Health). A total of 600 adults with type 2 diabetes who met one or more of the following criteria in the last 90 days were enrolled: HbA1c ≥8% and/or LDL cholesterol ≥100 mg/dL and/or systolic blood pressure (SBP) ≥140 mmHg. Participants at MAC clinics received in-person and telephone self-management support from a specially trained MA health coach for 12 months. Electronic medical records were used to examine clinical outcomes in the overall sample. Behavioral and psychosocial outcomes were evaluated in a subsample (n = 300). All clinical outcomes improved significantly over 1 year in the overall sample (P < 0.001). The reduction in HbA1c was significantly greater in the MAC versus UC group (unstandardized Binteraction = -0.06; P = 0.002). A significant time by group by site interaction also showed that MAC resulted in greater improvements in LDL cholesterol than UC at Neighborhood Healthcare relative to Scripps Health (Binteraction = -1.78 vs. 1.49; P < 0.05). No other statistically significant effects were observed. This was the first large-scale pragmatic RCT supporting the real-world effectiveness of MAC for type 2 diabetes in U.S. primary care settings. Findings suggest that this team-based approach may be particularly effective in improving diabetes outcomes in FQHC settings.