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Summary: Background: The human microbiome is linked to multiple metabolic disorders such as obesity and diabetes. Obstructive sleep apnoea (OSA) is a common sleep disorder with several metabolic risk factors. We investigated the associations between the gut microbiome composition and function, and measures of OSA severity in participants from a prospective community-based cohort study: the Hispanic Community Health Study/Study of Latinos (HCHS/SOL). Methods: Bacterial-Wide Association Analysis (BWAS) of gut microbiome measured via metagenomics with OSA measures was performed adjusting for clinical, lifestyle and co-morbidities. This was followed by functional analysis of the OSA-enriched bacteria. We utilized additional metabolomic and transcriptomic associations to suggest possible mechanisms explaining the microbiome effects on OSA. Findings: Several uncommon anaerobic human pathogens were associated with OSA severity. These belong to the Lachnospira, Actinomyces, Kingella and Eubacterium genera. Functional analysis revealed enrichment in 49 processes including many anaerobic-related ones. Severe OSA was associated with the depletion of the amino acids glycine and glutamine in the blood, yet neither diet nor gene expression revealed any changes in the production or consumption of these amino acids. Interpretation: We show anaerobic bacterial communities to be a novel component of OSA pathophysiology. These are established in the oxygen-poor environments characteristic of OSA. We hypothesize that these bacteria deplete certain amino acids required for normal human homeostasis and muscle tone, contributing to OSA phenotypes. Future work should test this hypothesis as well as consider diagnostics via anaerobic bacteria detection and possible interventions via antibiotics and amino-acid supplementation. Funding: Described in methods.

Abstract Idiopathic pulmonary fibrosis is a fatal lung disorder characterized by abnormal deposition of extracellular matrix (ECM), which is secreted by activated myofibroblasts. While the origin of myofibroblasts has been discussed, epithelial-mesenchymal transition (EMT) is being noticed as one of the mechanisms of myofibroblast activation. Recent studies have shown that reactive oxygen species appear to induce not only EMT but also fibrotic progression and maintenance. Therefore, we tested chemicals that have antioxidant capacity as drugs for fibrosis. To evaluate the effects of 4′,6,7-trimethoxyisoflavone (TMF) and catechol (CAT) on EMT and fibrosis, we used an in vitro transforming growth factor (TGF)-β1 or bleomycin-induced model and an in vivo BLM-induced model. The results showed that the co-administration of TMF/CAT ameliorated pulmonary fibrosis by decreasing EMT and ECM accumulation by hindering both Smad and non-Smad TGF-β signalling cascades. Furthermore, significant increases in the number of total immune cells (especially lymphocytes) were observed in BLM-treated animals treated with TMF/CAT. Our findings suggest that co-intervention with TMF/CAT may be a potential treatment for fibrosis.

Introduction This study was conducted to explore factors associated with smoking cessation in male smokers with cardiovascular disease (CVD) or cancer, the two leading causes of death worldwide, and to compare them with quitting factors in smokers without the two diseases. Methods This is a secondary dataset analysis of the Korea National Health and Nutrition Examination Survey (KNHANES), nationally representative data from 2008–2019 (excluding 2013–2014), and included 12998 men without CVD or cancer (group without CVD or cancer), 1027 men with CVD (CVD group), and 616 men with cancer (cancer group). A Wald test with multiple logistic regression analysis was conducted. Results The quitting success rates in the CVD and cancer groups were consistently higher than those in the group without CVD or cancer. Old age and willpower in the CVD group, and old age and being married in the cancer group were associated with quitting success. Secondhand smoking and methods of quitting other than willpower were related to quitting failure in both groups. When interaction effects between the groups were examined, household income was the only factor associated with successful cessation in the group without CVD or cancer (AOR=1.17, 1.18, and 1.40, among the second, third, and fourth highest income quartiles, respectively; p for interaction=0.023). Higher smoking amounts (AOR=0.85; p

Background: Sleep disturbance is common and problematic among both patients with cancer and their sleep partner caregivers. Although 70% of the general adult population sleep in the same bed with a significant other, as do adult cancer patients and their spousal/partner caregivers, and one's sleep affect the partner's sleep, existing psychobehavioral interventions have targeted patients' and caregivers' sleep problems independently. Methods: We developed a new sleep intervention, My Sleep Our Sleep (MSOS), for both adult patients with cancer and their sleep-partner caregivers together. This protocol is to test the feasibility and acceptability as well as to provide preliminary efficacy of the MSOS intervention, which is a dyadic intervention designed to reduce sleep disturbance and improving sleep quality of both adult cancer patients and their sleep-partner caregivers (dyads). The intervention will be delivered weekly for 4 weeks. Questionnaire and daily sleep logs will be collected at baseline (T1) and one-week after conclusion of the intervention (T2). Satisfaction with the intervention will be assessed weekly for 4 weeks. Results: We estimate 43 dyads be enrolled (43 patients and 43 sleep-partner caregivers). We expect >75% of eligible and screened dyads will enroll within the enrollment period, >80% of enrolled dyads will complete the intervention, and >80% of participants will report satisfaction across all acceptability measures. We also expect MSOS will reveal a small-to-medium effect on sleep efficiency (primary outcome), overall sleep disturbance, subjective sleep quality, and insomnia severity (secondary outcomes). Conclusions: Results will inform the feasibility and acceptability of conducting a dyadic sleep intervention, and provide preliminary efficacy data to guide further refinement of the intervention content and procedure for adult patients with cancer and their sleep-partner caregivers. Trial registration: NCT04712604 Clinicaltrials.gov

Introduction Adverse effects of smoking on kidney function have been demonstrated in both general populations and in populations with chronic kidney disease (CKD). Therefore, quitting smoking can have a significant impact on the mortality and disease progression of CKD. This study examined and compared factors associated with quitting status of smoking, in patients with and without CKD, among Korean adult male smokers, using the Korea National Health and Nutrition Examination Survey from 2008 to 2019, excluding 2013. Methods Wald test with multiple logistic regression was performed to investigate factors associated with quitting smoking in both CKD and non-CKD groups, along with the interaction effects between groups. Results Of the 15747 eligible individuals, 909 had CKD, of whom 703 (weighted percentage: 74.4%) were quitters. In the non-CKD group, 8393 (weighted percentage: 50.4%) succeeded in quitting. Regular exercise was the only factor associated with quitting in both groups. The adjusted odd ratios with confidence intervals were 1.29 (95% CI: 1.17–1.42) and 2.84 (95% CI: 1.52–5.31) in the non-CKD and CKD groups, respectively (interaction p=0.0153). Unlike in the CKD group, marriage and higher systolic blood pressure were also associated with quitting, and lifetime smoking amount and secondhand smoke exposure at home were negatively associated with smoking cessation in the non-CKD group. Conclusions Exercise was the only factor associated with quitting smoking in the CKD group.

Chronic stress is a well-established risk factor for cardiometabolic disease. Caregiving for individuals with cancer is perceived as a chronic stressor yet research on the risk for cardiometabolic disease in this population, opposed to the elderly and those with Alzheimer’s disease, is limited. Additionally, few studies have explored the early physiological changes that occur in family caregivers suggesting an elevated risk for illness. This cross-sectional study was designed to examine levels of cardiometabolic risk biomarkers and their correlates in caregivers of patients with colorectal cancer. Caregivers completed questionnaires that measure exposures to stress and vulnerability factors, psychological distress, and health habits as potential correlates. Traditional lipid and nontraditional lipoprotein particle biomarkers (e.g. concentration and size for all lipoprotein classes) were assayed from blood serum. Caregivers (N = 83, mean age = 49.8, 73% female) displayed levels of cardiometabolic biomarkers that suggest an elevated risk for cardiometabolic disease. Caregivers who were Hispanic, married, highly educated, employed, reported more hours spent caregiving daily, experienced higher caregiver burden associated with the lack of family support and impact on schedule, and psychological distress, demonstrated an elevated risk for cardiometabolic disease; primarily determined by nontraditional lipid biomarkers – large TRL-P, LDL-P, small HDL-P, large HDL-P, TRL-Z, LDL-Z and HDL-Z. These findings suggest that traditional lipid biomarkers may not be robust enough to detect early physiological changes associated with cardiometabolic disease risk in family caregivers. Moreover, findings reiterate the importance of assessing caregiver burden and providing evidence-based interventions to manage caregiving stress with the potential to improve caregivers’ cardiometabolic health.

Concerns pertaining to health and to problems in close relationships are both known to be major stressors, yet existing tools are inadequate to assess individual reactions to such stressors. Thus, we sought to develop and preliminarily validate a stress-inducing task for use in a laboratory setting that pertains to the sorts of health-related concerns people face in close relationships. Heterosexual dating couples (44 individuals: mean age 22) were randomized to be paired with their own partner or a stranger and to play a role of speaker or listener. Participants were asked to imagine a scenario in which one person is hit by a car (listener role) and the partner has no means to provide or seek out help for the victim (speaker role). The session consisted of baseline, speech preparation, stress task, and recovery phases. General linear modeling results revealed that the task induced stress, evidenced in cardiovascular activities and self-reported negative affect. Giving a brief speech about the stressful situation creates physiological and psychological strains, regardless of pairing with one’s own partner or stranger. Furthermore, cardiovascular and negative affect reactivity to the STress Induction Tool for Close relationships and Health (STITCH) task tended to vary by individual characteristics that reflect one’s sensitivity to close relationship-and health-related stress. This tool is intended to be used for testing relationship theory-driven phenomenon and longer-term implications of physiological and affective reactivities in the quality of life and health outcomes of those who experienced a medically stressful circumstance personally or in the family.

Abstract Background It is difficult to assess the impact of multiple comorbidities on clinical outcomes in chronic obstructive pulmonary disease (COPD). In this study, we aimed to investigate exacerbation-associated comorbidities, determine whether the number of comorbidities is an independent risk factor for exacerbation, and identify other exacerbation-associated factors in a Korean COPD population using a nationwide population-based cohort. This study focused on severe exacerbations that required hospitalisation or emergency room visits. Methods The National Health Insurance Service-National Sample Cohort, version 2.0, data sampled between 2002 and 2015 were analysed. Data from two years after the diagnosis of COPD were analysed for each participant (N = 12,554, entire cohort). Moreover, 42% of the participants underwent additional health examinations (N = 5306, health-screening cohort). Fifteen comorbidities that were previously reported as risk factors for exacerbations were examined. A logistic regression model was used to analyse association with exacerbations. Results Asthma (1.57 [1.39–1.76] and 1.24 [1.06–1.44]), lung cancer (1.84 [1.30–2.59] and 2.28 [1.54–3.37]), and heart failure (1.39 [1.16–1.67] and 1.52 [1.18–1.97]) were associated with exacerbation in both cohorts (odds ratio [95% confidence interval] in the entire cohort and health-screening cohort, respectively). The number of comorbidities was an independent risk factor, and old age, male sex, low body mass index, and current smoking were also independent risk factors. High cholesterol levels and body mass index exerted protective effects against exacerbation. Conclusions The number of comorbidities, certain comorbidities such as asthma, lung cancer and heart failure, and low BMI were associated with an increased risk of severe exacerbation in COPD patients.

Abstract Background The effects of comorbidities on chronic obstructive pulmonary disease (COPD) have been usually studied individually in the past. In this study, we aimed to investigate the comorbidities associated with mortality, the effect of multimorbidity on mortality and other factors associated with mortality among Korean COPD population. Methods The Korean National Health Insurance Service-National Sample Cohort version 2.0, collected between 2002 and 2015, was used. Among COPD patients [entire cohort (EC), N = 12,779], 44% of the participants underwent additional health examination, and they were analysed separately [health-screening cohort (HSC), N = 5624]. Fifteen comorbidities previously reported as risk factors for mortality were studied using Cox proportional hazards regression models. Results Total mortality rates were 38.6 per 1000 person-years (95% CI 37.32–40.01) and 27.4 per 1000 person-years (95% CI 25.68–29.22) in EC and HSC, respectively. The most common causes of death were disease progression, lung cancer, and pneumonia. Only some of the comorbidities had a direct impact on mortality. Multimorbidity, assessed by the number of comorbid diseases, was an independent risk factor of all-cause mortality in both cohorts and was a risk factor of respiratory mortality only in HSC. The Kaplan–Meier analysis showed significant differences in survival trajectories according to the number of comorbidities in all-cause mortality but not in respiratory mortality. Low BMI, old age and male sex were independent risk factors for both mortalities in both cohorts. Conclusions The number of comorbidities might be an independent risk factor of COPD mortality. Multimorbidity contributes to all-cause mortality in COPD, but the effect of multimorbidity is less evident on respiratory mortality.

Dynamic kinetic resolution is a common approach for the preparation of optically pure amino acids using enzymes. Here the authors report an alternative method based on enantioselective extraction coupled with racemization, in which a bulky extractant affords hydrophobic extractable imines with amino acids rapidly, reversibly and enantioselectively.

PURPOSEThe purpose of this study was to describe follow-up care for breast and colorectal cancer survivors in countries with varying levels of resources and highlight challenges regarding posttreatment survivorship care.METHODSWe surveyed one key stakeholder from each of 27 countries with expertise in survivorship care on questions including the components/structure of follow-up care, delivery of treatment summaries and survivorship care plans, and involvement of primary care in survivorship. Descriptive analyses were performed to characterize results across countries and variations between the WHO income categories (low, middle, high). We also performed a qualitative content analysis of narratives related to survivorship care challenges to identify major themes.RESULTSSeven low- or /lower-middle-income countries (LIC/LMIC), seven upper-middle-income countries (UMIC), and 13 high-income countries (HICs) were included in this study. Results indicate that 44.4% of countries with a National Cancer Control Plan currently address survivorship care. Additional findings indicate that HICs use guidelines more often than those in LICs/LMICs and UMICs. There was great variation among countries regardless of income level. Common challenges include issues with workforce, communication and care coordination, distance/transportation issues, psychosocial support, and lack of focus on follow-up care.CONCLUSIONThis information can guide researchers, providers, and policy makers in efforts to improve the quality of survivorship care on a national and global basis. As the number of cancer survivors increases globally, countries will need to prioritize their long-term needs. Future efforts should focus on efforts to bridge oncology and primary care, building international partnerships, and implementation of guidelines.

Big belly seahorse (Hippocampus abdominalis) is a well-known marine organism recognized for its pharmacological value. In this study, peptides derived from natively (Jeju-do, Republic of Korea) farmed seahorses were investigated for their potency on myoblast differentiation and endurance capacitance. Cell viability studies on C2C12 mouse myoblast cells showed that more than 80% of the cells treated with peptides were metabolically active. Morphological observation illustrated the loss of characteristic radial branching towards elongated and well-developed muscle fibers in the peptide-treated C2C12 cells. Immunoblot study on the in vitro translational expression level of key myogenic regulatory proteins (MyoD, MyoG, MyHC) and an in vivo endurance study (using zebrafish as a working model) demonstrated the significance of peptides on the myogenesis process and endurance swimming performance against water flow and gradient, respectively. Collectively, our findings suggest that seahorse-derived peptides can be used as a therapeutic nutrient supplement for improved endurance.

Antifungal activities of MOFs (metal organic frameworks) have been demonstrated in studies, and improvement in efficiency of fungal inactivation is a critical issue in the application of MOFs. In this study, we employed 4,4′-azopyridine (AZPY) in the construction of MOF to improve its antifungal activity. Three-dimensional (3D) copper metal organic framework containing glutarate (Glu) and AZPY (Cu(AZPY)-MOF) was synthesized by a solvothermal reaction. Glutarates bridge Cu2 dinuclear units to form two-dimensional (2D) layers, and these layers are connected by AZPY to form a 3D framework. When spores of two fungi, Candida albicans and Aspergillus niger, were treated with Cu(AZPY)-MOF for one day, number of CFU (colony forming unit) was continuously reduced over treated MOF concentrations, and maximum 2.3 and 2.5 log10CFU reductions (approximately 99% reduction) were observed in C. albicans and A. niger, respectively. Small amounts of CuII ions and AZPY released from Cu(AZPY)-MOF were not critical for fungal inactivation. Our results indicate that the level of antifungal activity of Cu(AZPY)-MOF is greater than that of Cu-MOF without AZPY constructed in our previous study, and intercalation of AZPY is able to improve the antifungal activity of Cu(AZPY)-MOF.

Purpose: The study was undertaken to see whether the culturally sensitive education for perinatal care using a face to face approach improves understanding of spouse’s culture, knowledge of pregnancy and parenting skills, and self-efficacy among Korean husbands and Vietnamese wives. Methods: This study has a pre- and post-test study design conducted in a total of 13 couples who live in Seoul and agreed to participate. The education program consisted of lecture and hands on practice. The self-administered questionnaires and the checklist developed based on the educational purpose were used to assess the education effects. Results: The knowledge scores on Korean/Vietnamese culture, pregnancy and parenting skills as well as the performance scores on hand washing, pelvic strengthening, feedings and newborn bathing techniques were significantly improved in both husbands and wives after education, but pelvic floor exercises were improved only in wives. Conclusion: Overall, the individual education for culturally sensitive perinatal care was effective in our study participants.

As smokers get older, they tend to quit smoking in association with declining health and economic status. However, the association with the changes in work and life situations in the older age has not been fully explored. This study investigated the factors associated with current smoking among older persons in Korea, using the data from 2016 survey as part of Korean Longitudinal Study of Ageing (KLoSA). Multiple logistic regression analysis was used for current smoking .as the dependent variable. Of the 6618 participants, average age was 70.8 years (range 56-108), 58% were women, and 10.3% were current smokers, including 1.6% of women and 22.3% of men. The factors associated with current smoking included younger age (p

The pseudotetrahedral node, [In(O2CR)4]−, often found in InIII-based metal-organic frameworks (MOFs) without a cluster-based secondary building unit (SBU) is a negatively charged center due to charge mismatch between an 8-coordinate InIII ion and four anionic carboxylate bridging ligands. Thus, In-MOFs with this pseudotetrahedral node tend to bear a counter-cation near each InIII center in the frameworks. Generally, dialkylammonium-based cations such as Me2NH2+ and Et2NH2+ directly derived from N,N-dimethylformamide (DMF) or N,N-diethylformamide (DEF) solvents during MOF formation reactions play a significant role to form a stable framework through charge matching. If these cations thermally derived from DMF or DEF were not suitable for crystal growth of In-MOFs, it becomes very challenging to obtain high quality single crystals for X-ray structure determination of the frameworks. In this context, high quality crystals of In-ABDC MOF were not easily prepared from a ditopic azobenzene-4,4'-dicarboxylic acid (H2ABDC) through a thermal reaction in DMF or DEF. We successfully overcome this problem by employing a room-temperature ionic liquid, 1-ethyl-3-methylimidazolium tetrafluoroborate ([EMIM][BF4]), and the resulting three-dimensional (3D) In-ABDC MOF, [EMIM][In(ABDC)2]·DEF·H2O (I), was structurally characterized by X-ray diffraction. The 3D framework indicates a 4-connected uninodal net with Schläfli symbol of 66 (dia). The gas sorption properties of solvent-free I were also investigated in detail.

Introduction Considering that only some and not all smokers develop chronic obstructive pulmonary disease (COPD), there may be other factors responsible for the development of COPD among smokers. Previous researchers have reported that ethnicity could be one of factors associated with the development of COPD. This study aimed to examine the factors associated with the development of airflow limitation, suggestive of having COPD, among Korean smokers using data from the Korea National Health and Nutrition Examination Survey conducted over the past 3 years. Methods A total of 2569 current and former smokers ≥40 years of age were included. Most studies exploring risk factors for COPD have compared smokers and non-smokers with smoking as only one of the independent variables. In this study, we took a different approach, studying only smokers and comparing those with or without airflow limitation. Results The prevalence of airflow limitation among the study participants was 19.2% and 22.1% in current and former smokers, respectively. There was no significant correlation between the severity of airflow limitation and total lifetime smoking amount. Among the many variables examined, only age, male gender and total lifetime smoking amount (pack-years) were significant factors associated with the development of cigarette smoke-induced airflow limitation. Conclusions Older Korean men who are heavy smokers may be at a higher risk of developing COPD. Our findings support the importance of smoking cessation as the best way to prevent the development of COPD.

Polysiloxanes (PSs) have been widely utilized in the industry as lubricants, varnishes, paints, release agents, adhesives, and insulators. In addition, their applications have been expanded to include the development of new biomedical materials. To modify PS for application in therapeutic purposes, a flexible antibacterial Cu-MOF (metal–organic framework) consisting of glutarate and 1,2-bis(4-pyridyl)ethane ligands was embedded in PS via a hydrosilylation reaction of vinyl-terminated and H-terminated PSs at 25 °C. The bactericidal activities of the resulting Cu-MOF-embedded PS (PS@Cu-MOF) and the control polymer (PS) were tested against Escherichia coli, Staphylococcus aureus, and methicillin-resistant Staphylococcus aureus. PS@Cu-MOF exhibited more than 80% bactericidal activity toward the tested bacteria at a concentration of 100 μg⋅mL−1 and exhibited a negligible cytotoxicity toward mouse embryonic fibroblasts at the same concentration. Release tests of the Cu(II) ion showed PS@Cu-MOF to be particularly stable in a phosphate-buffered saline solution. Furthermore, its physical and thermal properties, including the phase transition, rheological measurements, swelling ratio, and thermogravimetric profile loss, were similar to those of the control polymer. Moreover, the low cytotoxicity and bactericidal activities of PS@Cu-MOF render it a promising candidate for use in medicinal applications, such as in implants, skin-disease treatment, wound healing, and drug delivery.

Purpose: Smoking during pregnancy contributes to the risk of negative health outcomes in mothers and babies. The purposes of this study were to review the harmful effects of maternal smoking during pregnancy on fetal and child development, to discuss if maternal smoking should be criminalized as a form of child abuse, and to explore advocating for fetal rights. Methods: A variety of published literature and legal documents including the Korean constitution, criminal laws, and children’s welfare laws were reviewed and critically analyzed. Results: Women who smoke during pregnancy are more likely to experience abortion related to placental dysfunction. Their unborn risk premature birth, fetal growth restriction, low birth weight, neurobehavioral disturbances, and/or other complications and newborn babies are also at risk for complications. The advocates for fetal rights can assert that maternal smoking should be regarded as a crime. Conclusion: Findings show that maternal smoking during pregnancy is a major risk factor for many adverse pregnancy outcomes. Effective strategies and health policies for smoking cessation during pregnancy are required to protect pregnant women and their babies.

Introduction Tobacco smoking is currently considered to be the main preventable cause of death and disability worldwide. We examined the magnitude of cigarette smoking effects on major smoking-related diseases, such as chronic obstructive pulmonary disease (COPD), hypertension (HTN) and cardiovascular disease (CVD), among South Korean adults using nationwide and representative survey data. Methods We used data from the Korea National Health and Nutrition Examination Survey, which was conducted over a 9-year period from 2007 to 2015 by the Korea Centers for Disease Control and Prevention. Multiple logistic regression analyses were performed to assess the associations between smoking status and all outcomes of interest. A total of 24072 participants ≥40 years of age were sampled in the current study. Results The study results were as follows: 1) Current and former smoking is associated with lower socioeconomic status; 2) The prevalence of major smoking-related diseases was significantly higher in former and current smokers compared to non-smokers; 3) The odd ratios of developing COPD were 3.49 [95% confidence interval (CI): 2.44–5.00], 2.41 (95% CI: 1.68–3.45) and 3.45 (95% CI: 2.20–5.40) among male current smokers, male ex-smokers and female current smokers, respectively. The odd ratio of developing CVD was 2.01 (95% CI: 1.05–3.86) in male ex-smokers. Otherwise, no significant associations between smoking and other diseases were observed after controlling the sociodemographic and clinical factors; and 4) The risk for COPD tends to be related to the smoking amount and weaning after quitting smoking. Conclusions Our study showed that COPD had the strongest association with current and former smoking in both male and female smokers after controlling for all potential confounding factors among major smoking-related diseases.

Obesity and chronic kidney disease (CKD) are major global health problems. There are very little data concerning the prevalence and its associated factors of obesity in non-dialyzed patients who have different stages of CKD. Therefore, in this study, we examined the prevalence of obesity and its associated factors according to the stages of CKD. We used nationwide representative data from the Korean National Health and Nutrition Examination Survey, which was conducted over a 7-year period from 2008 to 2014 by the Korea Centers for Disease Control and Prevention. The results indicated that: (1) general obesity and abdominal obesity were more prevalent in patients with CKD compared to those without CKD; (2) the prevalence of general obesity and abdominal obesity was highest in stage 2 CKD; (3) stages 3a and 3b were the factors associated with general obesity, and stage 3a was significantly associated with abdominal obesity; (4) the association between general obesity/abdominal obesity and CKD disappeared in people with advanced stage 4/5 CKD; and (5) the presence of comorbidities contributed to the development of both general obesity and abdominal obesity. The findings of this study might support the idea that weight loss is a good potential intervention for the prevention of disease progression in moderate CKD (stage 3), but not severe CKD (stage 4/5).

In the title compound, poly[[(μ2-oxalato)[μ2-1,2-(pyridin-4-yl)ethylene]zinc(II)] dihydrate], {[Zn(μ2-C4O4)(μ2-C12H10N2)]·2H2O}n, 2-butyndioate and 1,2-bis(pyridin-4-yl)ethylene ligands bridge ZnII ions to form a three-dimensional network. The three-dimensional networks are fivefold interpenetrated, and each network features a 4-connected unimodal net with a Schläfli symbol of 66 (dia) with the ZnII ions as the nodes. Twofold rotation axes are located at the ZnII ions and the midpoints of the C[triple-bond]C bond of 2-butyndioate and the C=C bond of 1,2-bis(pyridin-4-yl)ethylene. The coordination geometry around the ZnII ions is tetrahedral constructed from two O atoms from 2-butyndioate and two N atoms from 1,2-bis(pyridin-4-yl)ethylene. Solvate water molecules are connected with each other via hydrogen bonds to create chains running parallel to [010] that are captured in infinite channels of the three-dimensional framework through hydrogen bonds to the non-coordinating carboxylate O atoms of the 2-butyndioate units. The water molecules are disordered, with two alternative positions that are distinguished by the direction of the chains, but that share the H atom hydrogen bonded to the carboxylate O atom.

In the title compound, {[Cu2(μ4-C5H6O4)2(μ2-C14H16N2)]·2CH3CN}n, the Cu2 dinuclear units are connected by glutartate ligands, forming one-dimensional double chains. These chains, are in turn bridged by 1,4-bis(pyridin-4-yl)butane ligands to form a two-dimensional layer structure parallel to (112). The carboxylate groups of the glutarate ligand bridge two copper(II) ions, forming a paddle-wheel-type Cu2(CO2)4 dinuclear secondary building unit. A crystallographic inversion centre is located midway between two CuII ions, with a Cu...Cu distance of 2.639 (3) Å. The coordination geometry of the unique CuII ion is slightly disorted square pyramidal, formed by four equatorial carboxylate O atoms and an axial pyridyl N atom.

In the title compound, {[Zn(C6H4O4)(C10H9N3)]·H2O}n, the di(pyridin-2-yl)amine (dpa) ligands chelate the ZnII ions, forming [Zn(dpa)]2+ units which are connected by two independent bridging muconate [(2E,4E)-hexa-2,4-dienedioate] ligands to form chains. A crystallographic inversion centre is located at the mid-point of the central C—C bond of each muconate ligand. The carboxylate groups of the muconate ligands bridge the ZnII ions in asymmetric chelating modes. The ZnII ion is coordinated by four O atoms of two chelating carboxylate groups and two pyridyl N atoms in a distorted octahedral coordination environment. In the crystal, N—H...O and O—H...O hydrogen bonds connect chains and solvent water molecules, forming a two-dimensional network parallel to (101).