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1.
J Hazard Mater ; 476: 135171, 2024 Sep 05.
Artículo en Inglés | MEDLINE | ID: mdl-39002481

RESUMEN

The accurate and rapid identification of explosives and their toxic by-products is an important aspect of safety protocols, forensic investigations and pollution studies. Herein, surface-enhanced Raman scattering (SERS) is used to detect different explosive molecules using an improved substrate design by controllable oxidation of the tungsten surface and deposition of Au layers. The resulting furrow-like morphology formed at the intersection of the tungsten Wulff facets increases nanoroughness and improves the SERS response by over 300 % compared to the untreated surface. The substrate showed excellent reproducibility with a relative standard deviation of less than 15 % and a signal recovery of over 95 % after ultrafast Ar/O2 plasma cleanings. The detection limit for the "dried on a surface" measurement case was better than 10-8 M using the moving scanning regime and an acquisition time of 10 s, while for the "water droplets on a surface" scenario the LoD is 10-7, which is up to 2 orders of magnitude better than the UV-Vis spectroscopy method. The substrates were successfully used to classify the molecular fingerprints of HMX, Tetryl, TNB and TNT, demonstrating the efficiency of a sensor for label-free SERS screening in the practice of monitoring traces of explosives in the water medium.

2.
Protein J ; 43(4): 805-818, 2024 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-38980534

RESUMEN

Spectroscopic studies on domains and peptides of large proteins are complicated because of the tendency of short peptides to form oligomers in aquatic buffers, but conjugation of a peptide with a carrier protein may be helpful. In this study we approved that a fragment of SK30 peptide from phospholipase A2 domain of VP1 Parvovirus B19 capsid protein (residues: 144-159; 164; 171-183; sequence: SAVDSAARIHDFRYSQLAKLGINPYTHWTVADEELLKNIK) turns from random coil to alpha helix in the acidic medium only in case if it had been conjugated with BSA (through additional N-terminal Cys residue, turning it into CSK31 peptide, and SMCC linker) according to CD-spectroscopy results. In contrast, unconjugated SK30 peptide does not undergo such shift because it forms stable oligomers connected by intermolecular antiparallel beta sheet, according to IR-spectroscopy, CD-spectroscopy, blue native gel electrophoresis and centrifugal ultrafiltration, as, probably, the whole isolated phospholipase domain of VP1 protein does. However, being a part of the long VP1 capsid protein, phospholipase domain may change its fold during the acidification of the medium in the endolysosome by the way of the formation of contacts between protonated His153 and Asp175, promoting the shift from random coil to alpha helix in its N-terminal part. This study opens up a perspective of vaccine development, since rabbit polyclonal antibodies against the conjugate of CSK31 peptide with BSA, in which the structure of the second alpha helix from the phospholipase A2 domain should be reproduced, can bind epitopes of the complete recombinant unique part of VP1 Parvovirus B19 capsid (residues: 1-227).


Asunto(s)
Proteínas de la Cápside , Parvovirus B19 Humano , Parvovirus B19 Humano/química , Parvovirus B19 Humano/genética , Proteínas de la Cápside/química , Proteínas de la Cápside/genética , Proteínas de la Cápside/metabolismo , Fosfolipasas A2/química , Fosfolipasas A2/metabolismo , Concentración de Iones de Hidrógeno , Péptidos/química , Péptidos/metabolismo , Dominios Proteicos , Albúmina Sérica Bovina/química , Animales
3.
J Colloid Interface Sci ; 668: 319-334, 2024 Aug 15.
Artículo en Inglés | MEDLINE | ID: mdl-38678887

RESUMEN

Wrinkled coatings are a potential drug-free method for mitigating bacterial attachment and biofilm formation on materials such as medical and food grade steel. However, their fabrication typically requires multiple steps and often the use of a stimulus to induce wrinkle formation. Here, we report a facile plasma-based method for rapid fabrication of thin (<250 nm) polymer coatings from a single environmentally friendly precursor, where wrinkle formation and fractal pattern development are controlled solely by varying the deposition time from 3 s to 60 s. We propose a mechanism behind the observed in situ development of wrinkles in plasma, as well as demonstrate how introducing specific topographical features on the surface of the substrata can result int the formation of even more complex, ordered wrinkle patterns arising from the non-uniformity of plasma when in contact with structured surfaces. Thus-fabricated wrinkled surfaces show good adhesion to substrate and an antifouling activity that is not observed in the equivalent smooth coatings and hence is attributed to the specific pattern of wrinkles.

4.
Glob Chall ; 8(1): 2300086, 2024 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-38223892

RESUMEN

Inhospitable, inaccessible, and extremely remote alike the famed pole of inaccessibility, aka Point Nemo, the isolated locations in deserts, at sea, or in outer space are difficult for humans to settle, let alone to thrive in. Yet, they present a unique set of opportunities for science, economy, and geopolitics that are difficult to ignore. One of the critical challenges for settlers is the stable supply of energy both to sustain a reasonable quality of life, as well as to take advantage of the local opportunities presented by the remote environment, e.g., abundance of a particular resource. The possible solutions to this challenge are heavily constrained by the difficulty and prohibitive cost of transportation to and from such a habitat (e.g., a lunar or Martian base). In this essay, the advantages and possible challenges of integrating Fischer-Tropsch, artificial photosynthesis, and plasma catalysis into a robust, scalable, and efficient self-contained system for energy harvesting, storage, and utilization are explored.

5.
Protein Pept Lett ; 2023 Dec 04.
Artículo en Inglés | MEDLINE | ID: mdl-38053353

RESUMEN

BACKGROUND: Binding appropriate cellular receptors is a crucial step of a lifecycle for any virus. Structure of receptor-binding domain for a viral surface protein has to be determined before the start of future drug design projects. OBJECTIVE: Investigation of pH-induced changes in the secondary structure for a capsid peptide with loss of function mutation can shed some light on the mechanism of entrance. METHODS: Spectroscopic methods were accompanied by electrophoresis, ultrafiltration, and computational biochemistry. RESULTS: In this study, we showed that a peptide from the receptor-binding domain of Parvovirus B19 VP1 capsid (residues 13-31) is beta-structural at pH=7.4 in 0.01 M phosphate buffer, but alpha- helical at pH=5.0, according to the circular dichroism (CD) spectroscopy results. Results of infra- red (IR) spectroscopy showed that the same peptide exists in both alpha-helical and beta-structural conformations in partial dehydration conditions both at pH=7.4 and pH=5.0. In contrast, the peptide with Y20W mutation, which is known to block the internalization of the virus, forms mostly alpha-helical conformation in partial dehydration conditions at pH=7.4. According to our hypothesis, an intermolecular antiparallel beta structure formed by the wild-type peptide in its tetramers at pH=7.4 is the prototype of the similar intermolecular antiparallel beta structure formed by the corresponding part of Parvovirus B19 receptor-binding domain with its cellular receptor (AXL). CONCLUSION: Loss of function Y20W substitution in VP1 capsid protein prevents the shift into the beta-structural state by way of alpha helix stabilization and the decrease of its ability to turn into the disordered state.

6.
Polymers (Basel) ; 15(15)2023 Jul 26.
Artículo en Inglés | MEDLINE | ID: mdl-37571064

RESUMEN

α-tricalcium (α-TCP) phosphate is widely used as an osteoinductive biocompatible material, serving as an alternative to synthetic porous bone materials. The objective of this study is to obtain a highly filled fibrous nonwoven material composed of poly-3-hydroxybutyrate (PHB) and α-TCP and to investigate the morphology, structure, and properties of the composite obtained by the electrospinning method (ES). The addition of α-TCP had a significant effect on the supramolecular structure of the material, allowing it to control the crystallinity of the material, which was accompanied by changes in mechanical properties, FTIR spectra, and XRD curves. The obtained results open the way to the creation of new osteoconductive materials with a controlled release of the source of calcium into the living organism.

7.
Nanomaterials (Basel) ; 13(11)2023 May 30.
Artículo en Inglés | MEDLINE | ID: mdl-37299666

RESUMEN

Recent advancements in space technology and reduced launching cost led companies, defence and government organisations to turn their attention to low Earth orbit (LEO) and very low Earth orbit (VLEO) satellites, for they offer significant advantages over other types of spacecraft and present an attractive solution for observation, communication and other tasks. However, keeping satellites in LEO and VLEO presents a unique set of challenges, in addition to those typically associated with exposure to space environment such as damage from space debris, thermal fluctuations, radiation and thermal management in vacuum. The structural and functional elements of LEO and especially VLEO satellites are significantly affected by residual atmosphere and, in particular, atomic oxygen (AO). At VLEO, the remaining atmosphere is dense enough to create significant drag and quicky de-orbit satellites; thus, thrusters are needed to keep them on a stable orbit. Atomic oxygen-induced material erosion is another key challenge to overcome during the design phase of LEO and VLEO spacecraft. This review covered the corrosion interactions between the satellites and the low orbit environment, and how it can be minimised through the use of carbon-based nanomaterials and their composites. The review also discussed key mechanisms and challenges underpinning material design and fabrication, and it outlined the current research in this area.

8.
Polymers (Basel) ; 15(5)2023 Mar 06.
Artículo en Inglés | MEDLINE | ID: mdl-36904556

RESUMEN

The combination of biocompatibility, biodegradability, and high mechanical strength has provided a steady growth in interest in the synthesis and application of lactic acid-based polyesters for the creation of implants. On the other hand, the hydrophobicity of polylactide limits the possibilities of its use in biomedical fields. The ring-opening polymerization of L-lactide, catalyzed by tin (II) 2-ethylhexanoate in the presence of 2,2-bis(hydroxymethyl)propionic acid, and an ester of polyethylene glycol monomethyl ester and 2,2-bis(hydroxymethyl)propionic acid accompanied by the introduction of a pool of hydrophilic groups, that reduce the contact angle, were considered. The structures of the synthesized amphiphilic branched pegylated copolylactides were characterized by 1H NMR spectroscopy and gel permeation chromatography. The resulting amphiphilic copolylactides, with a narrow MWD (1.14-1.22) and molecular weight of 5000-13,000, were used to prepare interpolymer mixtures with PLLA. Already, with the introduction of 10 wt% branched pegylated copolylactides, PLLA-based films had reduced brittleness, hydrophilicity, with a water contact angle of 71.9-88.5°, and increased water absorption. An additional decrease in the water contact angle, of 66.1°, was achieved by filling the mixed polylactide films with 20 wt% hydroxyapatite, which also led to a moderate decrease in strength and ultimate tensile elongation. At the same time, the PLLA modification did not have a significant effect on the melting point and the glass transition temperature; however, the filling with hydroxyapatite increased the thermal stability.

9.
Nanoscale Horiz ; 8(5): 568-602, 2023 May 02.
Artículo en Inglés | MEDLINE | ID: mdl-36928662

RESUMEN

Low-dimensional copper oxide nanostructures are very promising building blocks for various functional materials targeting high-demanded applications, including energy harvesting and transformation systems, sensing and catalysis. Featuring a very high surface-to-volume ratio and high chemical reactivity, these materials have attracted wide interest from researchers. Currently, extensive research on the fabrication and applications of copper oxide nanostructures ensures the fast progression of this technology. In this article we briefly outline some of the most recent, mostly within the past two years, innovations in well-established fabrication technologies, including oxygen plasma-based methods, self-assembly and electric-field assisted growth, electrospinning and thermal oxidation approaches. Recent progress in several key types of leading-edge applications of CuO nanostructures, mostly for energy, sensing and catalysis, is also reviewed. Besides, we briefly outline and stress novel insights into the effect of various process parameters on the growth of low-dimensional copper oxide nanostructures, such as the heating rate, oxygen flow, and roughness of the substrates. These insights play a key role in establishing links between the structure, properties and performance of the nanomaterials, as well as finding the cost-and-benefit balance for techniques that are capable of fabricating low-dimensional CuO with the desired properties and facilitating their integration into more intricate material architectures and devices without the loss of original properties and function.

10.
Biochemistry (Mosc) ; 87(6): 548-558, 2022 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-35790410

RESUMEN

Structurally modified virus particles can be obtained from the rod-shaped or filamentous virions of plant viruses and bacteriophages by thermal or chemical treatment. They have recently attracted attention of the researchers as promising biogenic platforms for the development of new biotechnologies. This review presents data on preparation, structure, and properties of the structurally modified virus particles. In addition, their biosafety for animals is considered, as well as the areas of application of such particles in biomedicine. A separate section is devoted to one of the most relevant and promising areas for the use of structurally modified plant viruses - design of vaccine candidates based on them.


Asunto(s)
Bacteriófagos , Virus de Plantas , Animales , Virión
11.
Front Genet ; 12: 625764, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34671379

RESUMEN

Curly birch [Betula pendula var. carelica (Merckl.) Hämet-Ahti] is a relatively rare variety of silver birch (B. pendula Roth) that occurs mainly in Northern Europe and northwest part of Russia (Karelia). It is famous for the beautiful decorative texture of wood. Abnormal xylogenesis underlying this trait is heritable, but its genetic mechanism has not yet been fully understood. The high number of potentially informative genetic markers can be identified through sequencing nuclear and organelle genomes. Here, the de novo assembly, complete nucleotide sequence, and annotation of the chloroplast genome (plastome) of curly birch are presented for the first time. The complete plastome length is 160,523 bp. It contains 82 genes encoding structural and enzymatic proteins, 37 transfer RNAs (tRNAs), and eight ribosomal RNAs (rRNAs). The chloroplast DNA (cpDNA) is AT-rich containing 31.5% of A and 32.5% of T nucleotides. The GC-rich regions represent inverted repeats IR1 and IR2 containing genes of rRNAs (5S, 4.5S, 23S, and 16S) and tRNAs (trnV, trnI, and trnA). A high content of GC was found in rRNA (55.2%) and tRNA (53.2%) genes, but only 37.0% in protein-coding genes. In total, 384 microsatellite or simple sequence repeat (SSR) loci were found, mostly with mononucleotide motifs (92% of all loci) and predominantly A or T motifs (94% of all mononucleotide motifs). Comparative analysis of cpDNA in different plant species revealed high structural and functional conservatism in organization of the angiosperm plastomes, while the level of differences depends on the phylogenetic relationship. The structural and functional organization of plastome in curly birch was similar to cpDNA in other species of woody plants. Finally, the identified cpDNA sequence variation will allow to develop useful genetic markers.

12.
Clin Exp Vaccine Res ; 10(2): 123-131, 2021 May.
Artículo en Inglés | MEDLINE | ID: mdl-34222124

RESUMEN

PURPOSE: Recombinant rotavirus A vaccines are being developed as an alternative to existing live oral attenuated vaccines. One of the main problems in the production of such vaccines is the genetic diversity of the strains that are in circulation. The goal of this study was to create an antigen panel for modern broad-spectrum recombinant rotavirus A vaccine. MATERIALS AND METHODS: The antigens of rotavirus were cloned and expressed in Escherichia coli. Antigenic specificity was investigated by Western blot analysis, which was performed using commercial polyclonal antisera to several RVA strains. Phylogenetic analysis was based on the amino acid sequences of the VP8* protein fragment of human RVA isolates representing genotypes P[4], P[6], and P[8]. RESULTS: A universal panel of antigens was established, including consensus and conserved sequences of structural proteins VP8*, VP5*, and VP7, which are the main targets of neutralizing antibodies. For the first time, a consensus approach was used in the design of extended antigens based on VP8* (genotypes P[4], P[6], and P[8]) and VP5* (genotype P[8]) proteins' fragments. In addition, a gene coding the protein (ep-875) containing several copies of conserved short neutralizing epitopes of VP8*, VP7, and VP5* was created. Western blot analysis demonstrated that three synthetic VP8*-based antigens were not recognized by commercial antiserum against rotavirus strains isolated more than 35 years ago, but the specific activity of the VP5* and ep-875 antigens was confirmed. The problems of serological mismatch of vaccine strains and antigens with currently circulating strains are discussed. CONCLUSION: Five antigens representing sequences of structural proteins belonging to different genotypes can be used in various combinations (from mono- to pentavalent mixtures) for the development of an effective broad-spectrum rotavirus vaccine.

13.
Molecules ; 26(13)2021 Jul 05.
Artículo en Inglés | MEDLINE | ID: mdl-34279431

RESUMEN

Plasma-enhanced synthesis and modification of polymers is a field that continues to expand and become increasingly more sophisticated. The highly reactive processing environments afforded by the inherently dynamic nature of plasma media are often superior to ambient or thermal environments, offering substantial advantages over other processing methods. The fluxes of energy and matter toward the surface enable rapid and efficient processing, whereas the charged nature of plasma-generated particles provides a means for their control. The range of materials that can be treated by plasmas is incredibly broad, spanning pure polymers, polymer-metal, polymer-wood, polymer-nanocarbon composites, and others. In this review, we briefly outline some of the recent examples of the state-of-the-art in the plasma-based polymer treatment and functionalization techniques.

14.
Nanomaterials (Basel) ; 9(10)2019 Oct 02.
Artículo en Inglés | MEDLINE | ID: mdl-31581687

RESUMEN

To unravel the influence of the temperature and plasma species on the growth of single-crystalline metal oxide nanostructures, zinc, iron, and copper foils were used as substrates for the study of nanostructure synthesis in the glow discharge of the mixture of oxygen and argon gases by a custom-made plasma-enhanced horizontal tube furnace deposition system. The morphology and microstructure of the resulting metal oxide nanomaterials were controlled by changing the reaction temperature from 300 to 600 °C. Experimentally, we confirmed that single-crystalline zinc oxide, copper oxide, and iron oxide nanostructures with tunable morphologies (including nanowires, nanobelts, etc.) can be successfully synthesized via such procedure. A plausible growth mechanism for the synthesis of metal oxide nanostructures under the plasma-based process is proposed and supported by the nanostructure growth modelling. The results of this work are generic, confirmed on three different types of materials, and can be applied for the synthesis of a broader range of metal oxide nanostructures.

15.
Micromachines (Basel) ; 9(11)2018 Nov 01.
Artículo en Inglés | MEDLINE | ID: mdl-30715064

RESUMEN

Carbon, one of the most abundant materials, is very attractive for many applications because it exists in a variety of forms based on dimensions, such as zero-dimensional (0D), one-dimensional (1D), two-dimensional (2D), and-three dimensional (3D). Carbon nanowall (CNW) is a vertically-oriented 2D form of a graphene-like structure with open boundaries, sharp edges, nonstacking morphology, large interlayer spacing, and a huge surface area. Plasma-enhanced chemical vapor deposition (PECVD) is widely used for the large-scale synthesis and functionalization of carbon nanowalls (CNWs) with different types of plasma activation. Plasma-enhanced techniques open up possibilities to improve the structure and morphology of CNWs by controlling the plasma discharge parameters. Plasma-assisted surface treatment on CNWs improves their stability against structural degradation and surface chemistry with enhanced electrical and chemical properties. These advantages broaden the applications of CNWs in electrochemical energy storage devices, catalysis, and electronic devices and sensing devices to extremely thin black body coatings. However, the controlled growth of CNWs for specific applications remains a challenge. In these aspects, this review discusses the growth of CNWs using different plasma activation, the influence of various plasma-discharge parameters, and plasma-assisted surface treatment techniques for tailoring the properties of CNWs. The challenges and possibilities of CNW-related research are also discussed.

16.
Diabetes Obes Metab ; 19(2): 200-207, 2017 02.
Artículo en Inglés | MEDLINE | ID: mdl-27709794

RESUMEN

AIM: To determine whether the addition of sitagliptin to pre-existing therapy with liraglutide changes glycaemic excursions after a mixed meal. METHODS: A total of 16 patients with type 2 diabetes treated with metformin and liraglutide (1.2 mg/d for ≥2 weeks) were randomized (sealed envelopes), within a cross-over design, to be studied on two occasions, after an overnight fast, with (1) sitagliptin (100 mg orally) and (2) placebo (patients and care givers blinded) administered 60 minutes before a mixed meal, or vice versa. Glucose excursions (incremental area under the curve [AUC]; primary endpoint) and insulin, C-peptide, glucagon and incretin concentrations were measured. The study setting was a metabolic study unit at a specialized diabetes hospital. RESULTS: All 16 patients completed the study and were analysed. Glucose (AUCglucose 319 ± 30 [placebo] vs 315 ± 18 mmol.L-1 .min-1 [sitagliptin], Δ 7 [95% confidence interval -50 to 63] mmol.L-1 .min-1 ), insulin, C-peptide and glucagon concentrations were not affected significantly by sitagliptin treatment ( P = .60-1.00). Intact glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP) concentrations were augmented by sitagliptin, by 78.4% and 90.2%, respectively (both P < .0001). The influence of sitagliptin treatment on incretin plasma concentrations was similar to previously published results obtained in patients with type 2 diabetes on metformin treatment only. CONCLUSIONS: Sitagliptin, in patients already treated with a GLP-1 receptor agonist (liraglutide), increased intact GLP-1 and GIP concentrations, but with marginal, non-significant effects on glycaemic control. GLP-1 receptors have probably been maximally stimulated by liraglutide. Our findings do not support combination treatment with GLP-1 receptor agonists and DPP-4 inhibitors, but longer-term trials are needed to support clinical recommendations.


Asunto(s)
Diabetes Mellitus Tipo 2/tratamiento farmacológico , Inhibidores de la Dipeptidil-Peptidasa IV/uso terapéutico , Hipoglucemiantes/uso terapéutico , Liraglutida/uso terapéutico , Metformina/uso terapéutico , Fosfato de Sitagliptina/uso terapéutico , Adulto , Anciano , Glucemia/metabolismo , Péptido C/metabolismo , Estudios Cruzados , Diabetes Mellitus Tipo 2/metabolismo , Quimioterapia Combinada , Femenino , Polipéptido Inhibidor Gástrico/metabolismo , Glucagón/metabolismo , Péptido 1 Similar al Glucagón/metabolismo , Receptor del Péptido 1 Similar al Glucagón/agonistas , Hemoglobina Glucada/metabolismo , Humanos , Insulina/metabolismo , Masculino , Persona de Mediana Edad , Resultado del Tratamiento
17.
Diabetes Obes Metab ; 18(11): 1100-1109, 2016 11.
Artículo en Inglés | MEDLINE | ID: mdl-27300579

RESUMEN

AIM: To compare directly the clinical effects of vildagliptin and sitagliptin in patients with type 2 diabetes, with a special emphasis on incretin hormones and L-cell feedback inhibition induced by dipeptidyl peptidase (DPP-4) inhibition. METHODS: A total of 24 patients (12 on a diet/exercise regimen, 12 on metformin) were treated, in randomized order, for 7-9 days, with either vildagliptin (50 mg twice daily = 100 mg/d), sitagliptin (100 mg once daily in those on diet, 50 mg twice daily in those on metformin treatment = 100 mg/d) or placebo (twice daily). A mixed-meal test was performed. RESULTS: Intact glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide concentrations were doubled by both DPP-4 inhibitors. Meal-related total GLP-1 responses were reduced by vildagliptin and sitagliptin treatment alike in the majority of patients (vildagliptin: p = 0.0005; sitagliptin: p = 0.019), but with substantial inter-individual variation. L-cell feedback appeared to be more pronounced in those whose intact GLP-1 relative to total GLP-1 increased more, and who had greater reductions in fasting plasma glucose after DPP-4 inhibition. K-cell feedback inhibition overall was not significant. There were no differences in any of the clinical variables (glycaemia, insulin and glucagon secretory responses) between vildagliptin and sitagliptin treatment. CONCLUSIONS: Vildagliptin and sitagliptin affected incretin hormones, glucose concentrations, insulin and glucagon secretion in a similar manner. Inter-individual variations in L-cell feedback inhibition may indicate heterogeneity in the clinical response to DPP-4 inhibition.


Asunto(s)
Adamantano/análogos & derivados , Diabetes Mellitus Tipo 2/tratamiento farmacológico , Retroalimentación Fisiológica/efectos de los fármacos , Péptido 1 Similar al Glucagón/metabolismo , Comidas/fisiología , Nitrilos/administración & dosificación , Pirrolidinas/administración & dosificación , Fosfato de Sitagliptina/administración & dosificación , Adamantano/administración & dosificación , Adamantano/efectos adversos , Adamantano/farmacología , Anciano , Terapia Combinada , Estudios Cruzados , Diabetes Mellitus Tipo 2/metabolismo , Diabetes Mellitus Tipo 2/terapia , Dieta para Diabéticos , Inhibidores de la Dipeptidil-Peptidasa IV , Método Doble Ciego , Regulación hacia Abajo/efectos de los fármacos , Esquema de Medicación , Quimioterapia Combinada/efectos adversos , Terapia por Ejercicio , Femenino , Humanos , Masculino , Metformina/administración & dosificación , Metformina/efectos adversos , Persona de Mediana Edad , Nitrilos/efectos adversos , Nitrilos/farmacología , Pirrolidinas/efectos adversos , Pirrolidinas/farmacología , Fosfato de Sitagliptina/efectos adversos , Vildagliptina
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