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Association between estimated glucose disposal rate and major adverse cardiovascular events in patients with type 2 diabetes
Background Estimated glucose disposal rate (eGDR) is associated with risk of adverse outcomes in patients with type 2 diabetes. However, whether eGDR affects long-term glycemic management in patients with type 2 diabetes remains unclear. This study aimed to investigate the relationships between eGDR, long-term visit-to-visit HbA1c variability, and adverse outcomes in patients with type 2 diabetes. Methods This post-hoc analysis of the Action to Control Cardiovascular Risk in Diabetes study (ACCORD) included 10,129 type 2 diabetes patients with high cardiovascular risk. Participants were divided into tertiles based on eGDR values. HbA1c variability was assessed using the HbA1c Variability Score (HVS). Primary outcome was major adverse cardiovascular events (MACEs), composite of nonfatal myocardial infarction, nonfatal stroke, and death from cardiovascular causes. Weibull accelerated failure-time models and causal mediation analyses were employed to evaluate relationships between variables. Results During a median follow-up of 4.75 years, compared to T1, T3 showed significantly higher risks of MACEs (HR 1.56, 95% CI: 1.27–1.91) and all-cause mortality (HR 1.81, 95% CI: 1.40–2.32) in fully adjusted models. Restricted cubic spline analysis revealed nonlinear relationships between eGDR and outcomes, with risk declining rapidly as eGDR increased until approximately 5 mg/kg/min, after which the curve flattened. A significant negative correlation was observed between HVS and eGDR (β −2.30; 95% CI: −2.65 to −1.95), following a similar nonlinear pattern. In mediation analysis, HVS explained 37.8% of eGDR’s effect on MACEs risk and 21.53% of its effect on all-cause mortality. Conclusion In type 2 diabetes patients with high cardiovascular risk, lower eGDR was associated with higher risk of MACEs and all-cause mortality, with HbA1c variability playing an important mediating role in this relationship.
Method and experimental verification of spatial attitude prediction for an advanced hydraulic support system under mining influence
Prevalence and correlates of metabolic syndrome in patients with initial-treatment and drug-naïve bipolar disorder: A large sample cross-sectional study
Patients with bipolar disorder (BD) are frequently prone to metabolic syndrome (MetS), and their co-morbidity adversely affects patient care outcomes. This study aimed to determine the prevalence of MetS and its clinical correlates among initial-treatment and drug-naïve (ITDN) BD patients.We recruited a cohort of 841 ITDN BD patients. Socio-demographic and clinical data were collected, and patients underwent routine serological testing, which included fasting blood glucose, lipid profiles, thyroid function, and prolactin levels. Psychometric evaluations were also conducted to measure manic, depressive, and psychotic symptoms, as well as illness severity. Additionally, we utilized a transformation approach for continuous variable analysis to compute a MetS score.We found a MetS prevalence of 17.84% among the study participants. Binary logistic regression identified age, body mass index (BMI), low-density lipoprotein cholesterol (LDL-C), free tetraiodothyronine (FT4), and psychotic symptoms as significant predictors of MetS development. Further, multiple linear regression analysis indicated that advanced age was a significant predictor of higher MetS scores.The findings highlight the prevalence of MetS in ITDN BD patients and suggest that certain demographic and clinical factors are influential in the development and severity of MetS. These insights may guide the development of targeted preventive and therapeutic strategies for MetS in this patient population.
Light-activated multimodal nanoplatform for enhanced synergistic therapy of breast cancer
Dual-target peripheral and central magnetic stimulation for rehabilitation of chronic pelvic pain syndrome associated with psychosomatic symptoms: Study protocol for a randomized controlled trial
Introduction Chronic pelvic pain syndrome (CPPS) is frequently associated with psychological issues. Repetitive peripheral magnetic stimulation (rPMS) is potentially effective in treating CPPS, while repetitive transcranial magnetic stimulation (rTMS) has demonstrated therapeutic effects on anxiety and depression. Therefore, the study proposed herein aims to assess the efficacy and safety of dual-target magnetic stimulation in CPPS patients with psychological disorders. Methods This prospective, double-blind, randomized controlled trial will recruit 75 CPPS participants. After stratification by sex, participants will be randomly assigned via block randomization (1:1:1), sequentially based on enrollment order, to one of three groups: dual-target magnetic stimulation (rPMS and rTMS), rPMS, and sham stimulation, all receiving standard treatment. The dual-site magnetic stimulation group will receive left dorsolateral prefrontal cortex (DLPFC) rTMS (120% resting motor threshold [RMT], 10 Hz, 4-s stimulation, 26-s interval, 3000 pulses in total [depression cases]) or right DLPFC rTMS (120% RMT, 1 Hz, 10-s stimulation, 2-s interval, 1000 pulses in total [anxiety cases]) combined with rPMS (50% of maximum stimulation intensity, 20 Hz, 2-s stimulation, 28-s interval, 1600 pulses in total). The rPMS group will receive only rPMS. The sham stimulation group will undergo sham transcranial and peripheral stimulation. All treatments will be administered five times a week, once daily, for 4 weeks. Primary outcomes will be the pelvic pain scale (females) or the National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI, males). Secondary outcomes will include assessment of pelvic floor muscle surface electromyography, pudendal nerve motor evoked potentials, the Depression, Anxiety, and Stress Scale (DASS-21), and the Short Form 36 (SF-36) quality of life scale. Discussion We hypothesize that dual-target magnetic stimulation will show greater effectiveness than rPMS and sham stimulation in relieving pain symptoms and psychological distress in CPPS patients with comorbid mental disorders. Clinical trial registration The study was prospectively registered at the Chinese Clinical Trial Registry (ChiCTR; http://www.chictr.org.cn, ID: ChiCTR2300078761) on December 18, 2023; Protocol version 1.0–20220709.
Emotion regulation, not executive functioning, mediates longitudinal links between unpredictability in adolescence and social connectedness in young adulthood
Genetic clustering within massive Porites species complex is the primary driver of holobiont assembly
The fate of coral reefs in response to climate change depends on their ability to adapt to new environments. The coral animal is buffered from environmental stress by its algal endosymbionts and microbial partners (together, the “holobiont”). However, the flexibility of holobiont community assembly is not well understood, making it difficult to estimate its contribution to coral adaptation. To clarify these processes, we genetically profiled holobiont components (coral, algal symbiont, and microbiome) of massive Porites sampled across two size classes (small, < 30 cm and large, > 2 m) and ecologically distinct reef sites near Orpheus and Pelorus Islands, Australia. We recovered five major genetic clusters in the coral host. We estimated the relative contributions of the host genetic structure, site, and size class to holobiont community composition. Host genetic structure was the primary driver of both Symbiodiniaceae and microbial communities, indicating strong holobiont specificity in genetic clusters. In addition, the microbial community was associated with reef site and size class, unlike Symbiodiniaceae that were not significantly affected by either factor. As environmentally segregated, cryptic genetic lineages emerge as a common feature of scleractinian corals, these results emphasize that failure to assess cryptic genetic structure of the coral host may lead to dramatic overestimation of holobiont flexibility.
Development and characterization of pegylated Fe3O4-CAPE magnetic nanoparticles for targeted therapy and hyperthermia treatment of colorectal cancer
Core outcome sets in symptomatic peripheral artery disease, COS-PAD: Study protocol for developing core outcome sets in symptomatic PAD utilising systematic reviews, interviews, and delphi consensus
Background Symptomatic peripheral artery disease (PAD) presents as intermittent claudication or chronic limb-threatening ischaemia (CLTI). PAD research suffers from wide heterogeneity and non-comparability of outcome measures. The solution is to develop a core outcome set (COS) – a minimum standard of outcomes developed and agreed by key stakeholders (patients, healthcare professionals, and researchers). There are currently no agreed COSs for research in PAD. The aim of this project is to develop two separate COSs for symptomatic PAD; for each of intermittent claudication and CLTI. Methods/Design The COSs will be developed according to Core Outcome Measures in Effectiveness Trials (COMET) guidelines. Two comprehensive systematic reviews will be supplemented by qualitative interviews of patients and carers and focus groups of healthcare professionals and researchers. A three-round Delphi consensus process followed by a stakeholder meeting will agree the final COSs. Full ethical approval has been granted by Health Research Authority, HRA and Health and Care Research Wales, HCRW (Brighton and Sussex REC reference 24/LO/0258). Conclusion Two separate core outcome sets for research involving patients with intermittent claudication and CLTI will be developed. This will aid study design and ensure meaningful results of clinical trials to guide patient management and development of best-practice guidelines for symptomatic PAD. Study Registrations COMET registrations: 1590 and 2650
Securing face images in UAV networks using chaos and DNA cryptography approach
Refractory solid condensation detected in an embedded protoplanetary disk
Radiation-induced amphiregulin drives tumour metastasis
SOX2, PIWI proteins, and MALAT1 – plasma-based emerging biomarkers for cancer detection and monitoring
Background SOX2, PIWI proteins, and MALAT1 are molecular regulators implicated in cancer progression, proliferation, and epithelial-mesenchmal transition (EMT). This study evaluated their expression in plasma samples from patients with colorectal, breast, and prostate cancers, and assessed their correlations with standard immunohistochemical (IHC) markers. Methods A total 300 participants were enrolled: 150 patients with histologically confirmed cancers (50 colorectal cancer, 50 breast cancer, and 50 prostate cancer cases) and 150 age- and sex-matched healthy controls. Plasma RNA and protein levels of SOX2, PIWIL1, PIWIL2, and MALAT1 were measured via quantitative real-time polymerase chain reaction (qRT-PCR) and enzyme-linked immunosorbent assay (ELISA), respectively. IHC scores (Ki-67, p53, E-cadherin, vimentin, estrogen receptor/progesterone receptor, human epidermal growth factor receptor 2, androgen receptor) were retrieved from clinical records. Receiver-operating characteristic curve (ROC) analysis, multivariable logistic regression (adjusting for age and sex), and Pearson’s correlation coefficients were used to evaluate biomarker diagnostic performance and tumor marker associations. Results SOX2, PIWI proteins, and MALAT1 were significantly elevated in cancer patients versus controls (p < 0.001), with qRT-PCR and ELISA results strongly correlated. All three biomarkers showed strong positive correlations with Ki-67 (r = 0.65–0.72, p < 0.001), and MALAT1 was associated with EMT marker changes (↓E-cadherin, ↑ vimentin; p < 0.001). Adjusted ROC analysis yielded area under the curve (AUC) values of 0.82–0.89 for individual biomarkers, with sensitivity ranging from 72−84% and specificity from 75−87%. SOX2 levels showed significant correlations with Ki-67 and p53 IHC positivity in colorectal and breast cancer tissues (p < 0.01), although the functional significance of p53 staining remains inconclusive. Conclusion The differential expression of SOX2, PIWI proteins, and MALAT1 between cancer patients and healthy controls supports their potential utility as plasma-based biomarkers for distinguishing cancer cases from non-cancer cases. These findings support their potential utility as non-invasive biomarkers for distinguishing cancer cases from healthy individuals.
Innovative design and comprehensive ergonomic assessment of an auxiliary colonoscopy handle device
Smart brain-zapping implants could revolutionize Parkinson’s treatment
Influence of renal function and daptomycin dose on clinical effectiveness and adverse events in Japanese pediatric patients: A multicenter retrospective observational study
Background Data on the clinical effectiveness and adverse events of daptomycin in pediatric patients, considering dosage and renal function, are limited. Aim In this study, we aimed to investigate the clinical effectiveness of daptomycin, incidence of related adverse events, and associations between clinical outcomes and risk factors, including dosage and renal function, in pediatric patients. Methods Medical records of pediatric patients treated with daptomycin between September 2011 and December 2022, were retrospectively reviewed. Clinical effectiveness was categorized as cure, improvement, failure, or non-evaluable. The clinical success rate was defined as the sum of cured and improved cases. We classified doses based on the approved ranges: underdose (>1 mg/kg less than the approved dose), adequate dose (approved dose ±1 mg/kg), and overdose (>1 mg/kg more than the approved dose). Obesity was defined as a body mass index ≥ 30 kg/m2, with adjusted body weight used for dosing in these patients. Findings We enrolled 54 patients, achieving a clinical success rate of 91%. Four (7%) patients died, particularly those with microbiological failure (P = 0.004) and underdosing (P < 0.001). The underdose group comprised a higher proportion of younger patients (P = 0.020). Additionally, seven (13%) patients experienced daptomycin-related adverse events, including creatine phosphokinase elevation, eosinophilic pneumonia, rhabdomyolysis, liver failure, and drug fever, occurring regardless of renal function. Five patients received an approved dose, while two received an overdose. Conclusion Adequate daptomycin dosing improved clinical effectiveness and the mortality rate. However, continuous monitoring of adverse events remains critical for patients receiving the approved dose, including those with a normal renal function.
Study on the performance of open countercurrent heat source tower under low temperature and high humidity environment
Abstract This study aims to investigate the efficient operation characteristics and energy-saving effects of the heat source tower heat pump system in low temperature and high humidity environments. First, the heat and mass transfer model of an open countercurrent heat source tower was established and the heat and mass transfer performance of the heat source tower was investigated. It was obtained that the inlet and outlet solution temperatures had a significant effect on the sensible heat exchange, and the relative humidity also had a great influence on the latent heat exchange, while the inlet solution temperature was negatively correlated with the amount of heat transfer. Finally, using actual engineering cases, the heating efficiency of the heat source tower is determined. In the low temperature and high humidity environment of January, the coefficient of performance of the heat source tower ranges from 2.18 to 2.94. Throughout the entire heating season, the seasonal performance coefficient of the heat source tower is 3.18. The research findings of this study provide a theoretical basis for the application of the heat source tower in low temperature and high humidity environments.
China’s journal ranking system stands up to scrutiny
The association between long-term outdoor air pollution exposure and Chinese visceral adiposity index: A nationwide study of middle-aged and older adults
Outdoor air pollutants, particularly particulate matter (PM) and nitrogen dioxide (NO2), have been closely linked to diabetes mellitus, other metabolic disorders, and cardiovascular diseases. Visceral adiposity, a common high-risk factor for these conditions, may mediate the impact of air pollution on disease development. However, the potential role of outdoor air pollution on visceral adiposity remains unclear, especially in the Asian population and in older adults (> 60 years). Given the high levels of air pollution and the rising prevalence of visceral obesity in China, this study investigated whether there is a linear and/or non-linear association between the Chinese Visceral Adiposity Index (cVAI) and exposure to individual and combined air pollutants in 7,552 participants aged ≥ 45 years in China. Data on air pollutants were acquired from the ChinaHighAirPollution dataset. These included PM with an aerodynamic diameter ≤ 2.5 μm (PM2.5), PM10, NO2, ozone (O3), and sulfur dioxide (SO2). Our results demonstrate that exposure to all of these pollutants (PM2.5, PM10, NO2, O3, and SO2) was significantly and positively associated with the cVAI, with dose-response relationships observed in trends test across pollutants. In subgroup anslysis, the associations were particularly pronounced in men and active smokers. Specifically, smokers in the highest quartile of PM2.5 exposure had a β coefficient of 16.89 (95%CI:11.00, 22.78), while males had a β coefficient of 14.38 (95%CI:9.68, 19.07). NO2 and PM2.5 were identified as the primary contributors to the total effect of outdoor air pollution exposure. In conclusion, this study is the first to reveal that outdoor air pollutants, particularly PM2.5 and NO2, are significantly associated with increased visceral adiposity in middle-aged and older Chinese adults. Males and active smokers could be high risk groups, when compared with females and non-smokers. This study highlights an urgent need for public health policies mitigating visceral obesity through the reduction of outdoor air pollution exposure.