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Background X-linked hypophosphatemia (XLHR) is the most common genetic form of hypophosphatemic rickets (HR), which is caused by phosphate regulating endopeptidase homolog X-linked (PHEX) gene mutation. At present, the genotype–phenotype relationship of XLHR and the pathogenic role of PHEX are not fully understood. Methods In this study, we summarized clinical features in a new cohort of 49 HR patients and detected 16 novel PHEX and 5 novel non-PHEX variants. Subsequently, we studied the pathogenesis of new variants by protein expression, glycosylation analysis, subcellular localization, and endopeptidase activity. Results The results showed that missense variants (Q189H and X750R) slightly reduced protein expression without obviously altering protein length and localization, whereas truncating variants significantly impaired the synthesis of PHEX and produced a shorter immature protein in cells. Interestingly, no evident correlation was observed between mutation types and clinical phenotypes. However, when we analyzed the relationship between PHEX activity and serum phosphorus level, we found that patients with low PHEX activity tended to have severe hypophosphatemia and high rickets severity score. Following this observation, we established 2 new knock-in XLHR mouse models with 2 novel Phex variants (c.T1349C and c.C426G, respectively) using CRISPR/Cas9 technology. Both mouse models demonstrated clinical manifestations of XLHR seen in patients, and PhexC426G mice showed more severe phenotype than PhexT1349C mice, which further confirmed the rationality of genotype–PHEX enzymatic activity correlation analysis. Conclusion Therefore, our findings demonstrated that novel PHEX variants could disrupt protein function via affecting protein synthesis, post-translational modification, cellular trafficking, and catalytic activity. Our study facilitates a better understanding of XLHR pathogenic mechanism and PHEX activity-phenotype correlation, which is of crucial importance for future diagnosis and treatment of XLHR. [ABSTRACT FROM AUTHOR]

Aiming at the prediction model of bearing performance degradation based on recurrent neural network (RNN) and its variants ignores the feature spatial correlation, and cannot effectively handle long time series data, this paper proposes a rolling bearing performance degradation prediction model based on temporal graph convolutional neural network (T-GCN). For non-stationary and nonlinear characteristics of vibration signals, this paper introduces a rolling bearing feature evaluation method based on multiscale dispersion entropy (MDE) to better characterize time series. To effectively solve the spatial correlation problem between samples and features, this paper uses the topological structure of a path graph to build a graph model and combines gated recurrent unit (GRU) and graph convolutional neural network (GCN) to build a T-GCN prediction model. Finally, this article established a rolling bearing fault prediction experimental platform and validated it using the University of Cincinnati public dataset. The experiment shows that compared with GRU, GCN, and LSTM models, the RMSE and the MAE evaluation indicators based on the T-GCN model have decreased by 6 % to 28 % and 11 % to 28 %, respectively, which suggests that the T-GCN model has a higher prediction accuracy and a better model fitting goodness. [ABSTRACT FROM AUTHOR]

The utilization of polymer conformations to construct a variety of superlattices is a common method within the field. However, this technique often results in only long‐range ordering rather than the formation of distinct superlattices. In this study, a well‐organized array of discrete pancake‐shaped superlattices (DPSs) is successfully obtained through the utilization of air–liquid interface self‐assembly, facilitated by the confined environment created by a block copolymer. It is crucial to note that both the self‐assembly behavior and resulting morphologies of the DPSs can be precisely tuned by adjusting several experimental parameters, most notably the concentration and molecular architecture of the block copolymers. Furthermore, this work provides valuable insights into the formation processes and mechanisms underpinning the DPSs. The approach described here is both straightforward and efficacious, establishing a strong foundation for subsequent research and the development of non‐close‐packed superlattice structures. [ABSTRACT FROM AUTHOR]

This article explores the potential of plasma extrachromosomal circular DNA (eccDNA) as a diagnostic biomarker for distinguishing between benign and malignant thyroid nodules, specifically papillary thyroid carcinoma (PTC). The study utilizes Circle-seq technology and machine learning to analyze eccDNA profiles in plasma samples from healthy controls, nodular thyroid goitre patients, and PTC patients. The results show significant differences in eccDNA counts and genomic characteristics between the groups, suggesting the potential of eccDNA as a non-invasive biomarker for diagnosing thyroid cancer. However, the study acknowledges the limitation of a small sample size and the need for further research to validate the findings. [Extracted from the article]

The protection of ecological systems is currently a trending topic. Numerous countries have implemented various measures to safeguard ecosystems. Evaluating the effectiveness of regional ecological protection and cooperative conservation is of paramount importance. In this paper, Hainan Island, China, was taken as an example to construct an evaluation framework of the ecosystem change characteristics and conservation effects of different types of protected areas. In this way, the study evaluated the ecological status of important protected areas and the effects of collaborative management and control, and it discussed the changes in ecological status and protection effects. The results revealed the following. (1) Important protected areas occupy a large proportion of natural ecological space, reaching 76.33%, more than twice the proportion of ecological space on Hainan Island. In the past 20 years, the ecological space retention rate has increased by 0.57%. (2) The contribution of excellent-quality and good-quality ecosystems is the greatest, accounting for 82.65% of the whole island. In the past 20 years, the ec7osystem quality has improved in more than 80% of the areas. The proportion of excellent-quality and good-quality ecosystems is as high as 96.75% in these conservation areas, and their contribution to Hainan Island is 44.29%, while conservation areas only account for about 38%. (3) The ecosystem services of Hainan Island have improved and become stable in the past 20 years. The contribution of all types of protected areas to the ecosystem services of Hainan Island is more than 53.22%. In general, the ecological quality and service function has increased in Hainan Island, and the ecological space tends to be stable. Different types of protected areas have effectively protected various ecosystems on Hainan Island with different protection and management mechanisms. [ABSTRACT FROM AUTHOR]

U3Si2 is regarded as a promising accident tolerant fuel (ATF) to replace the commercial fuel UO2; however, grain boundary (GB) embrittlement of U3Si2 caused by irradiation-induced defect segregation remains to be clarified. In this work, the U3Si2 Σ5(210) symmetrically tilted GB is taken as a representative to elucidate the individual effect of xenon (Xe) and vacancy on the tensile strength and failure of GBs using first-principles calculations. Compared with the predicted segregation energies of defects at the most energetically favourable positions of GBs, Si vacancy (VSi) has a much stronger preference to segregate to GBs than that of Xe substitution on the Si sublattice (XeSi). Moreover, the strengthening/embrittlement potency of GBs with single vacancy/Xe is evaluated using the first-principles-based uniaxial tensile test. Although both VSi and XeSi yield a weakening effect on the strength of the U3Si2 Σ5(210) GB, such defective GBs exhibit significantly stronger interface strengths compared to the corresponding defects segregated to the UO2 Σ3(111) GB. The underlying mechanism of strength change of U3Si2 GBs is discussed in terms of charge analysis. Our results can provide a fundamental understanding of the mechanical behavior of irradiated GBs from an atomic perspective. [ABSTRACT FROM AUTHOR]

The primary concerns for individuals using lithium-ion batteries (LIBs) are aging and thermal runaway (TR). This paper focuses on the thermal runaway propagation (TRP) of cycling aged LIB modules. The impacts of state of charge (SOC), state of health, and cyclic aging temperature on TRP in LIB modules are investigated. The analysis includes parameters such as temperature, voltage, and mass of the modules during TRP. It was found that as SOC increases, the maximum increase in temperature and maximum temperature rate of the modules increased, as did the total mass loss and smoke emissions. The average heat transfer between adjacent cells was higher for the lower SOC. Cycle aging reduces the thermal stability of LIBs, leading to a lower maximum temperature and maximum temperature rate, as well as a larger mass loss compared with fresh battery modules. Regarding aging temperature, low-temperature aging reduces the total duration of TRP compared with room temperature, but it increases the maximum temperature rate and causes greater mass loss. Aging also increases the average heat transfer between adjacent cells. [ABSTRACT FROM AUTHOR]

Background: Chinese topography appears a three-rung ladder-like distribution of decreasing elevation from northwest to southeast, which is divided by two sloping edges. Previous studies have reported that prevalence of thyroid diseases differed by altitude, and geographical factors were associated with thyroid disorders. To explore the association between three-rung ladder-like regions and thyroid disorders according to unique Chinese topographic features, we conducted an epidemiological cross-sectional study from 2015–2017 that covered all 31 mainland Chinese provinces. Methods: A total of 78,470 participants aged ≥ 18 years from a nationally representative cross-sectional study were included. Serum thyroid peroxidase antibody, thyroglobulin antibody, and thyroid-stimulating hormone levels; urine iodine concentration; and thyroid volume were measured. The three-rung ladder-like distribution of decreasing elevation from northwest to southeast in China was categorized into three topographic groups according to elevation: first ladder, > 3000 m above sea level; second ladder, descending from 3000—500 m; and third ladder, descending from 500 m to sea level. The third ladder was further divided into groups A (500–100 m) and B (< 100 m). Associations between geographic factors and thyroid disorders were assessed using linear and binary logistic regression analyses. Results: Participants in the first ladder group were associated with lower thyroid peroxidase (β = -4.69; P = 0.00), thyroglobulin antibody levels (β = -11.08; P = 0.01), and the largest thyroid volume (β = 1.74; P = 0.00), compared with the other groups. The second ladder group was associated with autoimmune thyroiditis (odds ratio = 1.30, 95% confidence interval [1.18–1.43]) and subclinical hypothyroidism (odds ratio = 0.61, 95%confidence interval [0.57–0.66]) (P < 0.05) compared with the first ladder group. Group A (third ladder) (500–100 m) was associated with thyroid nodules and subclinical hypothyroidism (P < 0.05). Furthermore, group B (< 100 m) was positively associated with autoimmune thyroiditis, thyroid peroxidase and thyroglobulin antibody positivity, and negatively associated with overt hypothyroidism, subclinical hypothyroidism, and goiter compared with the first ladder group(P < 0.05). Conclusion: We are the first to investigate the association between different ladder regions and thyroid disorders according to unique Chinese topographic features. The prevalence of thyroid disorders varied among the three-rung ladder-like topography groups in China, with the exception of overt hyperthyroidism. [ABSTRACT FROM AUTHOR]

Background: The relationship between obesity and non-Hodgkin's lymphoma (NHL) was controversial, which may be due to the crudeness definition of obesity based on body mass index (BMI). As obesity and metabolic abnormalities often coexist, we aimed to explore whether the classification of obesity based on metabolic status can help to evaluate the real impact of obesity on the readmission of NHL. Methods: In this retrospective cohort study, utilizing the 2018 Nationwide Readmissions Database, we identified NHL-related index hospitalizations and followed them for non-elective readmission. The patients with NHL were classified as metabolically healthy non-obese (MHNO) and obese (MHO) and metabolically unhealthy non-obese (MUNO) and obese (MUO). Readmission rates for each phenotype were calculated at 30-day intervals. Multiple COX regression was used to analyze the association of metabolic-defined obesity with 30-day, 90-day, and 180-day readmission rates in patients with NHL. Results: There were 22,086 index hospitalizations with NHL included. In the multivariate COX regression, MUNO was associated with increased 30-day (HR = 1.113, 95% CI 1.036–1.195), 90-day (HR = 1.148, 95% CI 1.087–1.213), and 180-day readmission rates (HR = 1.132, 95% CI 1.077–1.189), and MUO was associated with increased 30-day (HR=1.219, 95% CI: 1.081-1.374), 90-day (HR = 1.228, 95% CI 1.118–1.348), and 180-day readmission rates (HR = 1.223, 95% CI 1.124–1.33), while MHO had no associations with readmission rates. Conclusions: The presence of metabolic abnormalities with or without obesity increased the risk of non-selective readmission in patients with NHL. However, obesity alone had no associations with the risk of non-selective readmission, suggesting that interventions for metabolic abnormalities may be more important in reducing readmissions of NHL patients. [ABSTRACT FROM AUTHOR]

In present study, a virtual prototype of self-propelled artillery was constructed based on virtual prototype technology, and the whole impact process of artillery firing simulation was completed using ADAMS and AMEsim software. Results showed that the constructed artillery firing simulation system was reasonable. It could add a recoil dynamic response suitable for live firing to the tested artillery and could detect the vibration response characteristics of the artillery through the test device. Through numerical simulation, a quantitative analysis of artillery firing stability, stress state, and fatigue life under different working conditions was performed. All simulation results were in good agreement with the real situation. This research provides a certain reference for the evaluation of artillery firing stability and lays a good theoretical foundation for the engineering development and practical application of the test device. [ABSTRACT FROM AUTHOR]

A conjugated computational fluid dynamics model using convective thermal boundaries is proposed for the thermal analysis of the regenerative cooling system of an X-51A-like hypersonic aircraft in conditions closer to realistic scenarios. By X-51A-like, we mean that the convective boundaries of the cooling system are determined according to the structure and flight conditions (Mach 6 and an altitude of 20 km) of the X-51A Waverider. The aerodynamic heating, supersonic combustion, and convective heat transfer with an interior (fuel tank) are simulated from an engineering perspective. The flow, heat transfer, and pyrolysis characteristics of endothermic hydrocarbon fuels (EHFs) flowing in B-channels (bottom), S-channels (side), and T-channels (top) considering buoyancy effect are simulated and compared. A distinct temperature distribution difference in the solid region is observed between the cases with different boundary conditions. However, the cooling performance of EHFs is insensitive to the type of thermal boundary. Five indices, the maximum temperature, outlet temperature, n-decane conversion, total heat sink, and pressure drop, are compared to comprehensively assess the cooling performance. The cooling demands in the B-channels and S-channels are about 1.3 times those in the T-channels because of the additional cooling effect from the adjacent fuel tank. This study should be of great significance in the practical and systematic design of regenerative cooling systems. [ABSTRACT FROM AUTHOR]

Background: Preterm infants presented a high prevalence of congenital hypothyroidism (CH), while the optimal screening pattern is still under debate. This study aimed at evaluating the characteristics of thyroid function by conducting weekly screening during the first month of life in very preterm infants (VPIs) to achieve timely diagnosis and treatment of CH. Methods: A prospective cohort study was carried out on VPIs born with gestational age (GA) <32 weeks (w) and admitted to the participating institutes from January 1, 2019 to December 31, 2022. Serial serum thyroid hormone levels were measured weekly within the first month after birth, and at 36 w of corrected age, or before discharge. Datasets for serial thyroid hormone levels and general information were obtained. Results: A total of 5992 VPIs were enrolled in this study, of which 456 (7.6%) [95% confidence interval (CI), 6.9–8.3%] were diagnosed with CH. The incidence of CH increased with lower GA, moving from 4.8% [CI, 3.4–6.1%] at GA 31 w to 16.9% [CI, 8.3–25.4%] at GA <26 w. Among the CH subjects, 57.7% [CI, 53.1–62.2%] were identified after the first screening and classified as delayed thyrotropin elevation (dTSH). With the decrease of GA, the proportion of dTSH also increased, moving from 38.1% [CI, 27.5–48.7%] at GA 31 w to 82.6% [CI, 65.8–99.4%] at GA <26 w. Through conducting weekly screening of thyroid function, it was remarkable that only 42.3% [CI, 37.8–46.9%] of CH subjects were diagnosed during the first screening. The cumulative rate of CH identified by rescreening performed at the second, third, and fourth week was 76.1% [CI, 72.2–80.0%], 90.6% [CI, 87.9–93.3%], and 98.9% [CI, 97.9–99.9%], respectively. Conclusion: The incidence of CH and dTSH both increase with lower GA in VPIs. Dynamic screening of thyroid function by weeks within the first month of life is crucial for the timely diagnosis and treatment of CH in VPIs, and it might effectively reduce the implications of missed diagnosis and delayed treatment. Clinical Trials Registration: ChiCTR1900025234 and ChiCTR2000037918 (Registration number). [ABSTRACT FROM AUTHOR]

Osteogenesis imperfecta (OI) is a connective tissue disorder affecting the skeleton and other organs, which has multiple genetic patterns, numerous causative genes, and complex pathogenic mechanisms. The previous classifications lack structure and scientific basis and have poor applicability. In this paper, we summarize and sort out the pathogenic mechanisms of OI, and analyze the molecular pathogenic mechanisms of OI from the perspectives of type I collagen defects(synthesis defects, processing defects, post-translational modification defects, folding and cross-linking defects), bone mineralization disorders, osteoblast differentiation and functional defects respectively, and also generalize several new untyped OI-causing genes and their pathogenic mechanisms, intending to provide the evidence of classification and a scientific basis for the precise diagnosis and treatment of OI. [ABSTRACT FROM AUTHOR]

Background: Continuous glucose monitoring (CGM) can help manage diabetes mellitus (DM) and prevent hypoglycemia. This study aimed to evaluate the performance and usability of a novel SiJoy GS1 CGM system. Methods: This multicenter trial enrolled participants with DM. Based on the comparison of glucose values measured by SiJoy GS1 CGM and venous blood glucose test, the 20/20% consistency and mean absolute relative difference (MARD%) were calculated, as well as Clarke and consensus error grid analysis. Product usability was evaluated by questionnaire completed by participants. Any occurrence of adverse events (AE) was documented. Results: Seventy participants were included in the study. The mean age of participants was 41.5 ± 13.2 years, among which 29 (42.0%) were male, with the DM course of 8.6 ± 7.5 years. A total of 39 (56.5%) of them had type 1 DM, 24 (34.8%) had type 2 DM, and 6 (8.7%) were others for DM. The 20/20% consistency achieved 91.82%, which was higher than the target 65%. The percentage of A + B zones of Clarke and consensus error grid was 99.22% and 99.90%, respectively. The MARD value was 8.83% ± 4.03%. The mean score of usability questionnaire was 86.59 ± 5.17 out of 90. AE were observed in only one participant (mild fever), and no severe AEs occurred. Conclusions: The SiJoy GS1 CGM system achieved satisfactory performance and usability. No severe AEs occurred and mild AE was reported in only one case. [ABSTRACT FROM AUTHOR]

Many indicators, including red cell distribution width (RDW) and iron metabolism, are sensitive to a variety of risk factors, and are associated with the pathological alterations and disease onset. RDW reflects the degree of heterogeneous volumes of peripheral red blood cells (RBCs). It has been well‐known that increased RDW indicates iron deficiency anemia, hemolytic anemia, ineffective erythropoiesis, and shorten lifespan of RBCs. Increased RDW is also prevalent in various non‐anemic pathological conditions and diseases. We here review the factors affecting RDW, particularly disordered iron metabolism, chronic inflammation, and oxidative stress, and recapitulate the interplays among these factors. Furthermore, we review the application of increased RDW together with disordered iron homeostasis and the deregulations of hepcidin expression and ferritin levels in the diagnoses and prognosis of anemic and nonanemic diseases. RDW is inexpensive and readily available and may be valuable in adding to the diagnosis and monitoring of many pathological conditions. RDW combined with other indicators, for example, hepcidin and ferritin levels, should be utilized more frequently in clinical practice. [ABSTRACT FROM AUTHOR]

Extensive attention has been paid to accident tolerant fuels (ATFs), such as uranium mononitride (UN) and uranium sesquisilicide (U3Si2), which are regarded as potential candidates to replace uranium dioxide (UO2) in light-water reactors (LWRs). However, the thermodynamic behavior of fission gas atoms in these fuels that can quantitatively affect the burnup characteristics of ATFs needs to be explored. To this end, systematic density functional calculations on the energetic properties of xenon (Xe)-vacancy complexes in UO2, UN and U3Si2 are performed with the GGA+U approach as well as the corrected chemical potential. The stabilities of Xe-vacancy clusters, including interstitial trap site (IS), mono-, bi- and tri-atomic vacancies, are thoroughly assessed. The formation energies of vacancy complexes indicate that they are more likely to form vacancy cluster defects and their complexes with Xe in UO2 and to generate mono-atomic vacancy and Xe-vacancy complexes in both UN and U3Si2. Xe can be strictly confined by the trap sites in UO2 and UN, and yet in U3Si2, it prefers to move to the centre of a large free volume trap site. The strong solubility of Xe in U3Si2 indicates the excellent storage capacity of fission gas products in the matrix. Overall, this work provides comprehensive insights into the origins of the interplay between Xe and vacancies as well as the thermodynamic behavior of defects in uranium-based fuels. [ABSTRACT FROM AUTHOR]

Coking deposition is a critical phenomenon for endothermal hydrocarbon fuel cooling that can significantly affect the performance of a regenerative cooling system. Because of the complicated interactions between fluid flow, heat transfer, fuel cracking, and precursor coking kinetics, previous numerical studies have been limited to simplified two-dimensional circular channels, which cannot reveal the actual spatial distribution with consideration of buoyancy effect in rectangular cooling channels. This work proposes a novel framework for shrinking motion with an O-type hybrid mesh, permitting the direct three-dimensional simulation of coke deposition in complex channels and the visualization of both the axial and circumferential deposition distributions. The concept is tested in a rectangular channel using n-decane as an example, combining a detailed pyrolysis kinetic model with the MC-II coking model, and predictive results have been obtained. Results indicate two locations with heavy deposition rates. The buoyancy effect is weakened due to the acceleration resulting from the reduced cross-sectional area of the channel by the coke layer. The coupling of the flow and pyrolysis is discussed in terms of the dimensionless Damköhler number. The maximum temperature after coking can be 138 K higher than the initial. However, the conversion of n-decane at outlet is decreased due to the reduced flow residence time. The decreased total heat sink per temperature increment and the higher pressure drop are also the penalties from coking. The new framework for the direct three-dimensional simulations of coking is significant for the comprehensive investigation of the efficiency of regenerative cooling. [ABSTRACT FROM AUTHOR]

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This article addresses the distributed consensus control for multiple Euler–Lagrange systems under directed networks with time-varying transmission delays. Only some followers can access the information of the leader; communication is directed between agents. A distributed adaptive event-triggered control protocol is designed for the two cases where the generalized velocity of the leader is constant/time varying. When the generalized velocity of the leader is time varying, a distributed adaptive observer is designed to make followers obtain the time-varying information of the leader. Then, Lyapunov stability theory and the Linear matrix inequality algorithm prove the tracking errors can converge to zero in a completely distributed chattering-free manner. With the event-triggered mechanism, the number of communications can be decreased, and the system update frequency and the energy consumption can be reduced effectively. Meanwhile, the elimination of the Zeno behavior is also proved. Finally, the simulation results verify the effectiveness of the two controllers. [ABSTRACT FROM AUTHOR]

Background: The present definition of obesity based on body mass index (BMI) is not accurate and effective enough to identify hospitalized patients with a heavier burden, especially for postmenopausal hospitalized patients concomitant with osteoporosis. The link between common concomitant disorders of major chronic diseases such as osteoporosis, obesity, and metabolic syndrome (MS) remains unclear. Here, we aim to evaluate the impact of different metabolic obesity phenotypes on the burden of postmenopausal hospitalized patients concomitant with osteoporosis in view of unplanned readmissions. Methods: Data was acquired from the National Readmission Database 2018. The study population was classified into metabolically healthy non-obese (MHNO), metabolically unhealthy non-obese (MUNO), metabolically healthy obese (MHO), and metabolically unhealthy obese (MUO) patients. We estimated the associations between metabolic obesity phenotypes and 30- and 90-day unplanned readmissions. A multivariate Cox Proportional Hazards (PH) model was used to assess the effect of factors on endpoints, with results expressed as HR and 95% CI. Results: The 30-day and 90-day readmission rates for the MUNO and MUO phenotypes were higher than that of the MHNO group (all p < 0.05), whereas no significant difference was found between the MHNO and MHO groups. For 30-day readmissions, MUNO raised the risk mildly (hazard ratio [HR] = 1.110, p < 0.001), MHO had a higher risk (HR = 1.145, p = 0.002), and MUO further elevated this risk (HR = 1.238, p < 0.001). As for 90-day readmissions, both MUNO and MHO raised the risk slightly (HR = 1.134, p < 0.001; HR = 1.093, p = 0.014, respectively), and MUO had the highest risk (HR = 1.263, p < 0.001). Conclusions: Metabolic abnormalities were associated with elevated rates and risks of 30- or 90-day readmission among postmenopausal hospitalized women complicated with osteoporosis, whereas obesity did not seem to be innocent, and the combination of these factors led to an additional burden on healthcare systems and individuals. These findings indicate that clinicians and researchers should focus not only on weight management but also metabolism intervention among patients with postmenopausal osteoporosis. [ABSTRACT FROM AUTHOR]

The normalized differential vegetation index (NDVI) for Landsat is not continuous on the time scale due to the long revisit period and the influence of clouds and cloud shadows, such that the Landsat NDVI needs to be filled in and reconstructed. This study proposed a method based on the genetic algorithm–artificial neural network (GA-ANN) algorithm to reconstruct the Landsat NDVI when it has been affected by clouds, cloud shadows, and uncovered areas by relying on the MODIS characteristics for a wide coverage area. According to the self-validating results of the model test, the RMSE, MAE, and R were 0.0508, 0.0557, and 0.8971, respectively. Compared with the existing research, the reconstruction model based on the GA-ANN algorithm achieved a higher precision than the enhanced spatial and temporal adaptive reflectance fusion model (ESTARFM) and the flexible space–time data fusion algorithm (FSDAF) for complex land use types. The reconstructed method based on the GA-ANN algorithm had a higher root mean square error (RMSE) and mean absolute error (MAE). Then, the Sentinel NDVI data were used to verify the accuracy of the results. The validation results showed that the reconstruction method was superior to other methods in the sample plots with complex land use types. Especially on the time scale, the obtained NDVI results had a strong correlation with the Sentinel NDVI data. The correlation coefficient (R) of the GA-ANN algorithm reconstruction's NDVI and the Sentinel NDVI data was more than 0.97 for the land use types of cropland, forest, and grassland. Therefore, the reconstruction model based on the GA-ANN algorithm could effectively fill in the clouds, cloud shadows, and uncovered areas, and produce NDVI long-series data with a high spatial resolution. [ABSTRACT FROM AUTHOR]

(1) Background: As the introduction of "positive" diagnostic criteria for metabolic dysfunction-associated fatty liver disease (MAFLD) does not exclude alcohol consumption, some patients originally diagnosed with alcoholic fatty liver disease (AFLD) may be diagnosed with dual- etiology fatty liver disease (AFLD&MAFLD), which requires us to urgently explore the impact of the changes in this classification of AFLD on clinical manifestations. (2) Methods: Utilizing data from the Nationwide Inpatient Sample database 2016–2018, a total of 9269 participants with AFLD were selected. With the definition of MAFLD, these patients were further categorized into two groups: single AFLD and AFLD&MAFLD. The primary outcome was the risk of comorbidities and organ failures. The secondary outcomes were the length of stay, total charges, and in-hospital all-cause mortality. (3) Results: The patients with AFLD&MAFLD were older, were predominantly male, and had more comorbidities and organ failures compared to the patients with AFLD. These comorbidities included coronary atherosclerosis, myocardial infarction, cerebrovascular disease, arrhythmia, asthma, chronic obstructive pulmonary disease, and chronic kidney disease (all p values < 0.05). The patients with AFLD&MAFLD were more likely to develop acute and chronic heart and/or kidney failures than those with single AFLD (all p < 0.05). The length of stay and total charges of the patients in the AFLD&MAFLD group were greater than the single AFLD group (p = 0.029 and p < 0.001, respectively). No significant difference in all-cause mortality was observed. (4) Conclusions: The patients with AFLD&MAFLD have more comorbidities and organ failures, longer hospital stays, and higher hospitalization costs than the patients with single AFLD. Hence, patients with dual-etiology fatty liver disease deserve more attention from clinical staff during treatment. [ABSTRACT FROM AUTHOR]

Background and aims: Regional muscle distribution is associated with abdominal obesity and metabolic syndrome. However, the relationship between muscle distribution and nonalcoholic fatty liver disease (NAFLD) remains unclear. This study was to determine the relationship between regional muscle distribution and the risk and severity of NAFLD. Methods: This cross-sectional study ultimately included 3161 participants. NAFLD diagnosed by ultrasonography was classified into three groups (non, mild, and moderate/severe). We estimated the regional body muscle mass (lower limbs, upper limbs, extremities, and trunk) through multifrequency bioelectrical impedance analysis (BIA). The relative muscle mass was defined as the muscle mass adjusted for the body mass index (BMI). Results: NAFLD participants accounted for 29.9% (945) of the study's population. Individuals with a higher lower limb, extremity, and trunk muscle mass had a lower risk of NAFLD (p < 0.001). Patients with moderate/severe NAFLD had a lower muscle mass of the lower limbs and trunk than patients with mild NAFLD (p < 0.001), while the muscle mass of the upper limbs and extremities did not differ significantly between the two groups. Moreover, similar results were found for both sexes and among different age groups. Conclusions: A higher muscle mass of the lower limbs, extremities, and trunk was negatively associated with the risk of NAFLD. A lower muscle mass of the limbs and trunk was inversely associated with the severity of NAFLD. This study provides a new theoretical basis for the development of individualized exercise prescriptions for the prevention of NAFLD in non-NAFLD patients. [ABSTRACT FROM AUTHOR]

A long-held belief is that pituitary hormones bind to their cognate receptors in classical target glands to actuate their manifold functions. However, a number of studies have shown that multiple types of pituitary hormone receptors are widely expressed in non-classical target organs. Each pituitary gland-derived hormone exhibits a wide range of nonconventional biological effects in these non-classical target organs. Herein, the extra biological functions of pituitary hormones, thyroid-stimulating hormone, follicle-stimulating hormone, luteinizing hormone, adrenocorticotrophic hormone, and prolactin when they act on non-classical organs were summarized, defined by the novel concept of an "atypical pituitary hormone–target tissue axis." This novel proposal explains the pathomechanisms of abnormal glucose and lipid metabolism, obesity, hypertension, fatty liver, and atherosclerosis while offering a more comprehensive and systematic insights into the coordinated regulation of environmental factors, genetic factors, and neuroendocrine hormones on human biological functions. The continued exploration of the physiology of the "atypical pituitary hormone–target tissue axis" could enable the identification of novel therapeutic targets for metabolic diseases. [ABSTRACT FROM AUTHOR]

Background and objectives: Patients with bladder cancer (BC) are at high risk for recurrence rates and readmission costs. However, the evidence about obesity and metabolic abnormalities on the BC prognosis was inconsistent. Our primary aim was to determine the impact of obesity and different metabolic status on the readmission risk in patients with BC. Design and methods: We identified 16,649 patients with BC using the 2018 Nationwide Readmissions Database who were hospitalized from January to June 2018 and followed for 180days. The primary outcome was 180-day readmission. The multivariate Cox regression analysis and ordered logistic regression were performed to analyze data. Results: Obesity and metabolic abnormalities were associated with an increased readmission risk in patients with BC [obesity: adjusted hazard ratio (aHR)=1.08, 95% confidence interval (CI): 1.01–1.16; hyperglycemia: aHR=1.11, 95% CI: 1.05–1.17; hypertension: aHR=1.09, 95% CI: 1.03–1.15]. Compared with non-obese and no metabolic abnormalities, the risk of readmission was significantly increased in patients with metabolic abnormalities, irrespective of obesity (non-obese and metabolic abnormalities: aHR=1.07, 95% CI: 1.02–1.13; obese and metabolic abnormalities: aHR=1.20, 95% CI: 1.10–1.31), but not in obese and no metabolic abnormalities. These associations were consistent in patients aged 60years or older and the surgery group. Moreover, hyperglycemia, hypertension, and a graded increment of metabolic risk were associated with an increased readmission risk. We also found increased length of stay for readmission in patients with obesity and metabolic abnormalities (aOR=1.17, 95% CI: 1.00–1.36). Conclusion: Obesity with metabolic abnormalities and metabolic abnormalities alone were associated with higher readmission risks in patients with BC. It is suggested that prevention should focus not only on obesity but also on metabolic abnormalities to decrease the risk of readmission. [ABSTRACT FROM AUTHOR]

Quantifying the microstructure of materials is of significance in material development, especially for building the relationship between structure and property. To establish a remarkable structure‐property (SP) linkage, a novel concept referred to as irregular‐representative volume element (IRVE) based on panoramic image stitching technology (PIST) is proposed and a data‐driven scheme integrating irregular domain‐oriented two‐point statistics, principal component analysis (PCA), and symbolic regression based on genetic programming (GPSR) is constructed. Combining with advanced image processing and genetic programming technologies, this scheme improves the microstructure quantization framework. This scheme can not only be applied in different complex conditions for extracting the information of a material microstructure, but can also to embody details of microstructure from the perspective of large scale. IRVE is demonstrated to have both strong statistical representativeness and sufficient physical interpretation, which makes the scheme robust and reliable. Performing the scheme on an example of ferrite heat‐resistant steels, it shows a powerful ability in building an equational SP linkage with high precision (R = 0.91, RMSE = 13.17), the generalization ability of the linkage is also validated by an unseen steel (relative percentage error is 2.66%). The scheme has bright application prospects in predicting mechanical property and accelerating alloy design. [ABSTRACT FROM AUTHOR]

Prader—Willi syndrome (PWS) is a rare congenital disease with genetic alterations in chromosome 15. Although genetic disorders and DNA methylation abnormalities involved in PWS have been investigated to a significant degree, other anomalies such as those in erythrocytes may occur and these have not been clearly elucidated. In the present study, we uncovered slight anemia in children with PWS that was associated with increased red blood cell (RBC) distribution width (RDW) and contrarily reduced hematocrit (HCT) values. Intriguingly, the increased ratio in RDW to HCT allowed sufficient differentiation between the PWS patients from the healthy controls and, importantly, with individuals exhibiting conventional obesity. Further morphologic examinations revealed a significant deformity in erythrocytes and mild hemolysis in PWS patients. Comprehensive mechanistic investigations unveiled compromised membrane skeletal assembly and membrane lipid composition, and revealed a reduced F-actin/G-actin ratio in PWS patients. We ascribed these phenotypic changes in erythrocytes to the observed genetic defects, including DNA methylation abnormalities. Our collective data allowed us to uncover RBC deformation in children with PWS, and this may constitute an auxiliary indicator of PWS in early childhood. [ABSTRACT FROM AUTHOR]

The dysfunction of Na+-Cl− cotransporter (NCC) caused by mutations in solute carrier family12, member 3 gene (SLC12A3) primarily causes Gitelman syndrome (GS). In identifying the pathogenicity of R158Q and G212S variants of SLC12A3, we evaluated the pathogenicity by bioinformatic, expression, and localization analysis of two variants from a patient in our cohort. The prediction of mutant protein showed that p.R158Q and p.G212S could alter protein's three-dimensional structure. Western blot showed a decrease of mutant Ncc. Immunofluorescence of the two mutations revealed a diffuse positive staining below the plasma membrane. Meanwhile, we conducted a compound heterozygous model—Ncc R156Q/G210S mice corresponding to human NCC R158Q/G212S. NccR156Q/G210S mice clearly exhibited typical GS features, including hypokalemia, hypomagnesemia, and increased fractional excretion of K+ and Mg2+ with a normal blood pressure level, which made NccR156Q/G210S mice an optimal mouse model for further study of GS. A dramatic decrease and abnormal localization of the mutant Ncc in distal convoluted tubules contributed to the phenotype. The hydrochlorothiazide test showed a loss of function of mutant Ncc in NccR156Q/G210S mice. These findings indicated that R158Q and G212S variants of SLC12A3 were pathogenic variants of GS. [ABSTRACT FROM AUTHOR]

Objective: Elevation of energy expenditure through an increase of brown adipose tissue (BAT) thermogenesis is regarded as one of the most promising ways to prevent obesity development. The preoptic area (POA) of the hypothalamus is a critical area for control of BAT thermogenesis. However, the intracellular signaling cascades in the POA for regulation of BAT thermogenesis are poorly understood.Methods: Phosphorylation proteomics (phosphoproteomics) and bioinformatics approaches were used to disclose numerous hypothalamic signaling pathways involved in the regulation of BAT thermogenesis. Conditional manipulation of the p38α gene in mouse POA was performed by stereotaxic injection of adeno-associated virus 9 vector to explore the role of p38α in BAT thermogenesis.Results: Multiple hypothalamic signaling pathways were triggered by cold exposure, especially the mitogen-activated protein kinase (MAPK) signaling pathway. The p38α activation, but not extracellular signal-regulated kinase 1/2 (ERK1/2) and c-Jun NH2-terminal kinase (JNK), in the hypothalamus was significantly decreased during cold exposure. p38α deficiency in the POA dramatically elevated energy expenditure owing to a marked increase in BAT thermogenesis, resulting in significantly decreased body weight gain and fat mass. Overexpression of p38α in the POA led to a dramatic increase in weight gain.Conclusions: These results demonstrate that p38α in the POA exacerbates obesity development, at least in part owing to a decrease in BAT thermogenesis. [ABSTRACT FROM AUTHOR]

Habitat suitability assessment is critical for wildlife population conservation and management planning. The MaxEnt model is widely used in species habitat suitability modeling. In order to investigate the habitat status of the black-necked crane in the Zoige grassland wetland ecological function area, this study evaluated the habitat suitability of the black-necked crane using the MaxEnt model with 152 occurrence records and 13 environmental variables. Based on the Akaike information criterion corrected for the small sample size, the best optimal parameter combination (feature class LQPHT, regularization multiplier 3.0) was selected. The results show that the Maxent model had good accuracy with an area under the curve (AUC) value of 0.895. Distance to roads, average summer precipitation, distance to lakes, and altitude are the dominant environmental variables affecting the potential distribution of black-necked cranes, with the contribution rates of 31.6%, 29.8%, 14.3%, and 8.2%, respectively. The suitable habitat area of black-necked cranes is mainly distributed in and around the Zoige Wetland National Nature Reserve, accounting for 46.49% of the Zoige Grassland Wetland National Key Ecological Function Zone. The potential distribution area has a tendency to spread to Hongyuan County in the south of the functional zone, and the unsuitable habitat is mainly distributed in the high-altitude area in the southwest of the functional zone. This study recommends focusing on the distribution area of black-necked cranes around Zoige Wetland National Nature Reserve and Hongyuan County to improve conservation strategies and strengthen protection efforts. [ABSTRACT FROM AUTHOR]

Objective. Astragalus mongholicus Bunge [Fabaceae] (AMB), a traditional Chinese medicine (TCM), has been widely used to treat liver diseases in the clinic. However, the efficacy and mechanism of AMB in the treatment of nonalcoholic fatty liver disease (NAFLD) remain unclear. The purpose of this study was to systematically investigate the active components and mechanisms of AMB against NAFLD based on network pharmacology, molecular docking, and experimental verification. Methods. First, the bioactive components and relevant targets of AMB were screened from the Traditional Chinese Medicine Systematic Pharmacology (TCMSP) database, and NAFLD-related targets were obtained from the GeneCards database. Then, the AMB-NAFLD protein target interaction network was built by the STRING database. GO and KEGG pathway enrichment analyses were performed using the DAVID database. The component targets were visualized using Cytoscape software. Finally, molecular docking and experiments were used to verify the results of network pharmacological prediction. Results. Network pharmacology predicted that quercetin may be the main active component in AMB, and the TNF and MAPK signaling pathways may be the key targets of AMB against NAFLD. Molecular docking validation results demonstrated that quercetin, as the main active component of AMB, had the highest binding affinity with TNF. Furthermore, quercetin played a distinct role in alleviating NAFLD through in vitro experiments. Quercetin upregulated the phosphorylation levels of AMPK and inhibited the expression of p-MAPK and TNF-α. In addition, we further discovered that quercetin could increase ACC phosphorylation and CPT1α expression in PA-induced HepG2 cells. Conclusions. Our results indicated that quercetin, as the main active component in AMB, exerts an anti-NAFLD effect by regulating the AMPK/MAPK/TNF-α and AMPK/ACC/CPT1α signaling pathways to inhibit inflammation and alleviate lipid accumulation. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to clarify the association of soy intake with cardiovascular disease (CVD) and all-cause mortality. Methods: We conducted a prospective cohort study in a Chinese population composed of 97,930 participants aged ≥ 40 years old without CVD at baseline in 2011. Habitual soy intake over a period of 12 months was evaluated using a food frequency questionnaire. All participants were classified into four groups based on their soy food consumption levels: < 15, 15–29, 30–59, and ≥ 60 g/day, with the lowest category as the reference group. Follow-up was conducted between 2014 and 2016 to assess CVD incidence and all-cause mortality since baseline, which was collected from the local mortality and disease registers of the National Disease Surveillance Point System and National Health Insurance System. The Cox proportional hazards regression models were used to analyze the relationship of soy intake with later CVD events and all-cause mortality. Results: During 350,604 person-years of follow-up (median [interquartile range]: 3.16 [2.98, 4.77] years), 2523 total CVD events and 1473 all-cause mortalities were documented. After controlling for covariates, the hazard ratios (95% confidence intervals) for total CVD events across increasing soy intake levels were 1.03 (0.93–1.14); 0.96 (0.86–1.07); and 0.86 (0.75–0.98; p for trend = 0.0434), while those for all-cause mortality were 0.88 (0.77–1.02); 0.86 (0.74–1.00); and 0.83 (0.69–0.99; p for trend = 0.0084). Conclusion: High soy intake was associated with a reduced risk of total CVD events and all-cause mortality among a Chinese population. [ABSTRACT FROM AUTHOR]

An intelligent alloy design strategy integrating machine learning and adaptive sampling is proposed and successfully applied to an example of martensitic stainless steel. Short iterative experiments prove the feasibility of this strategy in quickly finding new alloys with hardness higher than that of the current best and reasonably augmenting training data to create a high‐confidence prediction model. A credible relationship between the composition and hardness is demonstrated by the proposed model and the most promising candidate in the designed space is identified. In contrast to the traditional approaches, this strategy can meet the goal of global quest as it offers the advantages of flexibility, reliability, and efficiency. The suggested strategy can be extended to guide the experimental design of other materials. [ABSTRACT FROM AUTHOR]

Electrochemical oxygen reduction could proceed via either 4e−-pathway toward maximum chemical-to-electric energy conversion or 2e−-pathway toward onsite H2O2 production. Bulk Pt catalysts are known as the best monometallic materials catalyzing O2-to-H2O conversion, however, controversies on the reduction product selectivity are noted for atomic dispersed Pt catalysts. Here, we prepare a series of carbon supported Pt single atom catalyst with varied neighboring dopants and Pt site densities to investigate the local coordination environment effect on branching oxygen reduction pathway. Manipulation of 2e− or 4e− reduction pathways is demonstrated through modification of the Pt coordination environment from Pt-C to Pt-N-C and Pt-S-C, giving rise to a controlled H2O2 selectivity from 23.3% to 81.4% and a turnover frequency ratio of H2O2/H2O from 0.30 to 2.67 at 0.4 V versus reversible hydrogen electrode. Energetic analysis suggests both 2e− and 4e− pathways share a common intermediate of *OOH, Pt-C motif favors its dissociative reduction while Pt-S and Pt-N motifs prefer its direct protonation into H2O2. By taking the Pt-N-C catalyst as a stereotype, we further demonstrate that the maximum H2O2 selectivity can be manipulated from 70 to 20% with increasing Pt site density, providing hints for regulating the stepwise oxygen reduction in different application scenarios. Controlling O2 reduction pathways can help optimize catalytic activity and product selectivity. Here the authors report facile manipulation of 2e‒ /4e‒ pathways on Pt-coordinated motifs by varying the Pt site density or the coordination environment. [ABSTRACT FROM AUTHOR]

Background: Whether smoking modifies the associations of diabetes and risk factor management with subsequent risk of cardiovascular disease (CVD), and whether the smoking related CVD risk differs among people with and without diabetes are unclear. This study aimed to examine the associations and interactions of smoking, diabetes, and risk factor management in relation to incident CVD. Methods: This nationwide, population-based, prospective cohort study of 20 communities from various geographic regions recruited adults aged 40 years or older during 2011–2012. The follow-up survey was conducted between 2014 and 2016. This study included 126,181 participants who were free from CVD at baseline. Results: Study participants included 19,397 current smokers (15.4%), 6,049 former smokers (4.8%), and 100,735 never smokers (79.8%). Mean (SD) age ranged from 55.8 (8.6) years to 60.7 (9.1) years. Compared with never smokers, heavy smokers exhibited a greater risk of CVD events among participants with diabetes (multivariable-adjusted hazard ratio [HR], 1.45; 95% CI, 1.17–1.78) than among participants without diabetes (HR, 1.20; 95% CI, 1.01–1.42; P for interaction = 0.006). Compared with participants without diabetes, participants with diabetes who were never smokers and had 5 or more controlled risk factors showed no significantly excess CVD risk (HR, 0.93; 95% CI, 0.71–1.22), but the cardiovascular benefits from risk factor management were counteracted among participants with diabetes who were current smokers (HR, 1.28; 95% CI, 0.77–2.14) or former smokers (HR, 1.22; 95% CI, 0.66–2.28). Conclusions: Smoking and diabetes interacted with each other in relation to increased risk of CVD events, and the beneficial effect of risk factor management on CVD risk among participants with diabetes was attenuated by current or former smoking. [ABSTRACT FROM AUTHOR]

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Objective: Nonalcoholic fatty liver disease (NAFLD) is becoming a global public health challenge. A convenient NAFLD indicator will greatly facilitate risk appraisal and prevention. As a readily available and inexpensive hematological index in routine clinical examinations, red blood cells (RBCs) are gaining increasing attention in many diseases, such as metabolic syndrome, but their association with NAFLD is unknown. Methods: This health management cohort study included 27,112 subjects (17,383 non-NAFLD and 9,729 NAFLD) with up to 5 years of follow-up (median 2.8 years). NAFLD was diagnosed by ultrasonography. NAFLD severity was categorized as mild, moderate, or severe. The generalized estimation equation (GEE), an extension of generalized linear models that allows for analysis of repeated measurements, was used to analyze the association between RBC count and NAFLD. Results: Overall, 4,332 of 17,383 (24.9%) subjects without NAFLD at baseline developed NAFLD. Incident NAFLD risk was positively associated with RBC count. After adjustment for hemoglobin and other confounders, the risk of incident NAFLD was 21%, 32%, and 51% higher in the second, third, and fourth RBC count quartiles, respectively, than in the lowest quartile. In 1,798 of 9,476 (19.0%) subjects with NAFLD at baseline, the severity of NAFLD increased. NAFLD progression risk increased progressively as RBC count increased (P for trend < 0.001). Every one-unit (1012 cells/L) increase in RBC count was associated with a 53% [OR 1.53 (95% CI 1.32-1.77)] increased risk for NAFLD progression. Conclusions: Elevated RBC count was independently associated with a high risk of NAFLD incidence and progression. This finding revealed a convenient NAFLD risk indicator. [ABSTRACT FROM AUTHOR]

Aims: The aims of this study were to evaluate the associations of metabolic abnormalities with incident diabetic kidney disease (DKD) and to explore whether dyslipidaemia, particularly high fasting triglyceride (TG), was associated with the development of DKD. Methods: In total, 11 142 patients with new‐onset type 2 diabetes with baseline estimated glomerular filtration rates (eGFR) ≥60 mL/min/1.73 m2 were followed up during 2011‐2016. Incident DKD was defined as eGFR <60 mL/min/1.73 m2 at follow‐up. Multiple logistic regression analysis was conducted to explore the relationship of metabolic abnormalities at baseline and at follow‐up with risks of DKD. High TG was defined by TG ≥1.70 mmol/L. Low high‐density lipoprotein cholesterol (HDL‐c) was defined by HDL‐c <1.0 mmol/L for men or <1.3 mmol/L for women. Results: Participants who developed DKD had higher levels of waist circumference and systolic blood pressure, and lower levels of HDL‐c at both baseline and follow‐up visits. The DKD group also had higher levels of post‐load plasma glucose and TG at follow‐up. Multivariate logistic regression analysis revealed that both high TG at baseline [odds ratio (OR) = 1.37, p =.012) and high TG at follow‐up (OR = 1.71, p <.001) were significantly associated with increased risks of DKD. Patients with high TG levels at both baseline and follow‐up had higher risk of DKD compared with constantly normal TG (OR = 1.65, p <.001) after adjustment for covariates. Conclusions: In a large population of patients with new‐onset type 2 diabetes, a high TG level was an independent risk factor for the development of DKD. Tight TG control might delay the occurrence of DKD. [ABSTRACT FROM AUTHOR]

Seawater electrolysis to produce hydrogen is a critical technology in marine energy projects; however, the severe anode corrosion caused by the highly concentrated chloride is a key issue should be addressed. In this work, we discover that the addition of sulfate in electrolyte can effectively retard the corrosion of chloride ions to the anode. We take nickel foam as the example and observe that the addition of sulfate can greatly improve the corrosion resistance, resulting in prolonged operating stability. Theoretical simulations and in situ experiments both demonstrate that sulfate anions can be preferentially adsorbed on anode surface to form a negative charge layer, which repulses the chloride ions away from the anode by electrostatic repulsion. The repulsive effect of the adsorbed sulfate is also applicable in highly‐active catalyst (nickel iron layered double hydroxide) on nickel foam, which shows ca. 5 times stability of that in traditional electrolyte. [ABSTRACT FROM AUTHOR]

Seawater electrolysis to produce hydrogen is a critical technology in marine energy projects; however, the severe anode corrosion caused by the highly concentrated chloride is a key issue should be addressed. In this work, we discover that the addition of sulfate in electrolyte can effectively retard the corrosion of chloride ions to the anode. We take nickel foam as the example and observe that the addition of sulfate can greatly improve the corrosion resistance, resulting in prolonged operating stability. Theoretical simulations and in situ experiments both demonstrate that sulfate anions can be preferentially adsorbed on anode surface to form a negative charge layer, which repulses the chloride ions away from the anode by electrostatic repulsion. The repulsive effect of the adsorbed sulfate is also applicable in highly‐active catalyst (nickel iron layered double hydroxide) on nickel foam, which shows ca. 5 times stability of that in traditional electrolyte. [ABSTRACT FROM AUTHOR]

Background: Berberine and Bifidobacterium have been reported to improve glucose tolerance in people with hyperglycemia or other metabolic disorders. This study aimed to assess the hypoglycemic effect and the regulation of the gut microbiota caused by berberine and Bifidobacterium and the possible additive benefits of their combination. Methods: This was an 18-week, multi-center, randomized, double-blind, parallel-controlled study of patients newly diagnosed with hyperglycemia. After a 2-week run-in period, 300 participants were randomly assigned to the following four groups for 16 weeks of treatment: berberine (Be), Bifidobacterium (Bi), berberine and Bifidobacterium (BB), and placebo group. The primary efficacy endpoint was the absolute value of fasting plasma glucose (FPG) compared with baseline after 16 weeks of treatment. Results: Between October 2015 and April 2018, a total of 297 participants were included in the primary analysis. Significant reductions of FPG were observed in the Be and BB groups compared with the placebo group, with a least square (LS) mean difference of − 0.50, 95% CI [− 0.85, − 0.15] mmol/L, and − 0.55, 95% CI [− 0.91, − 0.20] mmol/L, respectively. The Be and BB groups also showed significant reductions in 2-h postprandial plasma glucose. A pronounced decrease in HbA1c occurred in the BB group compared to the placebo group. Moreover, compared with the Bi and placebo groups, the Be and BB groups had more changes in the gut microbiota from the baseline. Conclusions: Berberine could regulate the structure and function of the human gut microbiota, and Bifidobacterium has the potential to enhance the hypoglycemic effect of berberine. These findings provide new insights into the hypoglycemic potential of berberine and Bifidobacterium. Trial registration: ClinicalTrials.gov, NCT03330184. Retrospectively registered on 18 October 2017 [ABSTRACT FROM AUTHOR]

Aim: To investigate whether the cardiorenal benefits of the sodium‐glucose co‐transporter‐2 inhibitor empagliflozin are affected by body mass index (BMI) in type 2 diabetes patients with established cardiovascular (CV) disease, including Asians. Methods: In this exploratory analysis of the EMPA‐REG OUTCOME trial, we used Cox regression to evaluate the effects of empagliflozin on all‐cause mortality, hospitalization for heart failure (HHF) or CV death, and incident or worsening nephropathy by baseline BMI category. Results: Of the 7020 participants (1517 Asians [21.6%]), 934 (13.3%), 2465 (35.1%) and 3621 (51.6%) had a BMI of less than 25, 25 to less than 30, and 30 kg/m2 or higher, respectively. Overall, hazard ratios for empagliflozin versus placebo for all‐cause mortality, HHF or CV death, and incident or worsening nephropathy were 0.68 (95% CI 0.57, 0.82), 0.66 (0.55, 0.79) and 0.61 (0.53, 0.70), respectively, and were consistent across BMI categories (P values for interaction between treatment and BMI were.6772,.3087 and.6265, respectively). Results were similar in Asians using these BMI categories and categories of less than 24, 24 to less than 28, and 28 kg/m2 or higher. Conclusion: Empagliflozin reduced cardiorenal and mortality risk regardless of BMI at baseline, including in Asians with a lower BMI. [ABSTRACT FROM AUTHOR]