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ObjectiveType 2 diabetes mellitus and metabolic dysfunction-associated steatotic liver disease (diabetic MASLD) frequently coexist and worsen liver and non-liver outcomes, but effective pharmacological therapies are limited. We aimed to evaluate the long-term effect of sodium-glucose cotransporter-2 inhibitor (SGLT-2i) on liver and non-liver outcomes among patients with diabetic MASLD.DesignThis population-based cohort study retrieved patients with diabetic MASLD from Merative Marketscan Research Databases (April 2013 and December 2021). The active comparator was other glucose-lowering drugs (oGLDs). Primary outcomes were liver complications including hepatocellular carcinoma (HCC) and liver cirrhosis, as well as non-liver complications including cardiovascular disease (CVD), chronic kidney disease (CKD) and non-liver cancer. Propensity score matching was applied and Cox regression models were conducted.ResultsCompared with oGLD, SGLT-2i users had significantly lower risk of HCC (HR 0.76, 95% CI 0.62 to 0.93), liver cirrhosis (HR 0.80, 95% CI 0.76 to 0.84), CVD (HR 0.82, 95% CI 0.79 to 0.85) and CKD (HR 0.66, 95% CI 0.62 to 0.70), non-liver cancer (HR 0.81, 95% CI 0.76 to 0.86). Compared with patients without metformin and SGLT-2i, a stepwise decreasing risk was observed in users of either metformin or SGLT-2i (HRs 0.76–0.97) and in users of both medications (HRs 0.58–0.79). The lower risk also was shown in liver decompensation, compensated cirrhosis, major CVD, end-stage renal disease and specific common cancers (HRs 0.61–0.84).ConclusionIn a nationwide cohort, SGLT-2i users were associated with a substantially lower risk of liver and non-liver complications than oGLD users among patients with diabetic MASLD. The risk was further reduced with concomitant metformin use.

ObjectiveWhether varying degrees of glycaemic control impact colonic neoplasm risk in patients with diabetes mellitus (DM) remains uncertain.DesignPatients with newly diagnosed DM were retrieved from 2005 to 2013. Optimal glycaemic control at baseline was defined as mean haemoglobin A1c (HbA1c)<7%. Outcomes of interest included colorectal cancer (CRC) and colonic adenoma development. We used propensity score (PS) matching with competing risk models to estimate subdistribution HRs (SHRs). We further analysed the combined effect of baseline and postbaseline glycaemic control based on time-weighted mean HbA1c during follow-up.ResultsOf 88 468 PS-matched patients with DM (mean (SD) age: 61.5 (±11.7) years; male: 47 127 (53.3%)), 1229 (1.4%) patients developed CRC during a median follow-up of 7.2 (IQR: 5.5–9.4) years. Optimal glycaemic control was associated with lower CRC risk (SHR 0.72; 95% CI 0.65 to 0.81). The beneficial effect was limited to left-sided colon (SHR 0.71; 95% CI 0.59 to 0.85) and rectum (SHR 0.71; 95% CI 0.57 to 0.89), but not right-sided colon (SHR 0.86; 95% CI 0.67 to 1.10). Setting suboptimal glycaemic control at baseline/postbaseline as a reference, a decreased CRC risk was found in optimal control at postbaseline (SHR 0.79), baseline (SHR 0.71) and both time periods (SHR 0.61). Similar associations were demonstrated using glycaemic control as a time-varying covariate (HR 0.75). A stepwise greater risk of CRC was found (Ptrend<0.001) with increasing HbA1c (SHRs 1.34, 1.30, 1.44, 1.58 for HbA1c 7.0% to <7.5%, 7.5% to <8.0%, 8.0% to <8.5% and ≥8.5%, respectively). Optimal glycaemic control was associated with a lower risk of any, non-advanced and advanced colonic adenoma (SHRs 0.73–0.87).ConclusionGlycaemic control in patients with DM was independently associated with the risk of colonic adenoma and CRC development with a biological gradient.

ObjectiveChina concentrates a large part of the global burden of HBV infection, playing a pivotal role in achieving the WHO 2030 global hepatitis elimination target.MethodsWe searched for studies reporting HBV surface antigen (HBsAg) seroprevalence in five databases until January 2023. Eligible data were pooled using a generalised linear mixed model with random effects to obtain summary HBsAg seroprevalence. Linear regression was used to estimate annual percentage change (APC) and HBsAg prevalence in 2021.Results3740 studies, including 231 million subjects, were meta-analysed. HBsAg seroprevalence for the general population decreased from 9.6% (95% CI 8.4 to 10.9%) in 1973–1984 to 3.0% (95% CI 2.1 to 3.9%) in 2021 (APC=−3.77; p<0.0001). Decreases were more pronounced in children <5 years (APC=−7.72; p<0.0001) and 5–18 years (−7.58; p<0.0001), than in people aged 19–59 years (−2.44; p<0.0001), whereas HBsAg seroprevalence increased in persons ≥60 years (2.84; p=0.0007). Significant decreases were observed in all six major Chinese regions, in both men (APC=−3.90; p<0.0001) and women (−1.82; p<0.0001) and in high-risk populations. An estimated 43.3 million (95% uncertainty interval 30.7–55.9) persons remained infected with HBV in China in 2021 (3.0%), with notable heterogeneity by region (<1.5% in North China to>6% in Taiwan and Hong Kong) and age (0.3%, 1.0%, 4.7% and 5.6% for <5 years, 5–18 years, 19–59 years and ≥60 years, respectively).ConclusionsChina has experienced remarkable decreases in HBV infection over the last four decades, but variations in HBsAg prevalence persist in subpopulations. Ongoing prevention of HBV transmission is needed to meet HBV elimination targets by 2030.Trial registration numberPROSPERO (CRD42021284217)

Improving the electrical conductivity is an important role in realizing high thermoelectric performance of solution-processable polymers. Herein, a simple and robust approach to boost the mobility and doping efficiency of a diketopyrrolopyrrole-based copolymer with the introduction of thermocleavable side chains (PDPPS-X, where Xis the molar ratio of the thermocleavable side chains and alkyl chains) is first provided. Notably, the incorporated thermocleavable groups can be effectively removed after thermal treatment and therefore contribute to the crystalline domain formation via hydrogen-bonded networks, which is critical for conductivity enhancements. Grazing incidence wide-angle X-ray scattering (GIWAXS) patterns give a clear indication that the thermal treatment of PDPPS-5 can greatly improve the structural arrangement, resulting in a significantly enhanced hole mobility (5.4 times that of PDPPS-0 without thermocleavable chains). Compared to PDPPS-0, a larger Fermi level shift is observed after doping PDPPS-5 with FeCl3, reflecting a better doping efficiency. Consequently, remarkably improved conductivity and power factor are achieved by PDPPS-5 after doping with 0.03 M FeCl3at room temperature, which are about 2.2 and 3.5 times higher than that of PDPPS-0 at the same testing condition, respectively. Moreover, PDPPS-5 achieved a maximum power factor of 57.5 μW m–1K–2at 404 K.

Single-walled carbon nanotubes (SWCNTs)/organic small molecules (OSMs) are promising candidates for application in thermoelectric (TE) modules; however, the development of n-type SWCNT/OSMs with high performance is lagging behind. Only a few structure–activity relationships of OSMs on SWCNT composites have been reported. Recently, we find that the n-type acridone/SWCNT composites display high power factor (PF) values at high temperature but suffer from low PFs at room temperature. Here, the performance of SWCNT composites containing an acridine derivative (AD) as well as its analogues with different counterions (Cl–, SO42–and F–) and lengths of alkyl chains (ADLA1–2 and ADLA4–5) is reported. Among the composites, SWCNT/ADLA4 with no counterions exhibits the highest PF value of 195.2 μW m–1K–2at room temperature, which is 4.9 times higher than that of SWCNT/ADTAd (39.8 μW m–1K–2), indicating that the acridine scaffold and the lengths of alkyl chains contribute to the dramatic changes in the TE performance. In addition, SWCNT/ADLA4 exhibits high PF values at all the temperatures we investigate, which range from 154.7 to 230.7 μW m–1K–2. Furthermore, a TE device consisting of five pairs of p (the pristine SWCNTs)–n (SWCNT/ADLA4) junctions is assembled, generating a relatively high open-circuit voltage (41.7 mV) and an output power of 1.88 μW at a temperature difference of 74.8 K. Our results suggest that structural modifications might be an effective way to advance the development of TE materials.