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Study Objectives: Diabetic ketoacidosis (DKA) is a common and serious endocrine emergency. Common triggers for diabetic ketoacidosis include infection, cardiovascular events, drug use, medication non-adherence, and new onset diabetes. Early evidence suggests a correlation between COVID-19 infection and DKA. Based on the limited data, it is unclear at this time if increases in DKA are triggered by acute COVID-19 infection, or secondary factors from the pandemic such as lack of access to care or acute stress. In this study, we examine trends in DKA prevalence among patients at an underserved urban public ED within the context of the COVID-19 pandemic. Methods: This is a retrospective study using administrative report data of all ED encounters. Cases of DKA, found using top 5 ICD10 ED diagnoses, were identified from 2019 and 2020. COVID-19 infection was pulled from laboratory data and merged to create one data set. Poisson regression was utilized to compare incidence rates of DKA (1) between 2019 and 2020 and (2) among COVID positive and COVID negative patients with DKA for the year of 2020. Yearly trends were examined month by month. Results: There were 180,158 patient visits in 2019 and 138,012 in 2020. Compared to 2019, incidence rates of DKA increased by 23% in 2020 (95% CI 4% to 42%, p=0.017). Among all those tested for COVID in 2020 (n=25,867), patients with positive COVID-19 tests trended to higher DKA rate (37% higher (95% CI -6% to 81% increase, p=0.098) than patients with negative COVID-19 tests. The increase was most prominent from April 2020 onward, with the largest increase in December 2020, correlating with the COVID surge at our hospital. (Figure 1). In December 2019, 20 out of 14,324 visits (0.14%) were coded as DKA, while in December 2020, 37 out of 10,942 visits (0.34%) were coded DKA. In December 2020, 11 DKA cases were COVID-19 positive and 26 were COVID-19 negative. When excluding the 11 cases of DKA with positive COVID-19 tests, the rate of DKA in 12/2020 would be 0.24%. Conclusions: We found the incidence rate ratio of DKA in 2020 increased compared to 2019, with an almost doubling of DKA rates in the month of December, the peak months of our pandemic surge. Our findings suggest a correlation between COVID-19 positivity and DKA, but is limited by small numbers at a single site. There is also limited data to suggest secondary factors may also play a role in increased rates. When removing COVID positive DKA cases in December 2020, the prevalence that month continued to 0.10% higher than in December 2019. While small numbers prevent firm conclusions, itis possible factors outside of COVID infection are attributing to higher rates. Various studies have shown reduced access to care for conditions managed in ambulatory settings during the COVID pandemic. Given this, decreased access to care for medication refill and titration may also be contributing to the rise in DKA rates. As more data becomes available, further research is required to establish the role of access to care versus inflammation from COVID-19 infection in triggering DKA. [Formula presented]

The stability problem of conducting fluid flow in a square duct with perfectly conducting walls is investigated. A homogeneous and constant static magnetic field is applied along the vertical direction of the flow. Nonmodal linear stability analysis is performed on this problem for the first time and the effect of the imposed magnetic field is also taken into account. The amplification and distribution of primary optimal perturbations are obtained by solving iteratively the direct and adjoint governing equations with respect of perturbations. Four modes of perturbations with different symmetries in the space are investigated. Computational results show that, the MHD duct flow is stable at either small or large Hartmann number, but unstable at moderate one. The primary optimal perturbations are in the form of streamwise vortices, which are located inside the thin sidewall layers parallel to the magnetic field. The size of the vortices is decreased with the growing of Hartmann number Ha, meanwhile the amplification of the perturbations is reduced due to the magnetic damping effect. The Hartmann layer perpendicular to the magnetic field seems to be irrelevant to the stability of the MHD duct flow. The most unstable perturbation is in the form of Mode I, which having co-rotating vortices at opposite sidewalls and the vortices tend to enhance each other.

Sheep production systems in northwest China depend mostly on natural grasslands. Seasonal growth and maturity fluctuations can cause periodical restrictions in food quality and quantity. These fluctuations, in turn, result in variability in fat deposition and fatty acid profiles in different fat depots. Consequently, the study objective was to compare fat deposition, intramuscular fat (IMF) percentage and fatty acid profiles of the longissimus dorsi (LD), kidney fat (KF), tail fat (TF), and subcutaneous fat (SF) in lambs under ME restrictions similar to seasonal changes observed in the natural grasslands of northwest China. Nineteen male Dorper × Small Tailed Han lambs were assigned to 2 treatments, a control (CON) fed at 1.0 MJ / W × d and restricted (RES) by restricting ME sequentially every 30 d (0.56 MJ / W × d, 0.84 / W × d, 1.0 MJ / W × d, 0.84 MJ / W × d, 0.56 MJ / W × d, 0.28 MJ / W × d). All lambs were harvested at the end of the 180 d experimental period. Compared to CON fed lambs, restricting ME resulted in lesser IMF, fat deposition indexes ( < 0.05) except testicular and heart fat and greater ( < 0.05) SFA in LD, KF, and TF depots. The RES fed lambs had greater ( < 0.05) -3 PUFA, eicosatrienoic acid (C20:3n3), eicosapentaenoic acid (C20:5n3, EPA), and trans-linolelaidic acid (C18:2n6t) in LD muscle. The conjugated linoleic acids (CLA) content was greater in the SF depots of the CON fed lambs compared to the RES fed lambs. Fatty acid ratios (unsaturated fatty acid; USFA:SFA, MUFA:SFA, PUFA:SFA), and percentage USFA in RES fed lambs were lesser in muscle and adipose tissue compared to CON fed lambs ( < 0.05), except SF depots. In RES fed lambs, EFA were less ( < 0.05) in LD and KF depots and the ratios of functional fatty acids were lesser in LD and some adipose tissues ( < 0.05), including lesser n-6:n-3 in KF and SF ( < 0.05) depots, lesser USFA, SFA, MUFA, SFA in LD, KF, and TF ( < 0.05) depots, and lesser PUFA and SFA in LD and TF ( < 0.05) depots. Results from this research demonstrate that sequential energy restriction, as might be experience during seasonal forage quality and quantity changes in natural grasslands, result in lesser intramuscular fat with associated lesser quality, as well as, changes in fatty acid composition in different fat depots, which has implications for both meat quality and animal physiological functions.

Parvalbumins (PVALBs) are particularly abundant in the fast-contracting muscles and correlate positively with muscle relaxation speed in amphibians and fishes. MiRNAs play important roles in diverse biologic processes via binding to the 3’ untranslated region (3’UTR) of the target mRNAs. In the study, four PVALB isoforms, named as PVALB1, 2, 3, and 4, were identified in the mandarin fish ( Siniperca chuatsi ) fast muscle and PVALB4 exhibited the highest expression level among them. By bioinformatics analysis, a putative miR-181a binding site in PVALB4 was detected and the direct interaction between miR-181a and PVALB4 was confirmed with the luciferase reporter assay. Further, when miR-181a was inhibited, it substantially increased PVALB4 mRNA expression level and the muscle relaxation rate in vivo . Taken together, the obtained results suggest that miRNA-181a/PVALB4 is an evolutionarily conserved miRNAtarget pair and their interaction is correlated with muscle relaxation rate in the mandarin fish. Therefore, the study revealed a novel molecular mechanism in the regulation of skeletal muscle relaxation in fish.

We investigated the effects of ventilator mask atomization inhalation of ipratropium bromide and budesonide suspension liquid in the treatment of acute exacerbation COPD (AECOPD) on circulating levels of inflammatory factors and prognosis.A total of 86 cases of patients on ventilator support were randomly divided into control group and observation group with 43 cases each. The control group was administered routine treatment including basic disease treatment, anti-infection, maintenance of a stable internal environment, nutritional support, oxygen inhalation and so on. The control group was administered saline through a ventilator mask. The observation group was treated with atomized inhalation of ipratropium bromide and budesonide suspension and oxygen flow 3-5 L/min, 15-20 min/time and twice a day for 1 week. The treatment effects were compared.Serum TNF-α, IL-6, and CRP levels were decreased in both groups after treatment, but levels in the observation group were significantly lower than those of the control group; differences were statistically significant (p0.05). Forced vital capacity (FVC), forced expiratory volume (FEV1), FEV1/FVC and maximal expiratory flow rate in the observation group were significantly higher than those in the control group after treatment (p0.05). After treatment, the PaO2, SpO2 and respiratory failure index (RFI) of the observation group were significantly higher than those of the control group. The PaCO2 levels of the observation group were lower than those of the control group. The differences were statistically significant (p0.05). The clinical efficacy of the observation group was better than that of the control group; the ventilation time and total treatment time was significantly shorter and the differences were statistically significant (p0.05).The ventilator mask atomizing inhalation of ipratropium bromide and budesonide suspension liquid in the treatment of AECOPD can significantly improve circulating inflammatory reaction, improve lung function and blood gas levels, increase the treatment efficiency, and shorten the treatment time.

The formation of microspheres from various pectin hydrogel complexes and corn zein in the presence of calcium and zinc ions has been studied. It is shown that the formation of microspheres and their loading capacity for a drug (piroxicam) depend on the type of biopolymers, their ratio, the sizes of the bivalent ions, and the molecular mass of the pectin. Complex formation between the two biopolymers results predominantly from bivalent metal cross-linking for low-methylated pectins and from hydrophobic interaction for high-methylated pectins. As a result, a series of microspheres have been prepared from biodegradable and biocompatible polymers and may find application as controlled-release drug delivery systems.

Kidney transplantation (KTx) recipients are at a higher risk of oncogenesis when compared to the general population. Sirolimus (SRL), a potent immunosuppressant, has shown promising antineoplastic effects in vitro and in vivo. This study retrospectively analyzed the neoplasm occurrence and the efficiency of SRL on unresectable malignancies in South Chinese KTx recipients. Thirty-three (1.64%) of 2017 patients who received KTx from January 1984 to December 2004 developed neoplasms at 4 to 117 months posttransplant, mostly in digestive organs (33.3%), the hematologic system (15.2%), or the skin (12.1%). The most common type was liver cancer (24.2%), followed by skin cancer, lymphoma, and thyroid cancer (9.1%). The median survival times were 41.5 and 6.0 months for those who did (n = 10) receive radical surgery or did not (n = 23), respectively. The 20-month survival rates were 70.0% versus 13.0% (P

Piroxicam ex vivo release kinetics from zein/pectin drug delivery systems were studied using rat cecum. The piroxicam release kinetic parameters were calculated using a first-order equation and the Peppas equation. The results indicated that diffusion of the therapeutic agent was the rate-limiting step in piroxicam release from the hydrogel microspheres. The created therapeutic drug forms based on biodegradable polymers were an alternative to the peroral administration of most drugs with limited bioavailability.

To establish through analysis of the radial pressure pulse waveform the dose dependent effects of glyceryl trinitrate (GTN) on properties of different blood vessels.Radial pulse waveform was measured in randomised order before, during a five hour application of a GTN patch delivering 0.104-0.625 mg/h, and for two hours after patch removal. The radial pressure waveform (Millar applanation tonometer) was convolved into an ascending aortic wave using a generalised transfer function (SphygmoCor process) enabling measurement of aortic systolic, diastolic, pulse, mean, and augmented pressure and left ventricular ejection duration in addition to standard brachial cuff pressures.Fu Wai and Ren Ming hospitals in Beijing, China.46 recumbent hospitalised patients aged 56 (9) years, awaiting electrophysiological or other diagnostic studies, fasting, and with other treatments suspended.Conventional brachial pressure measures and data from the synthesised aortic pulse.There was no consistent change in heart rate or brachial pressures except for a decrease in systolic and pulse pressures (p0.01) at dose0.416 mg/h. In contrast, there were substantial and significant (p0.0001) decreases in aortic systolic, pulse, and augmented pressures at all doses, mean pressure (p0.001) at doses0.416 mg/h, and ejection duration (p0.001) at doses0.208 mg/h.Pulse waveform analysis exposes dose dependent effects of GTN on the aortic waveform, suggesting muscular conduit arterial dilatation with reduced wave reflection at the lowest dose, arteriolar dilatation and decreased peripheral resistance at the highest dose, and venous dilatation at the intermediate dose.

The complete charge distribution of products from Au nuclei fragmenting in nuclear emulsion at 10.7A GeV has been measured. Multiplicities of produced particles and particles associated with the target source are used to select peripheral and central events. A statistical analysis, based on event-by-event charge distributions, show that a population of subcritical, critical and supercritical events, i.e. a phase transition like behaviour, is observed among peripheral collisions.

The effective potential of the scalar ϕ4 theory up to two loops is calculated. The subtraction scheme of regularization at finite temperature in real-time formalism is discussed.

The mechanism for producing slow, target associated particles in high energy heavy ion collisions is investigated. It is shown that the same mechanism which was proposed for hadron induced interactions is likely to appear also for heavy-ion reactions. The results indicate however a much weaker correlation between impact parameter and yield of slow particles.

Three collaborative studies on the relationship between blood pressure (BP) and urinary electrolytes confirmed a positive intrapopulation relationship between sodium (Na) intake and BP, especially in the Nothern districts of China. In the present article, data of overnight urinary electrolytes and BP of 3,251 subjects from 16 districts of China were pooled and analyzed. A consistent significantly positive correlation was shown between BP and UNa/UK ratio

As a part of the international cooperative Cardiovascular Diseases and Alimentary Comparison (CARDIAC) Study, we carried out surveys for the relationship of dietary factors to blood pressure (BP) in 10 areas in China. Systolic BP and diastolic BP were significantly positively associated with salt excretion and body mass index

In differentiating human preadipocytes glucose uptake in the presence of insulin is a prerequisite for lipid accumulation. The aim of this study was to characterize the insulin-regulated glucose transport system during and after differentiation.Human adipocyte precursor cells kept in primary culture were allowed to differentiate into fat cells under serum-free hormone-supplemented conditions. 2-Deoxy-glucose uptake was measured as a functional parameter of the glucose transport system, the amount of GLUT1 and GLUT4 protein was determined by Western blotting.In the undifferentiated state, cells did not increase 2-deoxy-glucose uptake in response to insulin. On day 16, when cells have acquired the adipocyte phenotype, there was a 3-4-fold stimulation of glucose transport by insulin compared to basal rates, whereas basal glucose uptake was dramatically diminished. Measurement of GLUT4 protein in cell extracts, showed a marked increase in the amount of this insulin-regulated transporter isoform during the differentiation period. On average, the amount of GLUT4 was 16.7-fold greater after than before differentiation. In contrast, the amount of GLUT1 protein decreased during differentiation to almost undetectable levels on day 16. When newly developed adipocytes were maintained in culture for another 14d, the stimulation of glucose uptake and the amount of GLUT4 remained stable.Differentiating human fat cells in primary culture develops an insulin-responsive glucose transport system which exhibits a high stability, thereby providing a valuable model for long-term studies of glucose transport and GLUT4 expression in human adipocytes.

Three collaborative studies on the relationship between blood pressure (BP) and urinary electrolytes confirmed a positive intrapopulation relationship between sodium (Na) intake and BP, especially in the northern districts of China. In the present article, data of overnight urinary electrolytes and BP of 3,251 subjects from 16 districts of China were pooled and analyzed. A consistent significantly positive correlation was shown between BP and UNa/UK ratio. Both men and women with a UCa less than 10 mmol/day showed a significant correlation of BP with UNa/UK. After age, body mass index adjusted, the correlation between BP and UNa or UNa/UCr showed consistently in males. BP correlated negatively with UCa only in men, whereas women in the age 50-59 group were found most sensitive to UNa/UK and a negative correlation of diastolic BP with UK was only found in women.

In August 1972 divers collected cores from the Central and Western basins of Lake Erie for microbiological analysis. The cores were sectioned and examined for sulfur cycle bacteria, nitrogen cycle bacteria, total heterotrophs, iron oxidizing bacteria, insoluble organic and inorganic phosphate solubilizing bacteria. Eh, nitrogen, organic carbon, and percentage moisture determinations were also made.Data from these cores indicate that offshore sediments, not directly influenced by land inputs, contain similar, homogenously distributed bacterial populations which vary less than one order of magnitude between the sediment surface and the 5-cm level.

BACKGROUND: Elevated levels of body mass index (BMI) and smoking are well established lifestyle risk factors for coronary heart disease (CHD) and stroke. If these two risk factors have a synergistic relationship, rigorous lifestyle modification may contribute to greater reduction in cardiovascular burden than previously expected. METHODS: A pooled analysis of individual participant data from 38 cohorts, involving 378,579 participants. Hazards ratios (HRs) and 95% confidence intervals (CIs) for BMI by cigarette smoking status were estimated using Cox proportional hazard models. RESULTS: During a mean follow-up of 3.8 years, 2706 CHD and 3264 strokes were recorded. There was a log-linear, positive relationship of BMI with CHD and stroke in both smokers and non-smokers with evidence of a synergistic effect of smoking on the association between BMI and CHD only: HRs (95% CIs) associated with a 2 kg/m2 higher BMI were 1.13 (1.10-1.17) in current smokers and 1.09 (1.06-1.11) in non-smokers (p-value for interaction=0.04). CONCLUSION: Smoking amplifies the positive association between BMI and CHD but not stroke. If confirmed, these results suggest that effective strategies that target smoking cessation and weight loss are likely to have a greater impact than anticipated on reducing the burden of CHD., published_or_final_version

The failure of conventional waste-treatment methods to solve problems associated with complex industrial wastes, suggests that we must re-examine our approach to this problem. Two distinct types of biodegradation, homogeneous and heterogeneous, have been recognized to occur in the environment and are distinguished according to the solubility or insolubility, respectively, of the compound involved. Unfortunately, many of the most persistent toxic compounds fall into the second or insoluble category, and conventional treatment processes are inefficient in dealing with them.Our studies have shown that the primary site of the biodegradation of these persistent compounds is at the substance–water interface and that the rate of such biodegradation can be greatly increased if the tested compound can be suspended in an aqueous phase as a fine stable emulsion. Our recent work on PCB biodegradation exemplifies the benefit of a multidisciplinary approach in solving environmental problems, and supports the need to continue fundamental research in such areas of applied environmental science.