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Objective To investigate the effects of triglyceride-glucose (TyG) index and its variability on diabetic kidney disease (DKD) in patients with type 2 diabetes mellitus (T2DM). Methods This study was a prospective cohort study. A total of 1 986 patients with T2DM who had regular visits at 6 centers of the Lee's United Clinics in Taiwan, China from January 1, 2002 to December 31, 2018 and no DKD at baseline were selected as the study subjects, and prospective follow-up was performed. Age, sex, serum creatinine, triglycerides (TG), fasting plasma glucose (FPG), urine microalbumin and urine creatinine were collected, and the TyG index, estimated glomerular filtration rate (eGFR) and urinary albumin-to-creatinine ratio (UACR) were calculated, and the mean value of TyG index and the variability of TyG index were calculated according to the TyG index once a year at baseline and follow-up years. DKD was diagnosed according to the diagnostic criteria of the Clinical guideline for the prevention and treatment of diabetic kidney disease in China (2021 Edition). According to whether the patients had DKD at the end of the follow-up, they were divided into DKD group and non-diabetic kidney disease (NDKD) group, and according to the mean value of TyG index, the patients were divided into T1 group (mean TyG index <8.67), T2 group (8.67≤ mean TyG index <9.09) and T3 group (mean TyG index ≥9.09), and according to the variability of TyG index, the patients were divided into T'1 group (TyG index variability <0.29) and T'2 group (0.29≤ TyG index variability <0.43) and T'3 group (TyG index variability ≥0.43). The t-test of two independent samples was used to compare the differences in the relevant indexes between the DKD group and the NDKD group, the Cox proportional hazards regression model was used to study the relationship between TyG index and DKD, and between TyG index variability and DKD, and the generalized linear mixed model was used to explore the effects of factors including TyG index on DKD. Results The follow-up period was (7.27±3.48) years. At the end of follow-up, of the 1 986 patients with T2DM, 676 were in the DKD group and 1 310 were in the NDKD group. Compared with the NDKD group, the UACR, mean TyG index and TyG index variability in patients with T2DM in the DKD group were higher, while the eGFR was lower (all P<0.05). The results of Cox proportional hazards regression model showed that after adjusting for confounding variables, the risk of DKD in patients with T2DM in the T3 group was the highest compared with that in the T1 group, which was 68.9% higher than that in the T1 group (HR=1.689,95%CI 1.376-2.073, P<0.001); compared with the T'1 group, the risk of DKD was highest in the T'3 group, which was 74.2% higher than that in the T'1 group(HR=1.742, 95%CI 1.421-2.135, P<0.001). The results of the generalized linear mixed model show that the TyG index of each year during the follow-up process has a significant effect on the occurrence of DKD (β=0.244, 95%CI 0.111-0.376, P<0.001). Conclusion Elevated TyG index and its variability both increase the risk of DKD in patients with T2DM, and the TyG index and its variability are independent risk factors for the DKD. [ABSTRACT FROM AUTHOR]

(1) Background: Previous studies have compared research into ski jumping in different motor processes, but there is a lack of comparative analysis of the biomechanical research methods used to investigate different ski jumping sports. (2) Content: Our study compared the advantages and disadvantages of six research methods and proposes future research directions. Motion video collection and analysis show that controlling angular momentum and achieving stable flight attitude in the take-off process are the most critical factors in ski jumping performance. Most research on force platforms focuses on dynamic performance at the time of take-off, but there are few training sites with an embedded force platform, and so, more empirical research is required. Wearable inertial measurement units, including gyroscopes and accelerometers, can be used to determine a series of forces, calculate the joint angle, and speculate the position of the centroid during motion. Surface EMG studies are primarily used to compare the activity characteristics of the lower limb muscles in the actual field of the jump, the exercise simulation, and the lack of complete training process data. Wind tunnel measurement can satisfy fluid mechanics simulation experiments and provide theoretical support for optimizing special ski jumping technology. Based on the theory of computational fluid dynamics, the optimal drag reduction posture data of ski jumpers can be derived using computer simulations. (3) Conclusions: Due to the wide range of ski jumping sports, the present research focused on the kinematics and dynamics of different movement stages, lacking the study of the complete exercise training process. The range of wearable inertial measurement and sensor equipment can cover the whole process of ski jumping, including kinematics and dynamics data, and is a feasible and reliable test method for monitoring ski jump training in natural environments. The simultaneous testing of surface electromyography, kinematics, and dynamics requires further exploration. (4) Future direction of development: Under computational fluid dynamics, wearable inertial measurement units and global navigation satellite systems (GNSSs), intelligent wind tunnel experimental training areas will become essential tools for ski jumping research. [ABSTRACT FROM AUTHOR]

This paper proposes probabilistic demand models to assess fragilities for high-rise buildings with three types of outrigger systems under seismic and wind loads. Parameters of the structural model are determined based on the structural material and geometric conditions. Parameters of the excitation model are determined based on the hazard characterization that varies with the hazard type. This paper involves three types of hazards: high-frequency ground motions, near-fault ground motions, and stochastic wind loads. With the input information from the structural model and the excitation model, 3D finite element models are built and computed using ANSYS to obtain structural responses (output information). Based on a database with the input-output pair obtained, we formulate probabilistic demand models for high-rise buildings with three types of outrigger systems under three types of hazards. These probabilistic models are proposed to estimate three response quantities of interest, the maximum inter-story drift, the maximum top acceleration, and the maximum top displacement. They, therefore, include univariate, bivariate, and tri-variate models. The probabilistic demand models account for both aleatory and epistemic uncertainties and provide unbiased estimates. With a direct and parsimonious formula, they have high accuracy and are extremely convenient to be used in practical engineering. They are finally used to formulate fragility estimates with bounds for an example high-rise building with three types of outrigger systems under three types of hazards. The results indicate that damped outrigger systems can effectively reduce fragilities for high-rise buildings under three types of hazards. [ABSTRACT FROM AUTHOR]

Peripheral nerve stimulators have emerged as a crucial instrument in the realm of neurological disease, capable of modulating nerve activity through precisely targeted electrical stimulation to specific sites within the nervous system. Herein, a new wireless battery‐free peripheral nerve stimulation device for remote muscle activation is developed. The device with conch‐inspired bionic design can be wirelessly powered and controlled by a mobile phone playing audio via the piezoelectric effect. The device consists of two parts: a conch‐like signal‐intensifying piezoelectric resonator for converting acoustic wave into electrostimulation signal; and a pedestal with stimulation electrodes for transmitting the electrostimulation signal to a peripheral nerve. For remote nerve intervention, a programmed audio tone from one mobile phone can be tele‐transmitted from other phones according to the desired stimulation protocols. In‐vivo experiments in stimulating the sciatic nerve in mice showed that the device can activate muscles (e.g., 1 Hz 920 mV for 26 degree of leg movement), and the neuron‐muscle interaction has been confirmed by electromyogram (EMG). The wireless peripheral nerve stimulation conch achieves feasible remote muscle activation without batteries, and can extend the scope of self‐powered techniques for telemedicine and limb/trunk rehabilitation. [ABSTRACT FROM AUTHOR]