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Peripheral electrical nerve stimulation enhances hand function during stroke rehabilitation. Here, we proposed a percutaneous direct median nerve stimulation guided by ultrasound (ultrasound‐guided median nerve electrical stimulation, UG-MNES) and evaluated its feasibility and effectiveness in the treatment of stroke patients with upper limb extremity impairments. Sixty-three stroke patients (2-3 months of onset) were randomly divided into control and UG-MNES groups. Both groups received routine rehabilitation and the UG-MNES group received an additional ultrasound-guided electrical stimulation of the median nerve at 2 Hz, 0.2 ms pulse-width for 20 minutes with gradual intensity enhancement. The Fugl-Meyer Assessment for upper extremity motor function (FMA-UE) was used as the primary outcome. The secondary outcomes were the Functional Test for the Hemiplegic Upper Extremity (FTHUE-HK), Hand Function Rating Scale, Brunnstrom Stages, and Barthel Index scores for motor and daily functions. All the participants completed the trial without any side effects or adverse events during the intervention. After 4 weeks of intervention, the functions of the upper limbs on the hemiplegic side in both groups achieved significant recovery. Compared to the control group, all evaluation indices used in this trial were improved significantly in the UG-MNES group after 2 and 4 weeks of intervention; particularly, the first intervention of UG-MNES immediately improved all the assessment items significantly. In conclusion, the UG-MNES is a safe and feasible treatment for stroke patients with upper limb extremity impairments and could significantly improve the motor function of the affected upper limb, especially in the first intervention. The UG-MNES could be an effective alternative intervention for stroke with upper limb extremity impairments.

DNA double-strand breaks (DSBs) caused by platinum drugs are dangerous lesions that kill cancer cells in chemotherapy. Repair of DSB by homologous recombination (HR) and nonhomologous end joining (NHEJ) is frequently associated with platinum resistance in ovarian cancer. While the role of the HR pathway and HR-targeting strategy in platinum resistance is well studied, dissecting and targeting NHEJ machinery to overcome platinum resistance in ovarian cancer remain largely unexplored. Here, through an NHEJ pathway-focused gene RNAi screen, we found that the knockdown of XRCC4 significantly sensitized cisplatin treatment in the platinum-resistant ovarian cancer cell lines. Moreover, upregulation of XRCC4 is observed in a panel of platinum-resistant cell lines relative to the parental cell lines, as well as in ovarian cancer patients with poor progression-free survival. Mechanistically, the increased sensitivity to cisplatin upon XRCC4 knockdown was caused by accumulated DNA damage. In cisplatin-resistant ovarian cancer, the JNK-cJUN complex, activated by cisplatin, translocated into the nucleus and promoted the transcription of XRCC4 to confer cisplatin resistance. Knockdown of XRCC4 or treatment of the JNK inhibitor led to the attenuation of cisplatin-resistant tumor growth in the xenograft mouse models. These data suggest targeting XRCC4 is a potential strategy for ovarian cisplatin resistance in ovarian cancer.

Background Growth differentiation factor 15 (GDF15) was newly discovered to be a promising target of metformin. The study was aimed to investigate the relationship between GDF15 and glycemic control after metformin treatment in patients with type 2 diabetes mellitus. Methods The study was a post-hoc analysis of AIM (the effect of Acarbose on glycemic variability in patients with type 2 diabetes mellitus using premixed Insulin compared to Metformin) study. The participants were randomly assigned to 12 weeks of metformin (MET) or acarbose (ACA) treatment combined with insulin. Serum GDF15 levels of 51 subjects from MET group and 53 subjects from ACA group were measured at baseline and after a 12-week treatment. Fasting plasma glucose (FPG), 2-h postprandial plasma glucose (2-h PG) and glycated hemoglobin A1c (HbA1c) were measured at baseline and endpoint. Results After a 12-week treatment, serum GDF15 levels significantly increased in MET group [baseline vs. endpoint, 936.70 (741.00, 1205.40) pg/mL vs. 1265.20 (1027.90, 1634.00) pg/mL, P P = 0.944]. However, there were no significant differences of glycemic control parameters (ΔFPG, Δ2-h PG and ΔHbA1c) between subgroups of MET group divided by median of ΔGDF15 (all P > 0.05). Spearman correlation coefficient and analysis of covariance after adjustment for baseline HbA1c levels showed that ΔGDF15 was not correlated with ΔFPG, Δ2-h PG and ΔHbA1c (all P > 0.05). Conclusion Serum GDF15 levels were significantly elevated after metformin treatment in patients with type 2 diabetes mellitus. However, the increase was not an indicator of the glucose-lowering effect of metformin. Trial registration Clinicaltrials.gov, NCT02438397. Registered 8 May 2015.

Polyolefin (PO) cables used in confined spaces need to have low smoke, low heat release, low toxic gas release and excellent physical properties. In this work, a series of rare earth stannates Re

Electrochemical two-electron water oxidation reaction (2e-WOR) provides a promising alternative route for hydrogen peroxide (H

Diabetes remission after bariatric surgery was reported to be characterized by increased risk of hypoglycemia.This study aimed to examine the contribution of glycemic variability (GV) to the risk of hypoglycemia, and the suitability of time in range (TIR), an emerging glycemic marker, to define diabetes remission after Roux-en-Y gastric bypass (RYGB).A single referral center in China.This retrospective study included 175 individuals with type 2 diabetes and obesity who underwent RYGB. Subjects were classified as remission/nonremission according to the current standard. Each participant underwent continuous glucose monitoring both before and 1 year after RYGB. GV was measured by glucose coefficient of variation (CV), and hypoglycemia was assessed by time below range (TBR).Complete remission was achieved in 88 of the 175 participants following RYGB. In the remission group, significant correlations between postoperative CV and TBRs (r = .353-.442, both P ≤ .001) were found. Excess hypoglycemia (TBRIncreased glycemic variability was linked to excess risk of hypoglycemia after RYGB. Furthermore, TIR may serve as a new metric, in addition to HbA1C, for defining diabetes remission.

Safety and high energy density have long restricted the large-scale practical application of lithium metal batteries because of the unbridled growth of lithium dendrites and the rapid deteriorating cycle performance of the LiNi

Economically, maximizing, the tendency to seek the best, is good because it entails possibilities to optimize decision outcomes. However, research has shown that maximizing is costly in that maximizers are more regretful and less satisfied with their decisions. Beyond these intrapersonal downsides, this research investigates another important but largely ignored downside—the interpersonal costs of being a maximizer—and documents a maximizing penalty in social cognition wherein maximizers (vs. satisficers) are viewed as less warm and consequently receive less social support. Four studies provide evidence for the maximizing penalty. This research contributes to the literature on maximizing by revealing the social cost of being a maximizer and the literature on choice perception by showing that decision makers are perceived by their aspiration.

In order to aid imaging physicians to effectively screen chest radiography medical images for presence of Coronavirus Disease 2019 (COVID-19), a novel computer aided diagnosis technology for automatic processing of COVID-19 images is proposed based on two-dimensional variational mode decomposition (2D-VMD) and locally linear embedding (LLE). 2D-VMD algorithm is used to decompose normal and COVID-19 images, and then feature extraction of intrinsic mode functions (IMFs) using Gabor filter. To better extract low-dimensional parameters which are useful for COVID-19 diagnosis, the performance of two dimensionality reduction techniques of principal component analysis (PCA) and LLE are compared, and the LLE is shown to offer satisfactory effect of dimension reduction. Thereafter, the particle swarm optimization-support vector machine (PSO-SVM) algorithm is used to classify. The simulation results show that the proposed technology has achieved accuracy of 99.33%, precision of 100%, recall of 98.63% and F-Measure of 99.31%. Hence, the developed diagnosis technology can be used as an important auxiliary tool to assist diagnosis of imaging physicians.

Transition-metal sulfides (TMSs) are attractive oxygen evolution reaction (OER) electrocatalysts. Developing new strategies to improve their electrochemical performance of TMSs is of great significance. Herein, a unique pacman-like titanium-doped cobalt sulfide hollow superstructure (Ti-CoSx HSS) is fabricated as an OER electrocatalyst. Using a prearranged metal-organic framework (MOF)-on-MOF heterostructure as a precursor treated by one-pot sulfidation, a sequential structural conversion process leads to the formation of Ti-CoSx HSS, which is assembled by interconnected Ti-doped CoSx nanocages around a cake-like cavity. Benefiting from the architecture and compositional advantages, Ti-CoSx HSS exhibits excellent OER performance with an overpotential of 249 mV at 10 mA cm-2 and Tafel slope of 45.5 mV dec-1 due to increased active site exposure, enhanced electron and mass transfer. This strategy enabled by MOF-on-MOF paves the way toward innovative MOF derivatives for various applications.

Flexible polyurethane foam (FPUF) is the most used polyurethane, but the highly flammable characteristic limits its widespread usage. In this work, ZIF-8@Ti

Flexible polyurethane foam (FPUF) is the most commonly used polyurethane, but its highly flammable characteristics makes it ignite easily and release a lot of heat and toxic gases. Here, the effect of different forms of copper salt modified graphene (rGO@CuO, rGO@Cu2O and rGO@CSOH) on improving the fire protection efficiency and mechanical property of FPUF is explored. Hybrid FPUF is characterized by thermogravimetric analysis (TGA), cone calorimeter, thermogravimetric analysis/Fourier transform infrared spectroscopy (TG-IR), tension, compression, and falling ball rebound testing. Compared with pure FPUF, the FPUF/rGO@CSOH show a significant decreasement in reducing the heat release of FPUF, the PHRR and THR are reduced by 36.9% and 29.4%, respectively. While the FPUF/rGO@Cu2O demonstrate excellent smoke and toxic gases suppression in FPUF, the PSPR and TSR are reduced by 24.6% and 51.9%, and the COP and COY are also reduced by 51.9% and 55.3%, respectively. After adding the copper salt hybrid, the buffering performance of FPUF did not change. Fortunately, the tensile and compressive strength increase obviously. The flame retardant and smoke suppression mechanism of hybrid FPUF has also been studied. This article gives a effective strategy for the preparation of FPUF with outstanding mechanical property, flame retardant and smoke suppression properties.

Establishing accurate electrical load prediction is vital for pricing and power system management. However, the unpredictable behavior of private and industrial users results in uncertainty in these power systems. Furthermore, the utilization of renewable energy sources, which are often variable in their production rates, also increases the complexity making predictions even more difficult. In this paper an interval type-2 intuitionist fuzzy logic system whose parameters are trained in a hybrid fashion using gravitational search algorithms with the ridge least square algorithm is presented for short-term prediction of electrical loading. Simulation results are provided to compare the performance of the proposed approach with that of state-of-the-art electrical load prediction algorithms for Poland, and five regions of Australia. The simulation results demonstrate the superior performance of the proposed approach over seven different current state-of-the-art prediction algorithms in the literature, namely: SVR, ANN, ELM, EEMD-ELM-GOA, EEMD-ELM-DA, EEMD-ELM-PSO and EEMD-ELM-GWO.

Background: The association between long-term glycemic variability and diabetic retinopathy (DR) among patients with type 2 diabetes has not been clarified yet. Objective: The aim of this study was to investigate the association of visit-to-visit variability of hemoglobin A1c (HbA1c) and glycated albumin (GA) with the risk of DR in patients with type 2 diabetes. Design: A prospective cohort study of 315 patients (191 males and 124 females) with at least 3 measurements of HbA1c and GA prior to baseline was performed. Different GA and HbA1c variability markers were calculated, including coefficient of variation (CV), variability independent of the mean (VIM), and the average real variability (ARV). Cox proportional hazard regression models were used to explore the association between visit-to-visit HbA1c and GA variability and the risk of DR. Results: During a mean follow-up period of 3.42 years, 81 participants developed incident DR. Multivariate-adjusted hazard ratios (HRs) of DR across tertiles of GA-CV values were 1.00, 1.42, and 2.12 (P for trend=0.027), respectively. When we used GA-VIM and GA-ARV values as exposures, similar positive associations with the risk of DR were found. Multivariable-adjusted HRs of DR associated with each unit increase in GA-CV, GA-VIM, and GA-ARV were 1.05 (95% CI 1.02-1.09), 1.69 (95% CI 1.24-2.32), and 1.13 (95%CI 1.04-1.23), respectively. However, there was no significant association between visit-to-visit variability of HbA1c and the risk of DR after multivariate adjustment. Conclusion: The visit-to-visit variability of GA can predict the risk of incident DR in patients with type 2 diabetes, and the prediction ability is independent of the average HbA1c levels. Disclosure J. Zhou: None. D. Dai: None. Y. Shen: None. J. Lu: None. Y. Wang: None. W. Zhu: None. Y. Bao: None. G. Hu: None. Funding National Key Research and Development Project of China (2018YFC2000802); Shanghai Municipal Education Commission (20161430); Shanghai Municipal Key Clinical Specialty

Batch processes repeatedly execute a given set of tasks over a finite duration, whose versatility and ability to adapt to rapidly changing markets make it prevalent in a multitude of industrial fie...

Iterative learning model predictive control (ILMPC), endowed with the merits of iterative learning control and model predictive control, has excellent abilities of disturbance rejection and constraints handling. It has been widely applied in regulation of industrial batch processes for its remarkable reference tracking performance. In practice, the presence of strong system nonlinearity fundamentally challenges the model mismatch cyclewise invariance assumption that underlies numerous synthesis of many ILMPC methods. It may further induce additional conservatism and thus ultimately leads to performance degradation. To circumvent this issue, in this paper a novel ILMPC scheme relying upon past error compensation from multiple time instances is presented, in which the associated weights are adaptively optimized, thereby resulting in considerable enhancement of robustness. These superior performances are confirmed by numerical experiments on injection molding process, a typical batch process.

A series of novel 3-(thiophen/thiazole-2-ylthio)pyridine derivatives were designed and synthesized as IGF-1R tyrosine kinase inhibitors. All the target compounds were tested for their IGF-1R kinase inhibitory activities and cytotoxicities against five cancer cell lines (K562, Hep-G2, HCT-116, WSU-DLCL2, and A549). Although all these compounds exhibited moderate to potent cancer cell proliferation inhibitory activities (the most potent compound 43 showed IC50 value of 1.3 ± 0.9 μM against WSU-DLCL2 cell line), IGF-1R inhibition were not observed. In order to identify the exact target of these analogues, selected compounds were further screened for various kinases. The results indicated that this series of compounds may exert their anticancer activities through inhibiting various kinases including FGFR 3, EGFR, JAK, and RON. In addition, cell cycle analysis of compound 43 on Hep-G2 cells showed cell cycle arrest at G1/G0 phase. All the experiments validated the potential of 3-(thiophen/thiazole-2-ylthio)pyridine analogues as multi-target anticancer agents.

The purpose of the current study was to investigate the clinical characteristics of fulminant type 1 diabetes mellitus (FT1DM) in Chinese patients and to further determine their glycaemic profiles through continuous glucose monitoring (CGM). Thirty subjects who were diagnosed with FT1DM according to the 2012 JDS criteria were enrolled. Clinical characteristics were compared to those reported in Japanese FT1DM. All subjects received retrospective CGM for 3 days after being converted to subcutaneous insulin injection therapy. Chinese FT1DM patients presented with a shorter duration of symptoms (2.84 ± 2.42 days vs 4.4 ± 3.1 days, P 0.01), worse islet function (fasting C-peptide, 0.09 ± 0.11 ng/mL vs 0.30 ± 0.21 ng/mL; 2-hour C-peptide, 0.13 ± 0.14 ng/mL vs 0.30 ± 0.30 ng/mL, both P 0.01), lower prevalence of flu-like symptoms (46.7% vs 71.4%, P 0.05), and a significantly higher GADA positive rate (23.3% vs 5.1%, P 0.01) when compared with Japanese patients. The CGM results showed that the mean time in range (TIR) of FT1DM patients was 49.8 ± 22.1%, while mean amplitude of glycaemic excursion (MAGE) and standard deviations of sensor glucose (SDSG) were 7.58 ± 3.59 mmol/L and 3.19 ± 1.22 mmol/L, respectively, with nearly 1/3 participants coefficient of variation (CV) 36% (all are male), suggesting a large glucose fluctuation. The female patients were further divided into pregnancy-related FT1DM (PF) and non-PF (NPF) subgroups (both n = 5), and we found that PF patients had a significantly higher TIR than NPF patients (77.0 ± 16.1% vs 41.0 ± 22.4%, P 0.05). There were heterogeneities in the clinical characteristics of FT1DM patients, and the CGM results indicated a very low TIR and large glucose fluctuation which needs careful attention.

In this paper, a novel, fully bio-based emulsifier has been successfully prepared from epoxidized soybean oil and glutaric acid through a solvent-free and self-catalysis method. The effects of reaction time and carboxyl : epoxy molar ratios on the structures of the emulsifier were systematically investigated. This novel emulsifier exhibits properties similar to those of dimethylolpropionic acid (DMPA) and dimethylolbutanoic acid (DMBA), with hydroxyl groups serving as crosslinking agents and the carboxylic acid group acting as an ionic segment. In order to validate the robustness of this emulsifier, a series of anionic, waterborne polyurethane dispersions were prepared from typical polyols (vegetable oil- and petroleum-based). The structure of this emulsifier and its good compatibility with bio-based polyols confer the resulting dispersions excellent storage stability and high solid content (up to 45%). The prepared waterborne polyurethane films exhibited higher toughness and thermal stability than traditional solvent-based polyurethane films and waterborne polyurethane films prepared from DMPA and DMBA. Moreover, a high bio-based content of up to 74% was achieved for the prepared polyurethanes. This new environmentally friendly, liquid emulsifier, prepared using a solvent-free and self-catalysis synthetic route, can potentially replace typical petroleum-based emulsifiers for the production of waterborne polyurethanes.

Model predictive control (MPC) is often combined with iterative learning control (ILC), which results in the so-called iterative learning model predictive control (ILMPC), to control batch processes with constraints. It is a long standing and challenging problem that how to simultaneously guarantee system stability and constraint satisfaction in ILMPC design. Several invariant set-based methods, such as the zero-terminal state and the ellipsoidal invariant set, have been proposed to solve this problem. However, these methods are often restrictive with conservative control performance and limited applicability. In this paper, we propose a polytopic invariant set based ILMPC method to reduce conservativeness. Specifically, a polytopic invariant set is designed based on geometric computation and proved to be convex and compact. An iterative algorithm is proposed to compute the maximal one. Numerical simulations are provided to demonstrate its effectiveness.

In order to solve the problem of recognition error caused by noise interference in oil and gas pipeline signal and traditional pipeline leakage detection relies on expert experience to extract features manually, an oil and gas pipeline leakage detection model based on deep learning is proposed in this paper. The model consists of data preprocessing part and pattern recognition part. Firstly, a signal denoising algorithm based on variational mode decomposition (VMD) and Manhattan distance (MD) is proposed to reduce the error caused by data quality in the subsequent pattern recognition process. Secondly, combined with the one-dimensional and temporal characteristics of pipeline signal, the signal denoised by VMD-MD algorithm is used as the input of one-dimensional convolution neural network (1DCNN) in deep learning, then the data features are learned independently through the characteristics of network structure. Finally, the network structure and parameters are optimized and analyzed to build the optimal pipeline leakage detection model according to the experiment. The experimental results show that, compared with other existing models, the ensemble VMD-MD-1DCNN model has a better improvement in each evaluation index, which verifies the effectiveness of its application in pipeline leakage detection.

Flexible polyurethane foam (FPUF) has been considered as an excellent material in many fields, such as furniture and electromagnetic interference (EMI) shielding products due to its lightweight and flexibility. However, there is a severe fire hazard problem for FPUF that makes it unsuitable to be used in practical. Herein, a facile method was to prepare anti-dripping FPUF via electroless plating at ambient temperature. The silver nanoparticles (SNPs) were in-situ grown on the surface along with the polydopamine (PDA) as an adhesive and template (SNP@PDA@FPUF). As a result, these FPUFs show outstanding fire safety and anti-dripping capacity, and the heat release rate reduced 80.92%. Furthermore, the amounts of carbon oxide (CO) and carbon dioxide (CO2) decreased 75.01% and 22.4%, respectively. Above all, the EMI shielding effectiveness (SE) accomplished almost 120 dB as the increasing electroless time with a low density of 0.051 g/cm3. Furthermore, the specific EMI SE (SSE) and the absolute EMI SE (SSE/t) accomplished 2630.98 dB·cm3/g and 2434 dB·cm2/g, respectively, which was far beyond the commercial request. Therefore, this work may provide a facile way to prepare low density and EMI shielding products with high fire safety for next generation electronic products.

Hybridization represents a natural experiment that can provide insight into processes of speciation and diversification. Though considerable research has focused on hybrid zone dynamics, macroevolutionary investigations of the factors that influence hybridization are few. Here, we compile a database of avian hybrids and perform comparative analyses to determine whether several social and life-history variables influence broad patterns of hybridization. We perform three main analyses: phylogenetic logistic regression to examine variables that are associated with the presence of hybridization, phylogenetic Poisson regression of only those species exhibiting hybridization to determine which variables are associated with the extent of hybridization, and a phylogenetic logistic regression on a subset of data to assess potential pseudoreplication. After testing several social and life-history variables, we found that social bond duration is associated with the presence and extent of hybridization. Specifically, lengthy social bonds are negatively associated with the presence and extent of hybridization. In addition to social bond length, migration is positively linked with a greater likelihood of hybridization. The broad-scale correlations between species-specific traits and hybridization across diverse avian lineages suggest commonalities in the fine-scale processes involved in mating with heterospecifics, which in turn has implications for how we think about, study and understand hybridization processes and their influence on evolutionary trajectories.

Periodontitis is a multifactorial chronic infectious disease leading to a host immune response involving inflammatory cytokines, especially IL-1β, which is the main reason for further developing this disease. IL-1 receptor antagonist (IL-1ra) binds IL-1 receptor, inhibiting IL-1β signaling and reducing the levels of other cytokines closely related to periodontitis, such as IL-6 and TNF-α. Therefore, the use of IL-1ra to inhibit periodontitis development in a system, ensuring its sustained release, might be an effective way to combat this disease. Hence, in this study, a novel IL-1ra-loaded dextran/PLGA microsphere was developed to allow the sustained release of IL-1ra and enhance the anti-inflammatory properties. Therefore, this study's purposes were to develop a novel periodontal treatment for inhibition and treatment of periodontitis and evaluate the sustained-release effect and anti-inflammatory properties of IL-1ra-loaded dextran/PLGA microspheres in vitro by cell experiments and in vivo by animal experiments. The results showed that IL-1ra-loaded dextran/PLGA microspheres were non-toxic both in vitro and in vivo and could be used as a safe and effective treatment. In addition, these microspheres could significantly prolong the half-life of IL-1ra drug, exerting a useful anti-inflammatory effect in macrophages stimulated with P. gingivalis lipopolysaccharide and in rats with periodontitis. In conclusion, IL-1ra-loaded dextran/PLGA microsphere might be a useful tool to combat periodontal disease.

Insulin release index (IRI) based on 72-h fasting test has been used for the definitive diagnosis of insulinoma; however, hospitalization and subsequent costs contribute to the disadvantage of IRI. Therefore, a simple and cost-effective screening procedure for the diagnosis of insulinoma for outpatients are crucially needed. Continuous glucose monitoring (CGM) has been widely used for monitoring high level of glucose in diabetic patients. The aim of the study is to determine the potential contribution or implementation of CGM in the screening of the insulinoma. We performed a single-center prospective study with the demographics and laboratory data including 28 patients with the pathological diagnosis of insulinoma and 25 patients with functional hypoglycemia as control group. The analysis showed that areas under the receiver operating characteristic (ROC) curve of coefficient of variation (CV) was 0.914. The CV cutoff point was 19% with the Youden 62.1%, the corresponding sensitivity and specificity were 82.1 and 80%, respectively. In patients with CV greater than the median, more than 60% of insulinomas were located in the head of the pancreas; most Ki-67 values were more than 2% and when compared with the group with CV smaller than the median, the average tumor size was 2.7 times larger. In conclusion, CGM can be used as a valuable tool in not only monitoring high glucose levels in diabetic patients but also identifying the etiology of insulinoma. CV greater than 19% can be highly effective for the screening of insulinoma in outpatients.

We consider the joint design of control and scheduling under stochastic Denial-of-Service (DoS) attacks in the context of networked control systems. A sensor takes measurements of the system output and forwards its dynamic state estimates to a remote controller over a packet-dropping link. The controller determines the optimal control law for the process using the estimates it receives. An attacker aims at degrading the control performance by increasing the packet-dropout rate with a DoS attack towards the sensor-controller channel. We assume both the controller and the attacker are rational in a game-theoretic sense and establish a partially observable stochastic game to derive the optimal joint design of scheduling and control. Using dynamic programming we prove that the control and scheduling policies can be designed separately without sacrificing optimality, making the problem equivalent to a complete information game. We employ Nash Q-learning to solve the problem and prove that the solution is guaranteed to constitute an $\epsilon$-Nash equilibrium. Numerical examples are provided to illustrate the tradeoffs between control performance and communication cost., Comment: 12 pages, 3 figures

Atherosclerotic cardiovascular disease remains the leading cause of death among patients with diabetes. Early identification of subclinical atherosclerosis is essential for the management of diabetic patients. This study aimed to characterize serum metabolic signatures associated with carotid intima-media thickness (C-IMT), a proxy of subclinical atherosclerosis, in patients with type 2 diabetes mellitus (T2DM).After 1:1 matching by sex, age, body mass index, glycated haemoglobin APatients with abnormal C-IMT had significantly higher deoxycholic acid (DCA) and taurodeoxycholic acid (TDCA) levels, and lower levels of taurocholic acid (TCA) than those with normal C-IMT. Conditional logistic regression analysis revealed that per 1-standard deviation increase of DCA, TDCA and TCA were significantly associated with 64.7% (95% CI: 1.234-2.196) and 38.5% (95% CI: 1.124-1.706) higher, and 26.8% (95% CI: 0.597-0.897) lower risk of abnormal C-IMT, after adjustment of confounders. The addition of DCA, TCA, or DCA × TDCA/TCA ratio significantly improved the discrimination of abnormal C-IMT over traditional risk factors.Serum bile acids may be potential biomarkers for subclinical atherosclerosis in T2DM patients, which needs further confirmation.

People often exhibit biases in probability weighting such as overweighting small probabilities and underweighting large probabilities. Our research examines whether increased social distance would reduce such biases. Participants completed valuation and choice tasks of probabilistic lotteries under conditions with different social distances. The results showed that increased social distance reduced these biases in both hypothetical (Studies 1 and 2) and incentivized (Study 3) settings. This reduction was accompanied by a decrease in emotional intensity and an increase in the attention to probability in the decision-making process (Study 4). Moreover, the bias-buffering effect of social distance was stronger in the gain domain than in the loss domain (Studies 1–4). These results suggest that increasing the social distance from the beneficiaries of the decisions can reduce biases in probability weighting and shed light on the relationship between social distance and the emotional-cognitive process in decision-making.

Background The aim of this study was to investigate the association of visit-to-visit variability of hemoglobin A1c (HbA1c) and glycated albumin (GA) with the risk of lower extremity atherosclerotic disease (LEAD). Method We performed a prospective cohort study of 436 patients with type 2 diabetes (258 men and 178 women) with at least 3 measurements of HbA1c and GA prior to baseline investigation from the Department of Endocrinology and Metabolism, Shanghai Sixth People’s Hospital. Different HbA1c and GA variability markers were calculated. Multivariable Cox proportional hazard regression models were used to demonstrate the association between visit-to-visit HbA1c and GA variability and the risk of incident or progressive LEAD. Results During a mean follow-up period of 3.77 years, 112 participants developed LEAD. Multivariate-adjusted hazard ratios (HRs) of LEAD across tertiles of GA-CV values were 1.00, 1.06 (95% confidence interval [CI] 0.65–1.75), and 1.71 (95% CI 1.07–2.73) (P for trend = 0.042), respectively. When we used GA-VIM and GA-ARV values as exposures, similar positive associations with the risk of LEAD primary were found. Multivariate-adjusted HRs of LEAD for each 1 unit increase in GA-CV, GA-VIM and GA-ARV were 1.03 (95% CI 1.01–1.06), 1.32 (95% CI 1.03–1.69), and 1.07 (95%CI 1.01–1.15), respectively. However, there was no significant association between visit-to-visit variability of HbA1c and the risk of LEAD. Conclusions Visit-to-visit variability of GA may be an optimal biomarker in relation to LEAD risk among patients with type 2 diabetes.

Electrochemical two-electron water oxidation reaction (2e-WOR) provides a promising alternative route for hydrogen peroxide (H2O2) production, where the design of earth abundant and environmentally friendly electrocatalysts with both high selectivity and production rate is crucial. Here we report the synthesis of ZnO nanoparticles embedded in hollow carbon fiber membrane as efficient 2e-WOR electrocatalyst by a metal-organic framework engaged electrospinning-pyrolysis method. The resultant ZnO@carbon composite fiber exhibits a foam-like hierarchical structure composed of interconnected hollow carbon nanocubes encapsulated with oxygen vacancy rich ZnO nanocrystals. Owing to the improved selectivity of ZnO, excellent conductivity of carbon fiber, promoted active site exposure and mass transfer of hollow structure, the free-standing membrane electrode shows superior 2e-WOR performances with high selectivity (83.8% at 2.8 V vs. RHE), H2O2 generation rate (19.7 μmol cm−2 min−1) and robust stability.

In recent years, developing high performance thermosetting nanocomposites has attracted wide-ranging research attention. As a rising two-dimensional material, MXene still confront the intrinsic weakness for preparing epoxy resin with superior comprehensive performance. Inspired by the overlap architecture of placoid scale, an in-situ growth technique was applied to fabricate biomimetic-structural MXene derivative, which displayed significant increase in interfacial compatibility, mechanical property, and flame retardancy of epoxy resin (EP). In contrast to pure EP, the tensile strength and impact strength of EP nanocomposites increased by 30.1% and 43.5%, respectively. Furthermore, the fire hazard of EP nanocomposites was significantly reduced. With 5 wt% of PEPA-IPTS@Ti3C2Tx incorporated into EP (EP5), the peak of total heat release (THR) and total smoke production (TSP) decreased by 44.1% and 26.8%, respectively. Therefore, biomimetic structure nanohybrid (PEPA-IPTS@Ti3C2Tx) provides a facile and reliable strategy to prepare EP nanocomposites with excellent comprehensive performances.

We study the maximum information gain that an adversary may obtain through hacking without being detected. Consider a dynamical process observed by a sensor that transmits a local estimate of the system state to a remote estimator according to some reference transmission policy across a packet-dropping wireless channel equipped with acknowledgments (ACK). An adversary overhears the transmissions and proactively hijacks the sensor to reprogram its transmission policy. We define perfect secrecy as keeping the averaged expected error covariance bounded at the legitimate estimator and unbounded at the adversary. By analyzing the stationary distribution of the expected error covariance, we show that perfect secrecy can be attained for unstable systems only if the ACK channel has no packet dropouts. In other situations, we prove that independent of the reference policy and the detection methods, perfect secrecy is not attainable. For this scenario, we formulate a constrained Markov decision process to derive the optimal transmission policy that the adversary should implement at the sensor, and devise a Stackelberg game to derive the optimal reference policy for the legitimate estimator., 16 pages, 6 figures

OBJECTIVE There is growing evidence linking time in range (TIR), an emerging metric for assessing glycemic control, to diabetes-related outcomes. We aimed to investigate the association between TIR and mortality in patients with type 2 diabetes. RESEARCH DESIGN AND METHODS A total of 6,225 adult patients with type 2 diabetes were included from January 2005 to December 2015 from a single center in Shanghai, China. TIR was measured with continuous glucose monitoring at baseline, and the participants were stratified into four groups by TIR: >85%, 71–85%, 51–70%, and ≤50%. Cox proportional hazards regression models were used to estimate the association between different levels of TIR and the risks of all-cause and cardiovascular disease (CVD) mortality. RESULTS The mean age of the participants was 61.7 years at baseline. During a median follow-up of 6.9 years, 838 deaths were identified, 287 of which were due to CVD. The multivariable-adjusted hazard ratios associated with different levels of TIR (>85% [reference group], 71–85%, 51–70%, and ≤50%) were 1.00, 1.23 (95% CI 0.98–1.55), 1.30 (95% CI 1.04–1.63), and 1.83 (95% CI 1.48–2.28) for all-cause mortality (P for trend CONCLUSIONS The current study indicated an association of lower TIR with an increased risk of all-cause and CVD mortality among patients with type 2 diabetes, supporting the validity of TIR as a surrogate marker of long-term adverse clinical outcomes.

A series of non-covalent piperidine-containing peptidyl derivatives with various substituents at side chains of different residues were designed, synthesized and evaluated as proteasome inhibitors. After proteasome inhibitory evaluations of all the synthesized target compounds, selected ones were tested for their anti-proliferation activities against three multiple myeloma (MM) cell lines. 8 analogues displayed more potent activities than carfilzomib, and the most promising compound 24 showed IC50 values of 0.8 ± 0.2 nM against 20S proteasome and 8.42 ± 0.74 nM, 7.14 ± 0.52 nM, 14.20 ± 1.08 nM for RPMI 8226, NCI-H929 and MM.1S cell lines, respectively. Additionally, mechanisms of anti-cancer activity of representative compound 24 were further investigated. Apoptosis of RPMI-8226 cells were achieved through accumulating polyubiquitin and inducing the cleavage of caspase and PARP. Besides, half-life in rat plasma of compound 24 was prolonged after optimization, which would be helpful for increasing in vivo activities of this series of derivatives. All the studies confirmed that piperidine-containing non-covalent proteasome inhibitors can be potential leads for anti-MM drug development.

Objective. The aim of this study was to explore the association of 1,5-anhydroglucitol with acute C peptide response (ACPR) to arginine among patients with type 2 diabetes. Methods. Patients with type 2 diabetes were enrolled from the Department of Endocrinology and Metabolism, Shanghai Sixth People’s Hospital. ACPR was assessed using arginine stimulation test. Decreased β-cell function was defined as ACPR<2.1. Multivariable logistic regression models were used to demonstrate the association between 1,5-anhydroglucitol and decreased β-cell function. Results. Finally, 623 patients with type 2 diabetes were enrolled into the analysis. Multivariable-adjusted odds ratios for decreased β-cell function across quartiles of 1,5-anhydroglucitol were 1.00, 0.47 (95% confidence interval (CI) 0.23-0.99), 0.41 (95% CI 0.20-0.84), and 0.27 (95% CI 0.13-0.57) (Ptrend=0.042), respectively. When 1,5-anhydroglucitol was considered as a continuous variable after logarithm, the corresponding odds ratio was 0.40 (95% CI 0.23-0.71). Conclusions. We demonstrated a dose-response linear association between 1,5-anhydroglucitol and ACPR. 1,5-Anhydroglucitol was likely to be associated with β-cell function. Further analysis with large sample size and prospective study design is warranted to validate our findings.

Compared with conventional glucose metrics including HbA1c, continuous glucose monitoring (CGM) can provide more information on diabetes management. Of the multiple metrics generated by CGM, time in range (TIR) is becoming popular for assessing glycemic control in practice and research (1–3). Various target ranges for TIR have been adopted and published, with 3.9–10.0 mmol/L (70–180 mg/dL) often headlined. Since hypoglycemia accounts for a small part of time during a day, TIR is largely a metric of hyperglycemia, thus correlating with vascular complications. Logically, ideal TIR would be matched to minimal complication risk, although pragmatic considerations, namely, what is achievable, may also influence choice of level. For CGM there is a lack of information on the relationship between derived metrics and complications, but normal glucose profiles suggest very tight physiological control, with only brief postprandial excursions >140 mg/dL (7.8 mmol/L) (4,5). To begin to address the issue of the threshold of range above which vascular risk can be detected, we have investigated the associations of multiple prespecified TIR levels with carotid intima-media thickness (CIMT) and diabetic retinopathy (DR) in a large sample of people with type 2 diabetes. Individuals with type 2 diabetes and using a stable glucose-lowering regimen for the previous 3 months were consecutively enrolled from hospitalized patients at …