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Abstract Background The relationship between obesity and diabetic retinopathy (DR) remains controversial, and the relationship between sarcopenic obesity and DR is still unclear. The purpose of this study is to investigate the relationship between obesity, sarcopenic obesity, and DR in patients with type 2 diabetes mellitus (T2DM). Methods A cross-sectional study was conducted on patients with T2DM. Obesity was assessed by body mass index (BMI), fat mass index (FMI), android fat mass, gynoid fat mass, and visceral adipose tissue (VAT) mass. Sarcopenia was defined according to the criteria of Consensus of the Asian Working Group for Sarcopenia (AWGS 2019). Sarcopenic obesity was defined as the coexistence of sarcopenia and obesity. The association between obesity, sarcopenic obesity, and DR was examined using univariable and multivariable logistic regression models. Results A total of 367 patients with T2DM (mean age 58.3 years; 57.6% male) were involved in this study. The prevalence of DR was 28.3%. In total patients, significant adverse relationships between obesity and DR were observed when obesity was assessed by BMI (adjusted odds ratio [aOR] 0.54, 95% confidence interval [CI] 0.31 to 0.96, p = 0.036), FMI (aOR 0.49, 95% CI 0.28 to 0.85, p = 0.012), android fat mass (aOR 0.51, 95% CI 0.29 to 0.89, p = 0.019), gynoid fat mass (aOR 0.52, 95% CI 0.30 to 0.91, p = 0.021) or VAT mass (aOR 0.45, 95% CI 0.25 to 0.78, p = 0.005). In patients with T2DM and obesity, the prevalence of sarcopenic obesity was 14.8% (n = 23) when obesity was assessed by BMI, 30.6% (n = 56) when assessed by FMI, 27.9% (n = 51) when assessed by android fat mass, 28.4% (n = 52) when assessed by gynoid fat mass, and 30.6% (n = 56) when assessed by VAT mass. Sarcopenic obesity was associated with DR when obesity was assessed by BMI (aOR 2.61, 95% CI 1.07 to 6.37, p = 0.035), android fat mass (aOR 3.27, 95% CI 1.37 to 7.80, p = 0.007), or VAT mass (aOR 2.50, 95% CI 1.06 to 5.92, p = 0.037). Conclusions Patients with T2DM showed a substantial inverse relationship between DR and obesity, and sarcopenic obesity was considerably favorably associated with DR. Detection of sarcopenia in patients with T2DM, especially in obese T2DM, is essential to guide clinical intervention in DR.

Abstract Background Scurvy has been a rare condition in the developed world due to the increasing availability of adequate nutrition and easy access to fruits and vegetables. Scurvy is caused by severe vitamin C deficiency and has been historically associated with malnutrition in high-risk populations such as sailors. As it is an uncommon nutritional deficiency, scurvy is seldom suspected and usually under-diagnosed especially in the pediatric population. Case presentation We report a case of a pediatric patient with a history of autism spectrum disorder presenting with atypical symptoms of scurvy with gait abnormalities, diffuse rash, musculoskeletal deconditioning, and bleeding manifestations. After multiple extensive investigations and a prolonged hospitalization, a detailed dietary analysis revealed a severely restricted diet devoid of fruits and vegetables. Physical examination revealed specific signs of corkscrew hair with peri-follicular hemorrhages, hypertrophic, and bleeding gums with a concurrent low vitamin C level. Treatment with vitamin C supplementation was initiated and he was ambulant within 1 month of discharge. Conclusion This case highlights the importance of nutrition history for determining micronutrient deficiency in children with special needs. Enhanced physician education and higher index of suspicion regarding nutritional deficiencies will avoid over-investigations and delays for the institution of specific treatment.

ABSTRACT In the two decades that have elapsed since the initial proposal of neuroendocrine cell hyperplasia of infancy (NEHI), several hundred cases have been reported and researched. However, a comprehensive analysis of research progress remains absent from the literature. The present article endeavors to evaluate the current progress of NEHI research and offer a reference for the clinical management of this condition.

The Changjiang Estuary and Hangzhou Bay system has experienced river damming and estuarine engineering in the last decades. However, few studies focused on the shifts in its sediment dynamics due to such human activities. In this study multi-decadal development of sediment dynamics in the transitional zone of the two large estuaries was analyzed, based on the synchronous hydrographic data in the winter of 2023, 2014 and 1983. The results revealed significant changes in regional hydrodynamics and suspended sediment transport, despite the continuous good correlations between the current velocity, suspended sediment concentration (SSC), water/sediment fluxes and tidal range. Specifically, the current velocity has been decreased by 8 - 21% after 2014, mainly due to the land reclamation (implemented around 2016) with several groins stretching into deep water and altering alongshore hydrodynamics. The SSC has decreased further by 29 - 38% in addition to the significant decrease during 1983 - 2014. The SSC changes are related to the combination of river damming which induced sediment load reduction and land reclamation which enclosed a large amount of sediment. Furthermore, the sediment transport from Changjiang Estuary to Hangzhou Bay decreased by 36% - 53%, explaining the observed bed erosion in the northern bay mouth in recent years. The findings are also relevant for studies on sediment dynamics in other large estuaries worldwide.

IntroductionWe previously reported that ATP1A3 c.823G>C (p.Ala275Pro) mutant causes varying phenotypes of alternative hemiplegia of childhood and rapid-onset dystonia-parkinsonism in the same family. This study aims to investigate the function of ATP1A3 c.823G>C (p.Ala275Pro) mutant at the cellular and zebrafish models.MethodsATP1A3 wild-type and mutant Hela cell lines were constructed, and ATP1A3 mRNA expression, ATP1A3 protein expression and localization, and Na+-K+-ATPase activity in each group of cells were detected. Additionally, we also constructed zebrafish models with ATP1A3 wild-type overexpression (WT) and p.Ala275Pro mutant overexpression (MUT). Subsequently, we detected the mRNA expression of dopamine signaling pathway-associated genes, Parkinson’s disease-associated genes, and apoptosisassociated genes in each group of zebrafish, and observed the growth, development, and movement behavior of zebrafish.ResultsCells carrying the p.Ala275Pro mutation exhibited lower levels of ATP1A3 mRNA, reduced ATP1A3 protein expression, and decreased Na+-K+-ATPase activity compared to wild-type cells. Immunofluorescence analysis revealed that ATP1A3 was primarily localized in the cytoplasm, but there was no significant difference in ATP1A3 protein localization before and after the mutation. In the zebrafish model, both WT and MUT groups showed lower brain and body length, dopamine neuron fluorescence intensity, escape ability, swimming distance, and average swimming speed compared to the control group. Moreover, overexpression of both wild-type and mutant ATP1A3 led to abnormal mRNA expression of genes associated with the dopamine signaling pathway and Parkinson’s disease in zebrafish, and significantly upregulated transcription levels of bad and caspase-3 in the apoptosis signaling pathway, while reducing the transcriptional level of bcl-2 and the bcl-2/bax ratio.ConclusionThis study reveals that the p.Ala275Pro mutant decreases ATP1A3 protein expression and Na+/K+-ATPase activity. Abnormal expression of either wild-type or mutant ATP1A3 genes impairs growth, development, and movement behavior in zebrafish.

Abstract Background Fasting is known to influence the immune functions of leukocytes primarily by regulating their mobilization and redistribution between the bone marrow and the peripheral tissues or circulation, in particular via relocalization of leukocytes back in the bone marrow. However, how the immune system responds to the increased risk of invasion by infectious pathogens with fewer leukocytes in the peripheral blood during fasting intervention remains an open question. Results We used proteomic, biochemical and flow cytometric tools to evaluate the impact of short-term intensive fasting (STIF), known as beego, on red blood cells by profiling the cells from the STIF subjects before and after 6 days of fasting and 6 days of gradual refeeding. We found that STIF, by triggering the activation of the complement system via the complement receptor on the membrane of red blood cells, boosts fairly sustainable function of red blood cells in immune responses in close relation to various pathogens, including viruses, bacteria and parasites, particularly with the pronounced capacity to defend against SARS-CoV-2, without compromising their oxygen delivery capacity and viability. Conclusion STIF fosters the immune function of red blood cells and therefore, it may be considered as a nonmedical intervention option for the stronger capacity of red blood cells to combat infectious diseases.

Lutein, zeaxanthin, and β-cryptoxanthin are polar oxygenated carotenoids found to be detectable in more than 95% of the population in the United States. Research has linked these carotenoids with lower coronary heart disease prevalence. This study investigates the association of serum lutein/zeaxanthin and β-cryptoxanthin with erectile dysfunction (ED) among middle-aged and older men in the United States. Serum lutein/zeaxanthin and β-cryptoxanthin were independent variables. The outcome variable was ED. Analyzed data from 1,302 men (≥40 years old) who participated in the National Health and Nutrition Examination Survey 2001–2002 cross-sectional study were included. After adjusting for all covariates, serum lutein/zeaxanthin negatively correlated with ED (odds ratio [OR]: 0.972, 95% confidence interval [CI]: [0.951, 0.994], p = .011). However, a U-shaped association between serum lutein/zeaxanthin and ED was detected in men with diabetes or prevalent cardiovascular disease. A U-shaped non-linear association was observed between β-cryptoxanthin levels and ED. These findings suggest that while both lutein/zeaxanthin and β-cryptoxanthin are recognized as essential antioxidants, maintaining lower serum lutein/zeaxanthin levels and appropriate serum β-cryptoxanthin levels may offer potential benefits for individuals with ED. Further investigations, particularly prospective studies, are warranted to determine the role of serum lutein/zeaxanthin and β-cryptoxanthin in the biological mechanism associated with ED.

Understanding the evolution and driving factors of sedimentation and erosion at the mouths of small and medium-sized mountain streams during various periods is essential for regional spatial utilization, development, and sustainable economic growth. This is particularly important when considering the combined impact of climate change and human activities. This paper presents an analysis of the changes in sedimentation and erosion of mouth isobaths and underwater deltas over different periods using nautical chart data (1950-2019) and analyzes the factors driving changes in sedimentation and erosion during different periods from 1950 to 2020 based on the runoff-sediment discharge of the Minjiang River (MR) and extreme climate factors such as typhoons, especially the driving factors that caused a sudden change in the sedimentation and erosion process between 1998 and 2005. The results indicate that runoff-sediment characteristics are crucial in driving sedimentation and erosion changes. In the past 70 years, the underwater delta of the MRE has mainly experienced four stages: deposition (1950-1992) -erosion (1993-1998) -deposition (1998-2011) -erosion (2011-2019). Taking the impoundment operation of the Shuikou Reservoir in 1993 as the node, the sediment load of the Minjiang River into the sea began to decrease sharply, and then the estuary quickly showed a state of erosion. The change of sediment flux into the sea is the main driving factor for the evolution of erosion and deposition in the Minjiang River Estuary (MRE). The critical value of the erosion-deposition transition is about 570.3 × 104 t/yr. After the estuary entered a state of erosion in 1993-1998, significant siltation suddenly occurred in 1998-2005. The reason for the siltation in this period may be related to the frequent transit typhoons and flood events in 1998-2005. Therefore, the change of river sediment supply into the sea is the main driving factor controlling the erosion and deposition evolution of the Minjiang River estuary on a long time scale of more than 10 years, which reflects the influence of large-scale human activities on the river and estuary area in the past half century. Extreme climate events are the incentive to adjust the estuary landform in the short term. Extreme climate events will not fundamentally change the process of estuarine geomorphological evolution under the background of sediment supply reduction.

Objectives: To explore the differences between low kiloelectron volt (keV) virtual monoenergetic images (VMIs) using IQon spectral CT and conventional CT (120 kVp) in the diagnosis of osteoporosis. Methods: This retrospective study included 317 patients who underwent IQon spectral CT and dual-energy X-ray absorptiometry (DXA) examination. Commercial deep learning–based software was used for the fully automated extraction of the CT values of the first to fourth lumbar vertebrae (L1–L4) from two different low-keV levels (including 40/70 keV) VMIs and conventional 120 kVp images. The DXA examination results served as the standard of reference (normal [T-score ≥ −1], osteopenia [-2.5 0.05). Conclusions: The performance of the osteoporosis diagnosis model using IQon spectral CT simulating the low tube voltage scanning condition (less than 120 kVp) was also satisfactory. Bone density screening evaluation can be performed with a combination of low-dose lung scanning CT, greatly reducing the radiation dose without affecting the diagnosis.

Abstract Background Tracheal stents can be placed in a narrow position in the human trachea to ensure smooth breathing. And the stent will deform during service by the influence of the physiological environment or random excitations, such as coughing. Methods This paper divides the vibration into periodic and random vibrations according to the different pressures. And a coupling vibration model was established by analyzing the contact relationship between the stent and the trachea tissue. And this study discusses the influence of tracheal diameter, respiratory pressure, and frequency on the stent vibration characteristics through Ansys simulation. In addition, the nonlinear equations were solved by the Matlab numerical analysis method, which could help analyze the influence of cough intensity on the stability of the tracheal stent system. Results The results showed that when tracheal stenosis occurred in the trachea's more significant grade, the trachea stent was more likely to fall off when treated with a tracheal stent. With the increase in respiratory frequency and pressure, the deformation of the tracheal stent is more considerable. Moreover, the frequency of normal cough hardly affects the stability of the stent system, while the excitation force and damping coefficient value greatly influence the system. When the excitation force of the cough exceeds the critical importance of 20 N, the tracheal stent is prone to fall off. This study comprehensively obtained the forced vibration characteristics of the stent under service conditions, which could make up for the shortage of the vibration theory of the stent. Conclusion The results can provide a theoretical basis for predicting the possibility of stent loss in clinical treatment.

Abstract Background The serum creatinine-to-cystatin C ratio (Scr/Scys) has been suggested as a surrogate marker of muscle mass and a predictor of adverse outcomes in many diseases. However, the prognostic value of Scr/Scys in patients with type 2 diabetes mellitus (T2DM) is unknown. The aim of this study is to assess the prognostic value of Scr/Scys in patients with T2DM. Methods In this retrospective observational study, we enrolled 3668 T2DM patients undergoing coronary angiography (CAG). Serum creatinine (Scr) and serum cystatin C (Scys) levels were measured at admission. The study population was separated into low muscle mass (low-MM) and normal muscle mass (normal-MM) groups by Scr/Scys cut-off point. The association between muscle mass and long-term all-cause mortality was examined using Cox regression analysis. Results During a median follow-up of 4.9 (3.0–7.1) years, a total of 352 (9.6%) patients died. The mortality was higher in patients with low-MM as compared with patients with normal-MM (11.1% vs. 7.3%; p

Abstract Background Increasing attention is being given to assessing treatment effect heterogeneity among individuals belonging to qualitatively different latent subgroups. Inference routinely proceeds by first partitioning the individuals into subgroups, then estimating the subgroup-specific average treatment effects. However, because the subgroups are only latently associated with the observed variables, the actual individual subgroup memberships are rarely known with certainty in practice and thus have to be imputed. Ignoring the uncertainty in the imputed memberships precludes misclassification errors, potentially leading to biased results and incorrect conclusions. Methods We propose a strategy for assessing the sensitivity of inference to classification uncertainty when using such classify-analyze approaches for subgroup effect analyses. We exploit each individual’s typically nonzero predictive or posterior subgroup membership probabilities to gauge the stability of the resultant subgroup-specific average causal effects estimates over different, carefully selected subsets of the individuals. Because the membership probabilities are subject to sampling variability, we propose Monte Carlo confidence intervals that explicitly acknowledge the imprecision in the estimated subgroup memberships via perturbations using a parametric bootstrap. The proposal is widely applicable and avoids stringent causal or structural assumptions that existing bias-adjustment or bias-correction methods rely on. Results Using two different publicly available real-world datasets, we illustrate how the proposed strategy supplements existing latent subgroup effect analyses to shed light on the potential impact of classification uncertainty on inference. First, individuals are partitioned into latent subgroups based on their medical and health history. Then within each fixed latent subgroup, the average treatment effect is assessed using an augmented inverse propensity score weighted estimator. Finally, utilizing the proposed sensitivity analysis reveals different subgroup-specific effects that are mostly insensitive to potential misclassification. Conclusions Our proposed sensitivity analysis is straightforward to implement, provides both graphical and numerical summaries, and readily permits assessing the sensitivity of any machine learning-based causal effect estimator to classification uncertainty. We recommend making such sensitivity analyses more routine in latent subgroup effect analyses.

How rapidly the mutation rate responds evolutionarily to ecological and population-genetic factors over time is unclear. Here, the authors show that the evolution of mutation rates in E. coli proceeds rapidly in response to these factors with substantial bidirectional shifts.

Insulin promotes hepatic lipogenesis, though underlying regulation remains unclear. Here the authors show that insulin translocates TRIM24 from the nucleus into cytosolic P-bodies to stabilise hepatic Pparγ mRNA, and that inactivation of TRIM24 promotes Pparγ degradation and alleviates hepatosteatosis.

Background Marinobufagenin, NKA (Na/K‐ATPase) inhibitor, causes vasoconstriction and induces fibrosis via inhibition of Fli1 (Friend leukemia integration‐1), a negative regulator of collagen synthesis. In vascular smooth muscle cells (VSMC), ANP (atrial natriuretic peptide), via a cGMP/PKG1 (protein kinase G1)‐dependent mechanism, reduces NKA sensitivity to marinobufagenin. We hypothesized that VSMC from old rats, due to downregulation of ANP/cGMP/PKG‐dependent signaling, would exhibit heightened sensitivity to the profibrotic effect of marinobufagenin. Methods and Results Cultured VSMC from the young (3‐month‐old) and old (24‐month‐old) male Sprague–Dawley rats and young VSMC with silenced PKG1 gene were treated with 1 nmol/L ANP, or with 1 nmol/L marinobufagenin, or with a combination of ANP and marinobufagenin. Collagen‐1, Fli1, and PKG1 levels were assessed by Western blotting analyses. Vascular PKG1 and Fli1 levels in the old rats were reduced compared with their young counterparts. ANP prevented inhibition of vascular NKA by marinobufagenin in young VSMC but not in old VSMC. In VSMC from the young rats, marinobufagenin induced downregulation of Fli1 and an increase in collagen‐1 level, whereas ANP blocked this effect. Silencing of the PKG1 gene in young VSMC resulted in a reduction in levels of PKG1 and Fli1; marinobufagenin additionally reduced Fli1 and increased collagen‐1 level, and ANP failed to oppose these marinobufagenin effects, similar to VSMC from the old rats with the age‐associated reduction in PKG1. Conclusions Age‐associated reduction in vascular PKG1 and the resultant decline in cGMP signaling lead to the loss of the ability of ANP to oppose marinobufagenin‐induced inhibition of NKA and fibrosis development. Silencing of the PKG1 gene mimicked these effects of aging.

Sediment dynamics under floods are critical for estuarine morphological evolution. A two-dimensional coupled hydrodynamic/sediment transport numerical modeling was adapted to investigate the flood-driven jet structure and the resultant sedimentary regime in a river-dominated estuary, Modaomen Estuary, Pearl River Delta, China. The results show that the flow velocity of flood jet exhibits a Gaussian distribution in the transverse direction and shows a linear decreasing trend in the longitudinal direction. Moreover, a distinct zonation, including a zone of flow establishment (ZOFE) and a zone of established flow (ZOEF), was detected. The ZOFE was the core area of high turbidity and strong erosion and provided sufficient sediments to the ZOEF, where sediment diffused and settled. Due to the settling lag, the sediment diffusion and deposition areas were larger than those of the jet. Estuarine geomorphology regulates the shape of flood jet, which shows an asymmetry configuration with the main body located at the west side of the bifurcated estuary. Tidal dynamics play a crucial role in altering the range of jet diffusion, especially in the longitudinal direction. Increased flood intensity has little effect on the jet structure and erosion/deposition pattern, but significantly increases the magnitude of seaward current velocities and bed level changes, as well as the transverse diffusion range of jet and sedimentation.

The distribution of pore structure inside rock has fractal characteristics in statistical sense, the determination of itsfractal dimension is of great significance to characterize the distribution law of pore structure quantitatively and reveal various mechanical behaviors and physical and mechanical indexes of rock.By combining image processing, fractal theory and mathematical statistics, the spatial distribution model of three-dimensional pore structure was reconstructed based on CT scan slice images, and the distribution box dimension and cluster dimension of pore structure in Hausdorff measure space were calculated. In order to quantitatively characterize the spatial complexity of pore structure distribution, the hypothesis of voxel box dimension and cylinder space bundle dimension was put forward, and the hypothesis was tested by various mathematical statistical methods. Finally, it is pointed out that the pore structure distribution is a multi-scale fractal model, and a single dimension cannot describe all its characteristics.The analysis results show that the voxel box dimension constructed for gray CT images can replace the traditional box dimension, and can quantitatively characterize the pore volume distribution law more reliably, accurately and comprehensively at the meso-scale. In essence, cluster dimension is used to quantitatively characterize the distribution law of pore position. If it is equal to Euclidean dimension, it indicates that pore position distribution has randomness.

Background. The relationship between malnutrition and diabetic retinopathy (DR) is still unclear. The purpose of this study is to investigate the relationship between malnutrition and DR in type 2 diabetic patients. Methods. A cross-sectional study was conducted on 612 patients with type 2 diabetes mellitus. Four malnutrition assessment tools: Global Leadership Initiative on Malnutrition (GLIM) criteria, controlling nutritional status (CONUT), nutritional risk index (NRI), and prognostic nutritional index (PNI), were applied to assess the nutritional status of the study population. The association between malnutrition and DR was examined using multivariable logistic regression and ordered logistic regression. Results. The proportion of malnutrition varied from 10.0% to 34.3% in total patients and from 16.3% to 45.1% in DR patients across the assessment tools. DR patients were more likely to be malnourished than patients without DR. The adjusted odds ratios (aOR) and 95% confidence interval (CI) for DR of malnutrition defined by different tools were 1.86 (1.01-3.14) for GLIM criteria, 1.67 (1.04-2.70) for NRI, and 2.24 (1.07-4.69) for PNI. The aOR and 95% CI for the severity of DR of malnutrition defined by different tools were 1.99 (1.12-3.51) for GLIM criteria, 1.65 (1.06-2.58) for NRI, and 2.51 (1.31-4.79) for PNI. Conclusions. Malnutrition was common in DR patients, and it was closely linked to the presence and severity of DR. Diabetic patients with DR should undergo nutritional assessment and early treatment of malnutrition to prevent the onset or progression of DR.

BackgroundWhile the End Tuberculosis (TB) Strategy has been implemented worldwide, the cause of the TB epidemic is multifactorial and not fully understood. ObjectiveThis study aims to investigate the risk factors of TB and incorporate these factors to forecast the incidence of TB infection across different age groups in Sichuan, China. MethodsCorrelation and linear regression analyses were conducted to assess the relationships between TB cases and ecological factors, including environmental, economic, and social factors, in Sichuan Province from 2006 to 2017. The transfer function-noise model was used to forecast trends, considering both time and multifactor effects. ResultsFrom 2006 to 2017, Sichuan Province had a reported cumulative incidence rate of 1321.08 cases per 100,000 individuals in male patients and 583.04 cases per 100,000 individuals in female patients. There were significant sex differences in the distribution of cases among age groups (trend χ225=12,544.4; P

Abstract Background Adropin, a newly‑identified energy homeostasis protein, has been implicated in the maintenance of metabolic homeostasis and insulin sensitivity. This study attempts to measure the association between serum adropin and carotid atherosclerosis in patients with type 2 diabetes mellitus (T2DM). Methods This cross‑sectional study was performed in 503 hospitalized patients with T2DM.Serum adropin level was measured by a sandwich enzyme-linked immunosorbent assay. The carotid atherosclerosis was assessed by color Doppler sonography. The association between adropin and carotid atherosclerotic plaque was tested by logistic regression model. The effect of adropin on carotid intimal-medial thickness (CIMT) was estimated using linear regression model. Results Overall, 280 (55.7%) patients had carotid atherosclerotic plaque. The risk of carotid atherosclerotic plaque decreased with the increment of serum adropin level (adjusted odds ratio [aOR], 0.90; 95%CI: 0.81–0.99) in patients with T2DM. Serum adropin (Standardized β = − 0.006, p = 0.028) was also independently protective factor for CIMT in patients with T2DM. Conclusion In patients with T2DM, high serum adropin level was correlated with a decreased risk of carotid atherosclerosis in T2DM patients. Low circulating level of adropin may promote carotid atherosclerosis.

Quantum thermalization in a many-body system is defined by the approach of local subsystems toward a universal form, describable as an ensemble of quantum states wherein observables acquire thermal expectation values. Recently, it has been demonstrated that the distribution of these quantum states can also exhibit universal statistics, upon associating each state with the outcome of a local projective measurement of the complementary subsystem. Specifically, this collection of pure quantum states—called the projected ensemble—can, under certain conditions, mimic the behavior of a maximally entropic uniformly random ensemble, i.e., form a quantum state design, representing a “deeper” form of quantum thermalization. In this work, we investigate the dynamical process underlying this novel emergent universality. Leveraging a space-time duality mapping for one-dimensional quantum circuits, we argue that the physics of dynamical purification, which arises in the context of monitored quantum systems, constrains the approach of the projected ensemble toward the uniform distribution. We prove that the absence of dynamical purification in the space-time dual dynamics (a condition realized in dual-unitary quantum circuits with appropriate initial states and final measurement bases) generically yields exact state designs for all moments k at the same time, extending previous rigorous results [Ho and Choi, Phys. Rev. Lett. 128, 060601 (2022)]. Conversely, we show that, departing from these conditions, dynamical purification can lead to a separation of time scales between the formation of a quantum state design for moment k=1 (regular thermalization) and for high moments k≫1 (deep thermalization). Our results suggest that the projected ensemble can probe nuanced features of quantum dynamics inaccessible to regular thermalization, such as quantum information scrambling.

Abstract Background High-sensitivity C-reactive protein (hs-CRP) plays an important role in hypoalbuminemia as a representative of inflammation, which is closely associated with poor prognosis among patients with coronary artery disease (CAD). The present study aimed to evaluate the independent and joint effects of high hs-CRP levels and hypoalbuminemia on long-term mortality among CAD patients. Methods A total of 1449 CAD patients were included from a prospective, multicenter, observational cohort study (REICIN, NCT01402232) of patients referred for coronary angiography (CAG). The primary endpoint was long-term all-cause death. Results During a median follow-up of 2.9 (2.0–3.0) years, a total of 107 (7.4%) patients died. The long-term mortality was higher among CAD patients with high hs-CRP levels (> 3 mg/L) than those with the low hs-CRP levels (≤ 3 mg/L; 10.7% versus 4.1%; hazard ratio [HR] 2.49; 95% confidence interval [CI] 1.48–4.17). Similarly, CAD patients with hypoalbuminemia had higher mortality than those without hypoalbuminemia (12.2% versus 4.9%; HR 1.93; 95% CI 1.20–3.08). When hs-CRP and albumin were combined, CAD patients with high hs-CRP levels (> 3 mg/L) and with hypoalbuminemia were at the highest risk of death compared with their reference group (hs-CRP ≤ 3 mg/L and albumin > 35 g/L; HR 3.79; 95% CI 1.91–7.52). Conclusions High hs-CRP levels and hypoalbuminemia were independently and jointly associated with long-term mortality among CAD patients. Patients with high hs-CRP levels and hypoalbuminemia had the highest risk of long-term mortality compared with other groups.

Abstract Background Malnutrition is associated with poor prognosis in cardiovascular disease patients or in diabetic patients. However, the relationship between malnutrition and clinical outcomes in diabetic patients with coronary artery disease (CAD) is not well known. The aim of this study is to report the prevalence and prognostic consequences of malnutrition in diabetic patients with CAD. Methods In this retrospective observational study, the Controlling Nutritional Status (CONUT) score applied to 12,898 consecutive diabetic patients with CAD. The association between malnutrition and long-term all-cause mortality was examined using Cox proportional hazards regression analysis. Results According to CONUT score, 60.5% patients suffered from malnutrition; 46.4%, 13.2%, and 0.9% patients had mild, moderate, and severe malnutrition, respectively. During a median follow-up of 4.88 (2.83–7.51) years, 1973 (15.3%) patients died. After adjustment for confounders, malnutrition was associated with significantly increased risk for long-term all-cause mortality (adjusted hazard ratio for mild malnutrition and moderate to severe malnutrition, respectively: 1.38 [95% confidence interval (CI) 1.07–1.77]; P value = 0.012 and 1.63 [95% CI 1.18–2.24]; P value = 0.003). A similar association was observed around subgroups. Conclusions Malnutrition is common in diabetic patients with CAD and is strongly associated with increased mortality. It is necessary to adequately assess the nutritional status and take the effective nutritional guidance to improve the prognosis of diabetic patients with CAD.

Abstract Background Predictive value of creatine kinase MB (CK-MB) for contrast-induced acute kidney injury (CI-AKI) among myocardial infarction (MI) patients has rarely been reported. We aim to evaluate the predictive value of CK-MB for CI-AKI among MI patients. Methods Totally, 1131 MI patients were included from the REduction of rIsk for Contrast-Induced Nephropathy (REICIN) study. The peak CK-MB before coronary angiography (CAG) was chosen. The study population was divided into two groups by log-transformed CK-MB cut-off point. The association between CK-MB and CI-AKI was tested by multivariable logistic regression. CK-MB was integrated with Age, creatinine and ejection fraction (ACEF) score and Mehran risk score (MRS) to evaluate the additive value of CK-MB. The integrated models were validated internally by the bootstrap method and externally by the PREdictive Value of COntrast voluMe to creatinine Clearance Ratio (PRECOMIN) study data set. Results Overall, 62(5.48%) patients developed CI-AKI, patients with CK-MB point > 4.7 displayed a higher incidence of CI-AKI than those without (11.9% vs. 4.0%, p 4.7 was independently associated with CI-AKI (adjusted OR: 3.40, 95% CI: 1.93–5.98, p

Karmakar et al produced a dermotropic, live attenuated centrin gene-deleted Leishmania major (LmCen −/− ) vaccine against Visceral Leishmaniasis (VL). They demonstrated in hamsters that a single intradermal injection confers robust and durable protection against lethal VL that is transmitted naturally via bites of L. donovani-infected sand flies.

Background:Meteorological factors can affect the emergence of scrub typhus for a period lasting days to weeks after their occurrence. Furthermore, the relationship between meteorological factors and scrub typhus is complicated because of lagged and non-linear patterns. Investigating the lagged correlation patterns between meteorological variables and scrub typhus may promote an understanding of this association and be beneficial for preventing disease outbreaks.MethodsWe extracted data on scrub typhus cases in rural areas of Panzhihua in Southwest China every week from 2008 to 2017 from the China Information System for Disease Control and Prevention. The distributed lag non-linear model (DLNM) was used to study the temporal lagged correlation between weekly meteorological factors and weekly scrub typhus.ResultsThere were obvious lagged associations between some weather factors (rainfall, relative humidity, and air temperature) and scrub typhus with the same overall effect trend, an inverse-U shape; moreover, different meteorological factors had different significant delayed contributions compared with reference values in many cases. In addition, at the same lag time, the relative risk increased with the increase of exposure level for all weather variables when presenting a positive association.ConclusionsThe results found that different meteorological factors have different patterns and magnitudes for the lagged correlation between weather factors and scrub typhus. The lag shape and association for meteorological information is applicable for developing an early warning system for scrub typhus.

Background: Uncoupling protein 1 (UCP1) and UCP2 are associated with tumor metabolism and immunity. However, the prognostic value and molecular mechanisms underlying their action in breast cancer (BC) remain unclear.Materials and methods: In TCGA-BRCA cohort, we investigated the expression characteristics of UCP mRNAs, analyzed their prognostic value by Kaplan-Meier survival analysis, their potential molecular functions by gene set enrichment analysis, and their relationship with immune infiltrating cell types using TIMER and CIBERSORT, along with the assessment of their association with mutational profiles. Kaplan-Meier survival analysis was performed for UCPs in our cohort and their association with BC thermogenesis was assessed by thermal tomography.Results: High expression of UCP1 and UCP2 were positive prognostic markers for BC. UCP1 was associated with the impaired glucose metabolism, while UCP2 with enhanced anti-tumor immunity. High expressions of UCP1 and UCP2 were associated with CDH1 mutations. High UCP1 expression was associated with a high rate of thermogenesis in BC.Conclusions: These results implied a key role of UCP1 and UCP2 in prognosis, metabolism, and immune infiltration in BC. Further investigation of the relevant molecular mechanisms may provide new strategies for BC treatment.

Absorbing aerosols have significant influences on tropospheric photochemistry and regional climate change. Here, the direct radiative effects of absorbing aerosols at the major AERONET sites in East Asia and corresponding impacts on near-surface photochemical processes were quantified by employing a radiation transfer model. The average annual aerosol optical depth (AOD) of sites in China, Korea, and Japan was 1.15, 1.02 and 0.94, respectively, and the corresponding proportion of absorbing aerosol optical depth (AAOD) was 8.61%, 6.69%, and 6.49%, respectively. The influence of absorbing aerosol on ultraviolet (UV) radiation mainly focused on UV-A band (315–400 nm). Under the influence of such radiative effect, the annual mean near-surface J[NO2] (J[O1D]) of sites in China, Korea, and Japan decreased by 16.95% (22.42%), 9.61% (13.55%), and 9.63% (13.79%), respectively. In Beijing–Tianjin–Hebei (BTH) and Yangtze River Delta (YRD) region, the annual average AOD was 1.48 and 1.29, and the AAOD was 0.14 and 0.13, respectively. The UV radiative forcing caused by aerosols dominated by black carbon (BC-dominated aerosols) on the surface was −3.19 and −2.98 W m−2, respectively, accounting for about 40% of the total aerosol radiative forcing, indicating that the reduction efficiency of BC-dominated aerosols on solar radiation was higher than that of other types of aerosols. The annual mean J[NO2] (J[O1D]) decreased by 14.90% (20.53%) and 13.71% (18.20%) due to the BC-dominated aerosols. The daily maximum photolysis rate usually occurred near noon due to the diurnal variation of solar zenith angle and, thus, the daily average photolysis rate decreased by 2–3% higher than that average during 10:00–14:00.

Playing online games is gradually becoming mainstream entertainment, but some people may develop Internet gaming disorder (IGD). Like other behavioral addictive diseases, one of the main characteristics of IGD is a craving for games, which also makes people tend to approach game-related clues. Recently, a few researchers have started to use the approach–avoidance task (AAT) paradigm to study the approach bias of IGD, and they also think it is an essential characteristic of IGD. However, the traditional AAT cannot provide realistic approach–avoidance behavior to stimuli, and virtual reality has been proven to provide a highly ecological environment to measure approach bias. Therefore, this study innovatively integrates virtual reality and the AAT paradigm to measure the approach bias of IGD. We found that compared with neutral stimuli, IGD spent less time approaching game-related stimuli, which indicates that it is difficult for IGD to avoid game-related situations in the virtual environment. This study also revealed that game-related content stimuli in virtual reality alone did not increase the IGD group’s craving for games. These results proved that AAT in VR could cause the approach bias of IGD and provide high ecological validity and an effective tool for the intervention of IGD in the future.

Abstract Background Self-expanding nitinol stent (SENS) implantation is commonly oversized in the superficial femoral artery (SFA), and leads to chronic outward force (COF) and in-stent restenosis (ISR). This study aimed to investigate the impact of COF of oversizing SENS on ISR of SFA. Methods In patients with implanted SENS in SFA, intimal hyperplasia especially between proximal segment and distal segment was evaluated by quantitative angiography, and the impact of COF on mid-term angiographic outcomes was investigated. In addition, porcine model with implanted SENS was used to evaluate the impact of COF on angiographic and histopathologic outcomes at 1 month. Excised stented arteries were evaluated by histopathologic analysis. Results We analyzed 65 SENS in 61 patients with follow-up angiography at 6 months to 1 year. The baseline diameter was 6.8 ± 0.71 mm and length were 97.0 ± 33.8 mm for the SENS. The ratio of the diameter of the stent to the reference vessel was 1.3 ± 0.24 at the proximal portion and 1.53 ± 0.27 at the distal portion (P

Abstract Background Several studies have found that a low baseline low -density lipoprotein cholesterol (LDL-C) concentration was associated with poor prognosis in patients with acute coronary syndrome (ACS), which is called the “cholesterol paradox”. Low LDL-C concentration may reflect underlying malnutrition, which was strongly associated with increased mortality. The aim of this study was to investigate the cholesterol paradox in patients with CAD and the effects of malnutrition. Method A total of 41,229 CAD patients admitted to Guangdong Provincial People’s Hospital in China were included in this study from January 2007 to December 2018 and divided into two groups (LDL-C

Abstract Our objective was to examine differences in cytokine/chemokine response in chronic hepatitis B(CHB) patients to understand the immune mechanism of HBsAg loss (functional cure) during antiviral therapy. We used an unbiased machine learning strategy to unravel the immune pathways in CHB nucleo(t)side analogue-treated patients who achieved HBsAg loss with peg-interferon-α(peg-IFN-α) add-on or switch treatment in a randomised clinical trial. Cytokines/chemokines from plasma were compared between those with/without HBsAg loss, at baseline, before and after HBsAg loss. Peg-IFN-α treatment resulted in higher levels of IL-27, IL-12p70, IL-18, IL-13, IL-4, IL-22 and GM-CSF prior to HBsAg loss. Probabilistic network analysis of cytokines, chemokines and soluble factors suggested a dynamic dendritic cell driven NK and T cell immune response associated with HBsAg loss. Bayesian network analysis showed a dominant myeloid-driven type 1 inflammatory response with a MIG and I-TAC central module contributing to HBsAg loss in the add-on arm. In the switch arm, HBsAg loss was associated with a T cell activation module exemplified by high levels of CD40L suggesting T cell activation. Our findings show that more than one immune pathway to HBsAg loss was found with peg-IFN-α therapy; by myeloid-driven Type 1 response in one instance, and T cell activation in the other.

Abstract Single‐atom catalysts (SACs) are attracting extensive attention due to their incredibly catalytic activity and selectivity, high utilization of metal atoms, and obvious cost reduction. The unique ordered porous materials (OPMs) are promising carriers for stabilizing single atoms due to their large surface areas and uniformly tunable pore sizes. Meantime, the geometric and electronic structures of single‐atom metals can be tuned by the interaction between the single‐atoms (SAs) and OPMs to enhance the catalytic activity of SACs. The SACs based on OPMs, such as zeolites, metal–organic frameworks, and ordered mesoporous materials, have been developing fast recently. Herein, we review recent advancements on structural feature, synthetic strategy, characterization technique, and catalytic applications of OPMs‐based SACs. The opportunities and challenges about SAs/OPMs are also provided to develop the novel catalysts with superior catalytic performances in the future.

Sudden unexpected death in epilepsy (SUDEP) is the leading cause of death in refractory epilepsy patients. Accumulating evidence from recent human studies and animal models suggests that seizure-related respiratory arrest may be important for initiating cardiorespiratory arrest and death. Prior evidence suggests that apnea onset can coincide with seizure spread to the amygdala and that stimulation of the amygdala can reliably induce apneas in epilepsy patients, potentially implicating amygdalar regions in seizure-related respiratory arrest and subsequent postictal hypoventilation and cardiorespiratory death. This study aimed to determine if an extended amygdalar structure, the dorsal bed nucleus of the stria terminalis (dBNST), is involved in seizure-induced respiratory arrest (S-IRA) and death using DBA/1 mice, a mouse strain which has audiogenic seizures (AGS) and a high incidence of postictal respiratory arrest and death. The presence of S-IRA significantly increased c-Fos expression in the dBNST of DBA/1 mice. Furthermore, disruption of synaptic output from the dBNST via viral-induced tetanus neurotoxin (TeNT) significantly improved survival following S-IRA in DBA/1 mice without affecting baseline breathing or hypercapnic (HCVR) and hypoxic ventilatory response (HVR). This disruption in the dBNST resulted in changes to the balance of excitatory/inhibitory (E/I) synaptic events in the downstream brainstem regions of the lateral parabrachial nucleus (PBN) and the periaqueductal gray (PAG). These findings suggest that the dBNST is a potential subcortical forebrain site necessary for the mediation of S-IRA, potentially through its outputs to brainstem respiratory regions.

As a large number of new energy electric vehicles are retired, the sequential utilization of retired power batteries has become one of the important means to improve the economic benefits of batteries, but there is a problem of disunity between available capacity and cycle life. Therefore, a peak-load power distribution method based on the principle of equal life of retired power batteries was proposed, which could effectively avoid the life difference caused by the battery difference and reduce the replacement cost. At the same time, in order to give reasonable investment suggestions for the stepwise utilization of retired power batteries, three economic boundary value models, including the payback period, peak–valley price difference, and investment cost, were constructed based on the leveling cost. Through the simulation of a 60 MW/160 MWh lithium iron phosphate decommissioned battery storage power station with 50% available capacity, it can be seen that when the cycle number is 2000 and the peak–valley price difference is above 0.8 yuan/kWh, it has investment value.

Abstract Background Clinical management of triple-negative breast cancer (TNBC) patients remain challenging because of the development of chemo-resistance. Identification of biomarkers for risk stratification of chemo-resistance and therapeutic decision-making to overcome such resistance is thus necessary. Methods Retrospective analysis was performed to identify potential stratification biomarkers. The levels of ceramide kinase (CERK) was determined in breast cancer patients. The roles of CERK and its downstream signaling pathways were analysed using cellular and biochemical assays. Results CERK upregulation was identified as a biomarker for chemotherapeutic response in TNBC. A > 2-fold change in CERK (from tumor)/CERK (from normal counterpart) was significantly associated with chemo-resistance (OR = 2.66, 95% CI 1.18–7.34), P = 0.04. CERK overexpression was sufficient to promote TNBC growth and migration, and confer chemo-resistance in TNBC cell lines, although this resistance could be overcome via CERK inhibition. Mechanistic studies suggest that CERK mediates intrinsic resistance and inferior response to chemotherapy in TNBC by regulating multiple oncogenic pathways such as Ras/ERK, PI3K/Akt/mTOR, and RhoA. Conclusions Our work provides an explanation for the heterogeneity of chemo-response across TNBC patients and demonstrates that CERK inhibition offers a therapeutic strategy to overcome treatment resistance.

Interstock is an important agronomic technique for regulating plant growth and fruit quality, and overcoming the incompatibility between rootstocks and scions; however, the underlying mechanisms remain largely unknown. In this study, the effects and regulatory mechanisms of tangor grafting, with and without interstocks, on the growth and development of scions were analyzed by combining morphology, physiology, anatomy and transcriptomics. Morphological and physiological analyses showed that interstocks (‘Aiyuan 38’ and ‘Daya’) significantly improved the growth of seedlings, effectively enhanced the foliar accumulation of chlorophyll and carotenoids, and increased the thickness of leaf tissues. Using ‘Aiyuan 38’ as the interstock, photosynthetic efficiency and starch content of citrus seedlings improved. Transcriptomics showed that genes related to photosynthesis and photosynthetic antenna proteins were upregulated in interstock-treated seedlings, with significant upregulation of photosystem PSI- and PSII-related genes. In addition, multiple key genes may be involved in plant hormone signaling, starch and sucrose metabolism, and transcriptional regulation. Taken together, these findings provide novel insights into the role of interstocks in regulating and contributing to the growth and development of grafted seedlings, and will further define and deploy candidate genes to explore the mechanisms of rootstock-interstock-scion interactions.

A central challenge in analog quantum simulation is to characterize desirable physical properties of quantum states produced in experiments. However, in conventional approaches, the extraction of arbitrary information requires performing measurements in many different bases, which necessitates a high level of control that present-day quantum devices may not have. Here, we propose and analyze a scalable protocol that leverages the ergodic nature of generic quantum dynamics, enabling the efficient extraction of many physical properties. The protocol does not require sophisticated controls and can be generically implemented in analog quantum simulation platforms today. Our protocol involves introducing ancillary degrees of freedom in a predetermined state to a system of interest, quenching the joint system under Hamiltonian dynamics native to the particular experimental platform, and then measuring globally in a single, fixed basis. We show that arbitrary information of the original quantum state is contained within such measurement data and can be extracted using a classical data-processing procedure. We numerically demonstrate our approach with a number of examples, including the measurements of entanglement entropy, many-body Chern number, and various superconducting orders in systems of neutral atom arrays, bosonic and fermionic particles on optical lattices, respectively, only assuming existing technological capabilities. Our protocol excitingly promises to overcome limited controllability and, thus, enhance the versatility and utility of near-term quantum technologies.

Fruit color is one of the quality indicators to judge the freshness of a plum. The coloring process of plum skin is valuable for research due to the high nutritional quality of anthocyanins found in plums. ‘Cuihongli’ (CHL) and its precocious mutant variety ‘Cuihongli Red’ (CHR) were used to analyze the changes of fruit quality and anthocyanin biosynthesis during plum development. The results showed that, during the development of the two plums, the total soluble solid and soluble sugar contents were highest at the mature stage, as the titratable acid trended gradually downward as the fruits of the two cultivars matured, and the CHR fruit showed higher sugar content and lower acid content. In addition, the skin of CHR turned red in color earlier than CHL. Compared with CHL, the skin of CHR had higher anthocyanin concentrations, higher activities of phenylalanine ammonia-lyase (PAL), chalcone isomerase (CHI), dihydroflavonol-4-reductase (DFR), and UDPglucose: flavonoid-3-O-glucosyltransferase (UFGT), and higher transcript levels of genes associated with anthocyanin production. In the flesh of the two cultivars, no anthocyanin content was detected. Taken together, these results suggest that the mutation exerted a major effect on anthocyanin accumulation via modification of the level of transcription; thus, CHR advances the ripening period of ‘Cuihongli’ plum and improves the fruit quality.

The distribution of congestion surplus affects not only the short-term economic interests of stakeholders in the power spot market, but the improvement of social welfare in the long run. At present, the congestion surplus in mature electricity spot markets of developed countries is usually returned to the power users or power generation enterprises according to established proportions. Although this method helps achieve rational distribution of congestion surplus, it does not offer a solution to the congestion problem and cannot achieve maximized social welfare. In light of the principles of welfare economics, we propose in this paper injecting the congestion surplus into the capital pool of the power grid as a transmission line expansion fund to fundamentally solve the power transmission congestion problem. Modeling results and case studies presented in our work verified that our proposed distribution model could achieve Pareto optimization. Finally, combining the power transmission and distribution (PTD) pricing and supervision method, this paper puts forward the method for use and supervision of congestion surplus on the power spot market to reach optimal allocation of resources.

Abstract Background E- and m-health interventions are promising to change health behaviour. Many of these interventions use a large variety of behaviour change techniques (BCTs), but it’s not known which BCTs or which combination of BCTs contribute to their efficacy. Therefore, this experimental study investigated the efficacy of three BCTs (i.e. action planning, coping planning and self-monitoring) and their combinations on physical activity (PA) and sedentary behaviour (SB) against a background set of other BCTs. Methods In a 2 (action planning: present vs absent) × 2 (coping planning: present vs absent) × 2 (self-monitoring: present vs absent) factorial trial, 473 adults from the general population used the self-regulation based e- and m-health intervention ‘MyPlan2.0’ for five weeks. All combinations of BCTs were considered, resulting in eight groups. Participants selected their preferred target behaviour, either PA (n = 335, age = 35.8, 28.1% men) or SB (n = 138, age = 37.8, 37.7% men), and were then randomly allocated to the experimental groups. Levels of PA (MVPA in minutes/week) or SB (total sedentary time in hours/day) were assessed at baseline and post-intervention using self-reported questionnaires. Linear mixed-effect models were fitted to assess the impact of the different combinations of the BCTs on PA and SB. Results First, overall efficacy of each BCT was examined. The delivery of self-monitoring increased PA (t = 2.735, p = 0.007) and reduced SB (t = − 2.573, p = 0.012) compared with no delivery of self-monitoring. Also, the delivery of coping planning increased PA (t = 2.302, p = 0.022) compared with no delivery of coping planning. Second, we investigated to what extent adding BCTs increased efficacy. Using the combination of the three BCTs was most effective to increase PA (x2 = 8849, p = 0.003) whereas the combination of action planning and self-monitoring was most effective to decrease SB (x2 = 3.918, p = 0.048). To increase PA, action planning was always more effective in combination with coping planning (x2 = 5.590, p = 0.014; x2 = 17.722, p

Aiming at the impact of energy storage investment on production cost, market transaction and charge and discharge efficiency of energy storage, a research model of energy storage market transaction economic boundary taking into account the whole life cycle cost was proposed. Firstly, a peak-valley filling time division method based on equal capacity is proposed, which effectively improves the peak-valley time division and the accuracy of ES should scene switch. On this basis, a control strategy of “off-time reuse” is proposed to give full play to the function of “one standby multi-purpose” of energy storage, which improves the energy storage utilization rate and economic benefits. Secondly, an economic boundary model based on the life-cycle cost of energy storage and the evolution function of energy storage cost is constructed and solved by improved genetic algorithm. Finally, the simulation results show that compared with mono-peak control, the UTILIZATION rate of ES is increased by 16.25% and the investment recovery life is shortened by 1.17 years with “off-time reuse” strategy. Compared with the fixed division method, the investment recovery life of “peak clipping and valley filling” period division method is shortened by 1.75 years. In 2022, compared with the critical value of 0.76 yuan/kWh for fixed charge-discharge efficiency and cost, the critical value of the life-cycle cost model is 0.8 yuan/kWh, with an error of up to 5.26%.

ObjectiveSodium glucose cotransporter type 2 inhibitors (SGLT-2i) are beneficial for cardiorenal outcomes in patients with type 2 diabetes mellitus (T2DM), heart failure (HF) or chronic kidney disease (CKD). However, whether or not the patients with coronary artery disease (CAD) have prognostic benefit from SGLT-2i treatment has not been fully studied. The purpose of this meta−analysis is to determine the prognostic benefit of SGLT-2i administration in CAD patients.MethodsWe searched the PubMed, Embase and Cochrane Library from inception until October 15, 2021. We included randomized controlled trials (RCTs) reporting the effect of SGLT-2i on major adverse cardiovascular event (MACE), hospitalization for heart failure (HHF), cardiovascular (CV) death and cardiorenal parameters in CAD patients. Hazard ratio (HR) with 95% confidence interval (CI) and mean difference (MD) from trials were meta-analyzed using fixed-effects models.ResultsNine trials enrolling 15,301 patients with CAD were included in the analyses. Overall, SGLT2i were associated with a reduced risk of MACE (HR: 0.84; 95% CI 0.74–0.95; I2 = 0%), HHF (HR: 0.69; 95% CI 0.58–0.83; I2 = 0%) and a composite of CV death or HHF (HR: 0.78; 95% CI 0.71–0.86; I2 = 37%) in CAD patients. Compared with control group, estimated glomerular filtration rate (eGFR) level decreased less in SGLT-2i group (mean difference [MD] = −3.60, 95% CI, −5.90 to −1.30, p = 0.002; I2 = 0%).ConclusionsSGLT-2i can improve cardiorenal outcomes in CAD patients. Further RCTs and real world studies are need to investigate the effect of SGLT2i on CAD patients.Systematic Review RegistrationPROSPERO, CRD42021258237.

Poor sleep has been associated with the increased risk of developing detrimental health conditions. Diet and certain nutrients, such as dietary protein (PRO) may improve sleep. This cross-sectional study aimed to investigate the relationship between PRO intake, their amino acid components, and sources with sleep quality in middle-aged and older adults residing in Singapore. A dataset of 104 healthy subjects between the age of 50 and 75 years old were used. Collected data included 3-day food record and sleep quality [sleep duration, global sleep score (GSS), sleep latency (SL), and sleep efficiency (SE)]. The collected 3-day food records were extracted for PRO, tryptophan (Trp), and large neutral amino acid (LNAA) intake. PRO intake was further categorized into plant and animal PRO. A multivariate multiple linear regression (MLR) was performed to assess the association between PRO intake and sleep quality. Dietary Trp:LNAA ratio was positively associated with sleep duration (βtotal: 108.234 h; p: 0.005) after multiple covariates adjustment. Similarly, plant Trp (βplant: 2.653 h/g; p: 0.020) and plant Trp:LNAA (βplant: 54.006 h; p: 0.008) was positively associated with sleep duration. No significant associations were observed for both SL and SE. Sleep duration in middle-aged and older Singaporean adults was positively associated with dietary Trp and Trp:LNAA, especially when obtained from plant sources.

The production of concrete emits greenhouse gases which aggravate global warming. Meanwhile, ceramic tile wastes generated from manufacturing factories, construction sites, and building demolition projects disposed of by landfills create land and water pollution. Therefore, in this study, the suitability of ceramic tile wastes (CTW) in powder form to partially replace cement in lightweight foamed concrete was investigated with the aim to discover a greener construction material. Once the research outputs show that the ceramic tile dust can appropriately serve as a replacement, environmental impact on air, land, and water pollution can all be reduced. Three types of lightweight foamed concrete with 0%, 25%, and 50% ceramic tile wastes as partial cement replacement material were prepared with a target density of 1,200 kg/m3, namely, LFC-CTW0, LFC-CTW25, and LFC-CTW50, respectively. The effects of ceramic tile wastes on the engineering properties of lightweight foamed concrete were investigated. Concrete specimens were water-cured and tested for various mechanical properties at the concrete ages of 7, 28, and 56 days. Results from the lab experiments showed that the incorporation of 25% ceramic tile wastes into lightweight foamed concrete was more feasible than that of 50%. LFC-CTW25, which performed better than LFC-CTW0 for the splitting tensile strength test at day 56. The results for the compressive strength test, modulus of elasticity, and compressive toughness test showed a minor reduction after the incorporation of ceramic tile wastes. Based on the results, it can be concluded that it is feasible to use ceramic tile wastes up to 25% as partial cement replacement material to produce foamed concrete.