Independent and interactive associations of heart rate and obesity with type 2 diabetes mellites: A population-based study

BACKGROUND

Although obesity and heart rate (HR) were closely related to the prevalence and development of type 2 diabetes mllitus (T2DM), few studies have shown a co-association effect of them on T2DM. We aimed at assessing the interactive effects of HR and obesity with prevalence of T2DM in Chinese population, providing the exact cutpoint of the risk threshold for blood glucose with high HR.

MATERIALS AND METHODS

In the Risk Evaluation of cAncers in Chinese diabeTic Individuals: a lONgitudinal study (REACTION) cohorts (N = 8398), the relationship between HR and T2DM was explored by linear regression, logistic regression, and restricted cubic spline, and odds ratios (ORs) and 95% confidence intervals (CIs) were calculated. Interaction terms between HR and body mass index (BMI) and HR and waist circumference (WC) were introduced into the logistic regression model.

RESULTS

In those with HR > 88.0 beats/min, fasting plasma glucose and oral glucose tolerance tests were significantly correlated with HR, and the prevalence of T2DM was highly correlated with HR (all p < .05). There were interactive associations of HR and obesity in patients with T2DM with HR < 74 beats/min.

CONCLUSION

High HR was in interaction with obesity, associating with prevalence of T2DM. The newly subdivided risk threshold for HR with T2DM might be HR > 88 beats/minute.

Changes in menopausal symptoms comparing oral estradiol versus transdermal estradiol

OBJECTIVE

This study aimed to compare the efficacy and safety of oral and transdermal estradiol in alleviating menopausal symptoms.

METHOD

A total of 257 recently menopausal women were randomized into two groups. The t-E2 group received transdermal estradiol (2.5 g per day) (n = 128) and the o-E2V group received oral estradiol valerate (2 mg per day) (n = 129) for 24 weeks; both groups received micronized progesterone (200 mg per day). The primary outcome measure is the change in the modified Kupperman Menopausal Index (KMI) after 24 weeks of treatment. Menopausal symptoms were recorded at screening and at 4, 12 and 24 weeks using both the KMI and the Menopause Rating Scale (MRS).

RESULTS

Significant amelioration was observed by KMI and MRS scores for both groups after treatment (p < 0.001). The mean KMI scores showed no difference between the two groups. The mean MRS scores were similar between the two groups at baseline and after 4 weeks of treatment. The results showed statistical differences after 12 weeks and 24 weeks of treatment (p = 0.005 and p = 0.011). Both the after-treatment scores minus the baseline scores of KMI and MRS and the incidence of adverse effects showed no difference between the two groups.

CONCLUSIONS

This study shows that both transdermal and oral estradiol are effective in relieving menopausal symptoms, with little difference in treatment efficacy and safety.

CLINICAL TRIAL NUMBER

ChiCTR2300073146.

Intermittent fasting improves glucose homeostasis not entirely dependent on caloric restriction in db/db male mice

Intermittent fasting (IF), which involves prolonged fasting intervals accompanied by caloric restriction, is an effective dietary treatment for obesity and diabetes. Although IF offers many benefits, it is difficult to determine whether these benefits are the consequences of caloric restriction. Every-other-day feeding (EODF) is a commonly used IF research model. This study was designed to identify other effectors of EODF, in addition to caloric restriction, and the possible underlying mechanisms. Diabetic db/db mice were divided into three groups: ad libitum (AL), meal-feeding (MF) and EODF. The MF model was employed to attain a level of caloric restriction comparable to EODF, with food distribution evenly divided between 10 AM and 6 PM, thereby minimizing the fasting interval. EODF yielded greater improvements in glucose homeostasis than MF in db/db mice by reducing fasting glucose levels and enhancing glucose tolerance. However, these effects on glucose metabolism were less pronounced in lean mice. Furthermore, ubiquitination of the liverspecific glucocorticoid receptor (GR) facilitated its degradation, and downregulating Kruppel-like factor 9 (KLF9), which ultimately suppressed liver gluconeogenesis in diabetic EODF mice. Although GR and KLF9 might mediate the metabolic benefits of EODF, the potential benefits of EODF might be limited by elevated serum glucocorticoid (GC) levels in diabetic EODF mice. Overall, this study suggests that the metabolic benefits of EODF in improving glucose homeostasis are independent of caloric restriction, possibly due to the downstream effects of liver-specific GR degradation.

Gut microbial co-metabolite 2-methylbutyrylcarnitine exacerbates thrombosis via binding to and activating integrin α2β1

Thrombosis represents the leading cause of death and disability upon major adverse cardiovascular events (MACEs). Numerous pathological conditions such as COVID-19 and metabolic disorders can lead to a heightened thrombotic risk; however, the underlying mechanisms remain poorly understood. Our study illustrates that 2-methylbutyrylcarnitine (2MBC), a branched-chain acylcarnitine, is accumulated in patients with COVID-19 and in patients with MACEs. 2MBC enhances platelet hyperreactivity and thrombus formation in mice. Mechanistically, 2MBC binds to integrin α2β1 in platelets, potentiating cytosolic phospholipase A2 (cPLA2) activation and platelet hyperresponsiveness. Genetic depletion or pharmacological inhibition of integrin α2β1 largely reverses the pro-thrombotic effects of 2MBC. Notably, 2MBC can be generated in a gut-microbiota-dependent manner, whereas the accumulation of plasma 2MBC and its thrombosis-aggravating effect are largely ameliorated following antibiotic-induced microbial depletion. Our study implicates 2MBC as a metabolite that links gut microbiota dysbiosis to elevated thrombotic risk, providing mechanistic insight and a potential therapeutic strategy for thrombosis.

Negative Lattice Expansion in an O3-Type Transition-Metal Oxide Cathode for Highly Stable Sodium-Ion Batteries

The sodium extraction/insertion in layered transition-metal oxide (TMO) cathode materials are typically accompanied by slab sliding and lattice changes, leading to microstructure destruction and capacity decay. Herein, negative lattice expansion is observed in an O3 type Ni-based layered cathode of Na0.9 Ni0.32 Zn0.08 Fe0.1 Mn0.3 Ti0.2 O2 upon Na+ extraction. It is attributed to the weak Zn2+ -O2- orbital hybridization and increased electron density of the surrounding oxygen for reinforced interlayer O-O repulsive force. This enables gliding of TMO slabs for the intergrowth phase transition of P3→OP2 to alleviate lattice strain with moderate lattice shrinkage, which exhibits general interslab spacings and volume changes as low as 2.4 % and 1.9 %, respectively. The strong Ti-O bonds accommodate the internal distortion of TMO6 octahedra due to the flexibility of TiO6 octahedra during cycling. These endow a high specific capacity of 144.9 mAh g-1 and excellent cycling performance of pouch-type sodium-ion batteries with 93 % capacity retention after 3600 cycles.

Highly Crystalized Cl-Doped SnO2 Nanocrystals for Stable Aqueous Dispersion Toward High-Performance Perovskite Photovoltaics

Tin dioxide (SnO2 ) with high conductivity and low photocatalytic activity has been reported as one of the best candidates for highly efficient electron transport layer (ETL) in perovskite solar cell (PSC). The state-of-the-art SnO2 layer is achieved by chemical bath deposition with tunable properties, while the commercial SnO2 nanocrystals (NCs) with low tunability still face the necessity of further improvement. Here, a kind of highly crystallized Cl-doped SnO2 NCs is reported that can form very stable aqueous dispersion with shelf life up to one year without any stabilizer, which can facilitate the fabrication of PSCs with satisfactory performance. Compared to the commercial SnO2 NCs regardless of the extrinsic Cl-doping conditions, the intrinsic Cl-doped SnO2 NCs effectively suppress the energy barrier and reduces the trap state density at the buried interface between perovskite and ETL. Consequently, stable PSCs based on such Cl-doped SnO2 NCs achieve a champion efficiency up to ≈25% for small cell (0.085 cm2 ) and ≈20% for mini-module (12.125 cm2 ), indicating its potential as a promising candidate for ETL in high-performance perovskite photovoltaics.

The intersection of virus infection and liver disease: A comprehensive review of pathogenesis, diagnosis, and treatment

Liver disease represents a significant global burden, placing individuals at a heightened risk of developing cirrhosis and liver cancer. Viral infections act as a primary cause of liver diseases on a worldwide scale. Infections involving hepatitis viruses, notably hepatitis B, C, and E viruses, stand out as the most prevalent contributors to acute and chronic intrahepatic adverse outcome, although the hepatitis C virus (HCV) can be effectively cured with antiviral drugs, but no preventative vaccination developed. Hepatitis B virus (HBV) and HCV can lead to both acute and chronic liver diseases, including liver cirrhosis and hepatocellular carcinoma (HCC), which are principal causes of worldwide morbidity and mortality. Other viruses, such as Epstein-Barr virus (EBV) and cytomegalovirus (CMV), are capable of causing liver damage. Therefore, it is essential to recognize that virus infections and liver diseases are intricate and interconnected processes. A profound understanding of the underlying relationship between virus infections and liver diseases proves pivotal in the effective prevention, diagnosis, and treatment of these conditions. In this review, we delve into the mechanisms by which virus infections induce liver diseases, as well as explore the pathogenesis, diagnosis, and treatment of liver diseases. This article is categorized under: Infectious Diseases > Biomedical Engineering.

Molecular mechanism of α-Hederin in tumor progression

α-Hederin is a monosaccharide pentacyclic triterpene saponin compound derived from the Chinese herb, Pulsatilla. It has garnered considerable attention for its anti-tumor, anti-inflammatory, and spasmolytic pharmacological activities. Given the rising incidence of cancer and the pronounced adverse reactions associated with chemotherapy drugs-which profoundly impact the quality of life for cancer patients-there is an immediate need for safe and effective antitumor agents. Traditional drugs and their anticancer effects have become a focal point of research in recent years. Studies indicate that α-Hederin can hinder tumor cell proliferation and impede the advancement of various cancers, including breast, lung, colorectal, and liver cancers. The principal mechanism behind its anti-tumor activity involves inhibiting tumor cell proliferation, facilitating tumor cell apoptosis, and arresting the cell cycle process. Current evidence suggests that α-Hederin can exert its anti-tumor properties through diverse mechanisms, positioning it as a promising agent in anti-tumor therapy. However, a comprehensive literature search revealed a gap in the comprehensive understanding of α-Hederin. This paper aims to review the available literature on the anti-tumor mechanisms of α-Hederin, hoping to provide valuable insights for the clinical treatment of malignant tumors and the innovation of novel anti-tumor medications.

Study on the Properties of Multi-Walled Carbon Nanotubes (MWCNTs)/Polypropylene Fiber (PP Fiber) Cement-Based Materials

In order to improve the mechanical properties and durability of cement-based materials, a certain amount of multi-walled carbon nanotubes (MWCNTs) and polypropylene fiber (PP fiber) were incorporated into cement-based materials. The mechanical properties of the multi-walled carbon nanotubes/polypropylene fiber cement-based materials were evaluated using flexural strength tests, compressive strength tests, and splitting tensile tests. The effects of multi-walled carbon nanotubes and polypropylene fiber on the durability of cement-based materials were studied using drying shrinkage tests and freeze-thaw cycle tests. The effects of the multi-walled carbon nanotubes and polypropylene fibers on the microstructure and pore structure of the cement-based materials were compared and analyzed using scanning electron microscopy and mercury intrusion tests. The results showed that the mechanical properties and durability of cement-based materials can be significantly improved when the content of multi-walled carbon nanotubes is 0.1-0.15%. The compressive strength can be increased by 9.5% and the mass loss rate is reduced by 27.9%. Polypropylene fiber has little effect on the compressive strength of the cement-based materials, but it significantly enhances the toughness of the cement-based materials. When its content is 0.2-0.3%, it has the best effect on improving the mechanical properties and durability of the cement-based materials. The flexural strength is increased by 19.1%, and the dry shrinkage rate and water loss rate are reduced by 14.3% and 16.1%, respectively. The three-dimensional network structure formed by the polypropylene fiber in the composite material plays a role in toughening and cracking resistance, but it has a certain negative impact on the pore structure of the composite material. The incorporation of multi-walled carbon nanotubes can improve the bonding performance of the polypropylene fiber and cement matrix, make up for the internal defects caused by the polypropylene fiber, and reduce the number of harmful holes and multiple harmful holes so that the cement-based composite material not only has a significant increase in toughness but also has a denser internal structure.

Effective strategies for reclamation of saline-alkali soil and response mechanisms of the soil-plant system

The combination of amendments has emerged as a potential strategy to efficiently alleviate salt stress in saline-alkali soil. However, knowledge regarding how to optimize the proportion of different amendment materials, comprehensively assess the contribution of each component, and clarify the response mechanisms of the amendment-saline-alkali soil-plant system is incomplete. Based on this, we conducted a pot experiment to evaluate the improvement effect of the combined application of different amendment materials at varying levels and the contribution of the amendment components to alleviating salt stress. Overall, T6 exhibited the most significant improvement effect on the physicochemical and biological properties of the saline-alkali soil and promoted the growth of oilseed rape, with the levels of 2.0 % phosphogypsum, 2.0 % humic acid, 0.25 % bentonite, and 0.03 % sodium carboxymethyl cellulose. Compared with the control group, the EC decreased by 1.51 % to 33.49 %, the soil salt content dropped by 11.40 % to 35.46 %, and the soil soluble Na + concentration significantly declined by 39.47 % to 63.20 %. Additionally, the soil nutrient content and soil microbial community structure were enhanced in treatment groups. Meanwhile, amendments alleviated salt stress in the oilseed rape plant by activating anti-oxidative enzymes and osmoregulatory substances such as soluble sugar and proline, thus improving their ability to remove reactive oxygen species (ROS). The anti-oxidative enzymes such as superoxide dismutase (SOD), peroxidase (POD), and catalase (CAT) were significantly increased, with an increase of 10.68 % (SOD, T2) ∼207.31 % (CAT, T6) compared to the control group. The structural equation modeling (SEM) analysis and simulation experiments indicated that the amendment components synergically promoted the amelioration effect on salt stress, and effectively improved soil properties, which affected the response of oilseed rape to soil environment. This research paper provides the relevant reference for the combined application of different amendment materials for soil reclamation.

Effects of soil amendments on Cd and As mobility in the soil-rice system and their distribution in the grain

The accumulation, mobilization, and distribution of toxic metal(loid)s in rice are key factors that affect food security and determine bio-utilization patterns. In this study, five soil amendments with different components were used in paddy fields to study the key factors: organic amendments: (1) polyaspartic acid (OA1) and (2) organic fertilizer (OA2); inorganic amendments: (3) kaolinite (IA1) and (4) magnesium slag (IA2); and organic-inorganic composite amendments: (5) modified biochar/quicklime (OIA). Although the Cd and As exhibited opposite chemical dissolution behaviors, IA1/OIA, can simultaneously reduce their accumulation and transfer coefficients in rice tissues, while other amendments only work for one of them. The in situ distribution in grains showed that IA1/OIA changed the original Cd distribution in the lemma and palea, whereas all amendments reduced Cd accumulation in the germ. In contrast, OA1/IA2 amendments led to more As accumulation in the rice husks and bran than in the endosperm center, and the germ had higher As signals. Because of their similar transport pathways and interactions, the concentrations of Cd and As in the grains were correlated with a variety of mineral elements (Fe, Mo, Zn, etc.). Changes in the Cd/As concentration and distribution in rice were achieved through the improvement of soil properties and plant growth behavior through amendments. The application of OIA resulted in the highest immobilization indices, at 82.17 % and 35.34 % for Cd and As, respectively. The Cd/As concentrations in the rice grains were highly positively correlated with extractable-Cd/As in the soil (Cd: R2 = 0.95, As: R2 = 0.93). These findings reveal the migration and distribution mechanisms of Cd and As in the soil-rice system, and thus provide fundamental information for minimizing food safety risk.

Comprehensive evaluation of the risk system for heavy metals in the rehabilitated saline-alkali land

A comprehensive assessment of the heavy metal system in the rehabilitated saline-alkali land holds significant importance, as the in-situ remediation process utilizing amendments substantially alters the initial physicochemical properties of the soil, which could lead to the migration or reactivation of previously stabilized heavy metals. In this context, the present study aims to evaluate the heavy metal content and health risk within the improved saline-alkali soil-plant system. Moreover, a comprehensive evaluation based on the TOPSIS-RSR method is carried out to accurately gauge the soil health status. The findings indicate that the modification process has an impact on the concentrations of heavy metals in the soil and crops, causing either an increase or decrease. However, the level of heavy metal pollution in the improved saline-alkali soil and rape remains within safe limits. The results of the migration of heavy metals after amendment application indicated that the migration of heavy metals in the soil was influenced by the properties of the heavy metals, the composition of the amendment, and leaching. Furthermore, the total non-carcinogenic hazard quotients in the soil and rape were within the safe threshold for all populations. The findings provided novel insights into the status and risk assessment of the pollution of improved saline-alkali soil.

Neuromodulatory effects of high-definition theta transcranial alternating current stimulation on the parietal cortex: a pilot study of healthy males

Introduction

Transcranial alternating current stimulation (tACS) can regulate brain functions by modulating endogenous brain rhythms. Theta-band neural oscillations are associated with memory function. In particular, theta neural oscillatory power evoked in the parietal cortex is closely related to memory retrieval processes. In this study, the immediate effects of high-definition theta transcranial alternating current stimulation (HDθ-tACS) on the human left parietal cortex were investigated using short-latency afferent inhibition (SAI) and electroencephalography (EEG).

Methods

Ten subjects participated in this study. We used 6-Hz HD tACS to stimulate the left parietal cortex for 15 min. SAI was calculated, and non-linear dynamic analysis of the EEG was performed to analyze neuronal function after HD θ-tACS.

Results

The results showed a significant decrease in SAI (p < 0.05), while the left frontoparietal network was reinforced, leading to brain lateralization after HD θ-tACS. During performance of a memory task, F3 signals showed a significant upward trend in approximate entropy following treatment (p < 0.05). There was also a significant decrease in cross-approximate entropy in the C3-C4 and P3-P4 connections following the intervention (p < 0.05) in a resting eyes-open condition and in the memory task condition.

Discussion

In conclusion, HD θ-tACS could alter cholinergic transmission and cortical excitability between the parietal and motor cortices, as well as reinforcing the frontoparietal network and the left-lateralization phenomenon, which may facilitate memory formation, encoding, and consolidation.

Internal Electric Field-Modulated Charge Migration Behavior in MoS2 /MIL-53(Fe) S-Scheme Heterojunction for Boosting Visible-Light-Driven Photocatalytic Chlorinated Antibiotics Degradation

Inadequate photo-generated charge separation, migration, and utilization efficiency limit the photocatalytic efficiency. Herein, a MoS2 /MIL-53(Fe) photocatalyst/activator with the S-scheme heterojunction structure is designed and the charge migration behavior is modulated by the internal electric field (IEF). The IEF intensity is enhanced to 40 mV by modulating band bending potential and the depletion layer length of MoS2 . The photo-generated electron migration process is boosted by constructing the electron migration bridge (Fe-O-S) and modulating the IEF as the driving force, confirmed by the density functional theory calculation. Compared with the pristine materials, the photocurrent density of MoS2 /MIL-53(Fe) is significantly enhanced 27.5 times. Contributed by the visible-light-driven cooperative catalytic degradation and the high-efficiency direct photo-generated electron reduction dichlorination process, satisfactory chlorinated antibiotics removal and detoxification performances are achieved. This study opens up new insights into the application of heterojunctions in photocatalytic activation of PDS in environmental remediation.

Surface Termination on Unstable Methylammonium-based Perovskite Using a Steric Barrier for Improved Perovskite Solar Cells

Compared to widely adopted low-dimensional/three-dimensional (LD/3D) heterostructure, functional organic cation based surface termination on perovskite can not only realize advantage of defect passivation but also prevent potential disadvantage of the heterostructure induced intercalation into 3D perovskite. However, it is still very challenging to controllably construct surface termination on organic-inorganic hybrid perovskite because the functional organic cations' substitution reaction is easy to form LD/3D heterostructure. Here, we report using a novel benzyltrimethylammonium (BTA) functional cation with rational designed steric hindrance to effectively surface terminate onto methylammonium lead triiodide (MAPbI3 ) perovskite, which is composed of the most unstable MA cations. The BTA cation is difficult to form a specific 1.5-dimensional perovskite of BTA4 Pb3 I10 by cation substitution with MA cation, which then provides a wide processing window (around 10 minutes) for surface terminating on MAPbI3 films. Moreover, the BTAI surface terminated BTAI-MAPbI3 shows better passivation effect than BTA4 Pb3 I10 -MAPbI3 heterojunction. Finally, BTAI surface terminated solar cell (0.085 cm2 ) and mini-module (11.52 cm2 ) obtained the efficiencies of 22.03 % and 18.57 %, which are among the highest efficiencies for MAPbI3 based ones.

[Clinicopathological and prognostic features of subungual melanoma in situ]

Objective: To investigate the clinicopathological characteristics, immunohistochemical profiles, molecular features, and prognosis of subungual melanoma in situ (SMIS). Methods: Thirty cases of SMIS were collected in Fudan University Shanghai Cancer Center, Shanghai, China from 2018 to 2022. The clinicopathological characteristics and follow-up data were retrospectively analyzed. Histopathologic evaluation and immunohistochemical studies were carried out. By using Vysis melanoma fluorescence in situ hybridization (FISH) probe kit, combined with 9p21(CDKN2A) and 8q24(MYC) assays were performed. Results: There were 8 males and 22 females. The patients' ages ranged from 22 to 65 years (median 48 years). All patients presented with longitudinal melanonychia involving a single digit. Thumb was the most commonly affected digit (16/30, 53.3%). 56.7% (17/30) of the cases presented with Hutchinson's sign. Microscopically, melanocytes proliferated along the dermo-epithelial junction. Hyperchromatism and nuclear pleomorphism were two of the most common histological features. The melanocyte count ranged from 30 to 185. Most cases showed small to medium nuclear enlargement (29/30, 96.7%). Pagetoid spread was seen in all cases. Intra-epithelial mitoses were identified in 56.7% (17/30) of the cases. Involvement of nailfold was found in 19 cases, 4 of which were accompanied by cutaneous adnexal extension. The positive rates of SOX10, PNL2, Melan A, HMB45, S-100, and PRAME were 100.0%, 100.0%, 96.0%, 95.0%, 76.9%, and 83.3%, respectively. FISH analysis was positive in 6/9 of the cases. Follow-up data were available in 28 patients, and all of them were alive without disease. Conclusions: SMIS mainly shows small to medium-sized cells. High melanocyte count, hyperchromatism, nuclear pleomorphism, Pagetoid spreading, intra-epithelial mitosis, nailfold involvement, and cutaneous adnexal extension are important diagnostic hallmarks. Immunohistochemistry including SOX10 and PRAME, combined with FISH analysis, is valuable for the diagnosis of SMIS.

Clinical Research Progress of the Post-Stroke Upper Limb Motor Function Improvement via Transcutaneous Auricular Vagus Nerve Stimulation

Stroke is a disease with high morbidity and disability, and motor impairment is a common sequela of stroke. Transcutaneous auricular vagus nerve stimulation (taVNS) is a type of non-invasive stimulation, which can effectively improve post-stroke motor dysfunction. This review discusses stimulation parameters, intervention timing, and the development of innovative devices for taVNS. We further summarize the application of taVNS in improving post-stroke upper limb motor function to further promote the clinical research and application of taVNS in the rehabilitation of post-stroke upper limb motor dysfunction.

The association of FGF-21 with the risk of newly diagnosed type-2 diabetes mellitus: a cross-sectional study in Southern China

BACKGROUND

This study investigated the relationship between fibroblast growth factor 21 (FGF-21) and newly diagnosed type-2 diabetes mellitus (T2DM).

METHODS

In this cross-sectional study, FGF-21 and T2DM risk were analyzed using restricted cubic splines with univariate or multivariate logistic regression analysis. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated via logistic regression analysis. Cluster and subgroup analyses were conducted to evaluate the associations between FGF-21 and diabetes in different subpopulations. Nomograms and ROC curves were used to explore the clinical utility of FGF-21 in the diabetes assessment model.

RESULTS

High levels of FGF-21 were significantly associated with a high risk of T2DM after adjusting for confounding factors in both the total population and subpopulations (P for trend < 0.001). In the total population, the ORs of diabetes with increasing FGF-21 quartiles were 1.00 (reference), 1.24 (95% CI 0.56-2.80; quartile 2), 2.47 (95% CI 1.18-5.33; quartile 3), and 3.24 (95% CI 1.53-7.14; quartile 4) in Model 4 (P < 0.001), and the trend was consistent in different subpopulations. In addition, compared with the model constructed with conventional noninvasive indicators, the AUC of the model constructed by adding FGF-21 was increased from 0.668 (95% CI: 0.602-0.733) to 0.715 (95% CI: 0.654-0.777), indicating that FGF-21 could significantly improve the risk-assessment efficiency of type-2 diabetes.

CONCLUSION

This study demonstrated that a high level of circulating FGF-21 was positively correlated with diabetes, and levels of FGF-21 could be an important biomarker for the assessment of diabetes risk.

Whole-Voltage-Range Solid-Solution Reaction in Layered Oxide Cathode of Sodium-Ion Batteries

Layered manganese-based oxides (LMOs) are promising cathode materials for sodium-ion batteries (SIBs) due to their versatile structures. However, the Jahn-Teller effect of Mn3+ induces severe distortion of MnO6 octahedra, and the resultant low symmetry is responsible for the gliding of MnO2 layers and then inferior multiple-phase transitions upon Na+ extraction/insertion. Here, hexagonal P2-Na0.643 Li0.078 Mn0.827 Ti0.095 O2 is synthesized through the incorporation of Li and Ti into the distorted orthorhombic P'2-Na0.67 MnO2 to function as a phase-transition-free oxide cathode. It is revealed that Li in both the transition-metal and Na layers enhances the covalency of Mn-O bonds and allows degeneracy of Mn 3d eg orbitals to favor the formation of hexagonal phase, and the high strength of Ti-O bonds reduces the electrostatic interaction between Na and O for suppressed Na+ /vacancy rearrangements. These collectively lead to a whole-voltage-range solid-solution reaction between 1.8 and 4.3 V with a small volume variation of 1.49%. This rewards its excellent cycling stability (capacity retention of 90% after 500 cycles) and rate capability (89 mAh g-1 at 2000 mA g-1 ).

Glucose Metabolism Indices and the Development of Chronic Kidney Disease: A Cohort Study of Middle-Aged and Elderly Chinese Persons

Objective

Chronic kidney disease (CKD) has become a major global health issue, and abnormalities of glucose metabolism are a risk factor responsible for development of CKD. We aimed to investigate associations between glucose metabolism indices and CKD in a Chinese population and determine which index is superior for predicting incident CKD.

Methods

We performed a community-based population on 5232 subjects aged ≥40 years without baseline CKD. CKD was defined as an estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m2 or urinary albumin-to-creatinine ratio (UACR) ≥30 mg/g. We examined the associations of glucose metabolism indices, including fasting plasma glucose (FPG), 2-hour (2 h) oral glucose tolerance test (OGTT), hemoglobin A1c (HbA1c), fasting insulin level, homeostasis model assessment of insulin resistance (HOMA-IR), and HOMA-β and the development of CKD.

Results

With an average follow-up of 3.6 years, 6.4% of the subjects developed CKD. Pearson's correlation analysis revealed that FPG, HbA1c, fasting insulin, and HOMA-IR were all significantly correlated with UACR and eGFR. The association persisted in multivariate linear regression analysis adjusted for age and sex. Compared with other glucose indices, HOMA-IR exhibited the strongest associations with CKD in COX multivariate regression analysis (HR = 1.17, 95% CI: 1.04-1.31).

Conclusion

HOMA-IR is superior to other routine indices of glucose metabolism for predicting the development of CKD in middle-aged Chinese persons. Screening with HOMA-IR may help prevent the development of CKD in the general population.

Exploration of the preterm birth risk-related heat event thresholds for pregnant women: a population-based cohort study in China

Background

Heat events increase the risk of preterm birth (PTB), and identifying the risk-related event thresholds contributes to developing early warning system for pregnant women and guiding their public health response. However, the event thresholds that cause the risk remain unclear. We aimed to investigate the effects of heat events defined with different intensities and durations on PTB throughout pregnancy, and to determine thresholds for the high-risk heat events.

Methods

Using a population-based birth cohort data, we included 210,798 singleton live births in eight provinces in China during 2014-2018. Daily meteorological variables and inverse distance weighted methods were used to estimate exposures at a resolution of 1 km × 1 km. A series of cut off temperature intensities (50th-97.5th percentiles, or 18 °C-35 °C) and durations (at least 1, 2, 3, 4 or 5 consecutive days) were used to define the heat events. Cox regression models were used to estimate the effects of heat events on PTB in various gestational weeks during the entire pregnancy, and event thresholds were determined by calculating population attributable fractions.

Findings

The hazard ratios of heat event exposure on PTB ranged from 1.07 (95% CI: 1.00, 1.13) to 1.43 (1.15, 1.77). Adverse effects of heat event exposure were prominently detected in gestational week 1-4, week 21-32 and the four weeks before delivery. The heat event thresholds were determined to be daily maximum temperature at the 90th percentile of the distribution or 30 °C lasting for at least one day. If pregnant women were able to avoid the heat exposures from the early warning systems triggered by these thresholds, approximately 15% or 17% of the number of total PTB cases could have been avoided.

Interpretation

Exposure to heat event can increase the risk of PTB when thermal event exceeds a specific intensity and duration threshold, particularly in the first four gestational weeks, and between week 21 and the last four weeks. This study provides compelling evidence for the development of heat-health early warning systems for pregnant women that could substantially mitigate the risk of PTB.

Funding

National Key R&D Program of China (No. 2018YFA0606200), National Natural Science Foundation of China (No. 42175183), Sanming Project of Medicine in Shenzhen (No. SZSM202111001).

Celastrol relieves myocardial infarction-induced cardiac fibrosis by inhibiting NLRP3 inflammasomes in rats

BACKGROUND

Myocardial infarction (MI) triggers a strong inflammatory response mediating by NLRP3 inflammasome which is associated with cardiac fibrosis. The key players in this response are Interleukin (IL)-1 and IL-18, which are regulated by NLRP3 inflammasomes. Celastrol, a traditional Chinese medicine with strong anti-inflammatory activity, has recently reported as a cardioprotective agent. However, the mechanisms by which celastrol is cardioprotective in MI remain elusive. We hypothesized that Celastrol could reduce IL-1β and IL-18 expression and ameliorate myocardial fibrosis after myocardial infarction in rats, improve poor heart remodeling, and preserve heart function.

METHODS

Myocardial infarction (MI) was caused by ligating the left anterior descending of male SD rats. Celastrol (1 mg/kg) or saline was administered every other day for 4 weeks. Heart function and fibrosis were assessed. Inflammatory and fibrotic markers in the myocardia were evaluated with immunohistochemistry, western blot, and ELISA. Molecular docking was employed to predict Celastrol's binding to NLRP3 protein. The effects of Celastrol on the expression of NLRP3 inflammasome and myocardial fibrosis genes were then examined in vitro.

RESULTS

Celastrol maintained the left ventricular fractional shortening (FS) and ejection fraction (EF). Fibrosis was significantly reduced in animals treated with 1 mg/kg Celastrol (15.17 ± 1.82%) relative to controls (29.88 ± 4.28%). Celastrol also significantly reduced the NLRP3, IL-18, and IL-1β levels, together with macrophage and neutrophil infiltration in the myocardium. Molecular docking predicted that NLRP3 would bind tightly to Celastrol [Docking energy: -8.9 (kcal/mol)]. In vitro experiments showed reduced NLRP3 inflammasome and myocardial fibrosis-associated proteins expression in neonatal rat cardiac fibroblasts treated with Celastrol.

CONCLUSIONS

In post-MI rats, Celastrol, a naturally occurring active ingredient, was able to reduce myocardial fibrosis and improve cardiac function, according to our study. These effects may result from inhibiting the NLRP3 inflammasome and attenuating the early inflammatory storm after MI, suggesting that Celastrol may be useful in treating acute MI.

Effect of high-level PM2.5 on survival in lung cancer: a multicenter cohort study from Hebei Province, China

Globally, air pollution is the fourth leading risk factor for death, while lung cancer (LC) is the leading cause of cancer-related death. The aim of this study was to explore the prognostic factors of LC and the influence of high fine particulate matter (PM_2.5) on LC survival. Data on LC patients were collected from 133 hospitals across 11 cities in Hebei Province from 2010 to 2015, and survival status was followed up until 2019. The personal PM_2.5 exposure concentration (μg/m³) was matched according to the patient's registered address, calculated from a 5-year average for every patient, and stratified into quartiles. The Kaplan-Meier method was used to estimate overall survival (OS), and Cox's proportional hazard regression model was used to estimate hazard ratios (HRs) with 95% confidence intervals (CIs). The 1-, 3-, and 5-year OS rates of the 6429 patients were 62.9%, 33.2%, and 15.2%, respectively. Advanced age (75 years or older: HR = 2.34, 95% CI: 1.25-4.38), subsite at overlapping (HR = 4.35, 95% CI: 1.70-11.1), poor/undifferentiated differentiation (HR = 1.71, 95% CI: 1.13-2.58), and advanced stages (stage III: HR = 2.53, 95% CI: 1.60-4.00; stage IV: HR = 4.00, 95% CI: 2.63-6.09) were risk factors for survival, while receiving surgical treatment was a protective factor (HR = 0.60, 95% CI: 0.44-0.83). Patients exposed to light pollution had the lowest risk of death with a 26-month median survival time. The risk of death in LC patients was greatest at PM_2.5 concentrations of 98.7-108.9 μg/m³, especially for patients at advanced stage (HR = 1.43, 95% CI: 1.29-1.60). Our study indicates that the survival of LC is severely affected by relatively high levels of PM_2.5 pollution, especially in those with advanced-stage cancer.

Solvation Structure with Enhanced Anionic Coordination for Stable Anodes in Lithium-Oxygen Batteries

Li-O2 batteries have garnered much attention due to their high theoretical energy density. However, the irreversible lithium plating/stripping on the anode limits their performance, which has been paid little attention. Herein, a solvation-regulated strategy for stable lithium anodes in tetraethylene glycol dimethyl ether (G4) based electrolyte is attempted in Li-O2 batteries. Trifluoroacetate anions (TFA-) with strong Li+ affinity are incorporated into the lithium bis(fluorosulfonyl)imide (LiTFSI)/G4 electrolyte to attenuate the Li+-G4 interaction and form anion-dominant solvates. The bisalt electrolyte with 0.5 M LiTFA and 0.5 M LiTFSI mitigates G4 decomposition and induces an inorganic-rich solid electrolyte interphase (SEI). This contributes to decreased desolvation energy barrier from 58.20 to 46.31 kJ mol-1, compared with 1.0 M LiTFSI/G4, for facile interfacial Li+ diffusion and high efficiency. It yields extended lifespan of 120 cycles in Li-O2 battery with a limited Li anode (7 mAh cm-2). This work gains comprehensive insights into rational electrolyte design for Li-O2 batteries.

Lung cancer risk and exposure to air pollution: a multicenter North China case-control study involving 14604 subjects

BACKGROUND

For North Chinese lung cancer patients, there is limited study on the distribution of air pollution and smoking related features based on analyses of large-scale, high-quality population datasets. The aim of the study was to fully analyze risk factors for 14604 Subjects.

METHODS

Participants and controls were recruited in 11 cities of North China. Participants' basic information (sex, age, marital status, occupation, height, and weight), blood type, smoking history, alcohol consumption, history of lung-related diseases and family history of cancer were collected. PM2.5 concentration data for each year in each city of the study area from 2005 to 2018 were extracted based on geocoding of each person's residential address at the time of diagnosis. Demographic variables and risk factors were compared between cases and matched controls using a univariate conditional logistic regression model. Multivariate conditional logistic regression models were applied to estimate the odds ratio (OR) and 95% confidence interval (CI) for risk factors in univariate analysis. The nomogram model and the calibration curve were developed to predict lung cancer probability for the probability of lung cancer.

RESULTS

There was a total of 14604 subjects, comprising 7124 lung cancer cases and 7480 healthy controls included in the study. Marital status of unmarried persons, people with a history of lung-related disease, corporate personnel and production /service personnel were protective factors for lung cancer. People younger than 50 years old, people who were smoking and quit smoking, people who had been drinking consistently, people with family history of cancer and PM2.5 exposure were proven to be a risk factor for lung cancer. The risk of lung cancer varied with sex, smoking status and air pollution. Consistent alcohol consumption, persistent smoking and smoking quit were risk factors for lung cancer in men. By smoking status, male was risk factor for lung cancer in never smokers. Consistent alcohol consumption added risk for lung cancer in never smokers. The combined effects of PM2.5 pollution exposure and ever smoking aggravated the incidence of lung cancer. According to air pollution, lung cancer risk factors are completely different in lightly and heavily polluted areas. In lightly polluted areas, a history of lung-related disease was a risk factor for lung cancer. In heavily polluted areas, male, consistent alcohol consumption, a family history of cancer, ever smokers and smoking quit were all risk factors for lung cancer. A nomogram was plotted and the results showed that PM2.5 was the main factor affecting the occurrence of lung cancer.

CONCLUSIONS

The large-scale accurate analysis of multiple risk factors in different air quality environments and various populations, provide clear directions and guidance for lung cancer prevention and precise treatment.

Case report: High-frequency repetitive transcranial magnetic stimulation for treatment of hereditary spastic paraplegia type 11

Hereditary spastic paraplegia (HSP) is a heterogeneous group of inherited neurodegenerative disorders that currently have no cure. HSP type 11 (SPG11-HSP) is a complex form carrying mutations in the SPG11 gene. Neuropathological studies demonstrate that motor deficits in these patients are mainly attributed to axonal degeneration of the corticospinal tract (CST). Repetitive transcranial magnetic stimulation (rTMS) is a non-invasive technique that can induce central nervous system plasticity and promote neurological recovery by modulating the excitability of cortical neuronal cells. Although rTMS is expected to be a therapeutic tool for neurodegenerative diseases, no previous studies have applied rTMS to treat motor symptoms in SPG11-HSP. Here, we report a case of SPG11-HSP with lower extremity spasticity and gait instability, which were improved by applying high-frequency rTMS (HF-rTMS) at the primary motor cortex (M1). Clinical and physiological features were measured throughout the treatment, including the Modified Ashworth Scale (MAS), Berg Balance Scale (BBS), the timed up and go (TUG) test and the 10-meter walk test time (10 MWT). The structure and excitability of the CST were assessed by diffusion tensor imaging (DTI) and transcranial magnetic stimulation (TMS), respectively. After treatment, the patient gained 17 points of BBS, along with a gradual decrease in MAS scores of the bilateral lower extremity. In addition, the TUG test and 10 MWT improved to varying degrees. TMS assessment showed increased motor evoked potential (MEP) amplitude, decreased resting motor threshold (RMT), decreased central motor conduction time (CMCT), and decreased difference in the cortical silent period (CSP) between bilateral hemispheres. Using the DTI technique, we observed increased fractional anisotropy (FA) values and decreased mean diffusivity (MD) and radial diffusivity (RD) values in the CST. It suggests that applying HF-rTMS over the bilateral leg area of M1 (M1-LEG) is beneficial for SPG11-HSP. In this study, we demonstrate the potential of rTMS to promote neurological recovery from both functional and structural perspectives. It may provide a clinical rationale for using rTMS in the rehabilitation of HSP patients.

Human activities have more impacts on the recent discharge reduction of the largest tributary of the Yellow River relative to last three centuries

How to quantitatively decouple the impacts of climate change and human activities on river discharge changes is a challenge in current global change research. As the largest tributary of the Yellow River (YR), the Weihe River (WR) is a typical river whose discharge is influenced by climate change and human activities. Here, we first attempt to obtain the normal-flow season and high-flow season discharge in the lower reaches of the WR by using tree rings and historical documents, respectively. The relationship between natural discharge in the two seasons is unstable and complex since 1678. Using an innovative method, we reconstructed the natural discharge from March to October (D_M-O), which explains >73 % of the variance in the observed D_M-O during the modeling period 1935-1970. There were 44 high-flow years, 6 extremely high-flow years, 48 low-flow years and 8 extremely low-flow years from 1678 to 2008. The contribution of WR annual discharge to the YR is 17 % over the past three centuries, and their natural discharge changes synchronously rise and fall. Human activities, such as the construction of reservoirs and check-dams, agricultural irrigation and domestic and industrial water consumption, have more impacts than climate change on the decrease in the observed discharge. In total, 53.5 % of the discharge reduction since 1971 is due to human activities, and 46.5 % is due to climate change. In addition, this study provides an important model for how to quantify the influences of human activities and nature on discharge reduction and to reconstruct seasonal resolution climate in global change studies.

Improved YOLOv5 infrared tank target detection method under ground background

The detection precision of infrared seeker directly affects the guidance precision of infrared guidance system. To solve the problem of low target detection accuracy caused by the change of imaging scale, complex ground background and inconspicuous infrared target characteristics when infrared image seeker detects ground tank targets. In this paper, a You Only Look Once, Transform Head Squeeze-and-Excitation (YOLOv5s-THSE) model is proposed based on the YOLOv5s model. A multi-head attention mechanism is added to the backbone and neck of the network, and deeper target features are extracted using the multi-head attention mechanism. The Cross Stage Partial, Squeeze-and-Exclusion module is added to the neck of the network to suppress the complex background and make the model pay more attention to the target. A small object detection head is introduced into the head of the network, and the CIoU loss function is used in the model to improve the detection accuracy of small objects and obtain more stable training regression. Through these several improvement measures, the background of the infrared target is suppressed, and the detection ability of infrared tank targets is improved. Experiments on infrared tank target datasets show that our proposed model can effectively improve the detection performance of infrared tank targets under ground background compared with existing methods, such as YOLOv5s, YOLOv5s + SE, and YOLOV 5 s + Convective Block Attention Module.

Myth behind Metastable and Stable n-Hexylammonium Bromide-Based Low-Dimensional Perovskites

In perovskite solar cells, passivating the surface or interface that contains a high concentration of defects, specifically deep-level defects, is one of the most important topics to substantially enhance the power conversion efficiency and stability of the devices. Long-chain alkylammonium bromides have been widely and commonly adapted for passivation treatment. However, the mechanism behind is still not well explored as the formation route and the exact structure of these alkylammonium bromide-based low-dimensional perovskites are unclear. Herein, we investigate the physical and chemical properties of an n-hexylammonium bromide (HABr)-based low-dimensional perovskite including both thin films and single crystals. First of all, the HA₂PbBr₄ perovskite film and aged single crystal demonstrate different X-ray diffraction patterns from those of the fresh as-prepared single crystal. We found that the fresh HA₂PbBr₄ single crystal exhibits a metastable phase as its structure changes with aging due to the relaxation of crystal lattice strains, whereas the HA₂PbBr₄ perovskite film is pretty stable as the aged single crystal. Upon reacting with FAPbI₃, HABr can be intercalated into the FAPbI₃ lattice to form a mixed-cation perovskite of HAFAPbI₃Br, which is in a dynamic equilibrium of decomposition and formation. In contrast, the reaction of HABr with excess PbI₂ forms a stable HA₂PbI₂Br₂ perovskite. Based on such findings, we rationally develop a HA₂PbI₂Br₂-passivated FACs-based perovskite by reacting HABr with excess PbI₂, the photovoltaics based on which are more stable and efficient than those passivated by the HAFAPbI₃Br perovskite. Our discovery paves way for a more in-depth study of bromide-containing low-dimensional perovskites and their optoelectronic applications.

U-shaped association between serum IGF2BP3 and T2DM: A cross-sectional study in Chinese population

OBJECTIVE

To clarify the expression of N6-methyladenosine (m⁶ A) modulators involved in the pathogenesis of type 2 diabetes mellitus (T2DM). We further explored the association of serum insulin-like growth factor 2 mRNA-binding proteins 3 (IGF2BP3) levels and odds of T2DM in a high-risk population.

METHODS

The gene expression data set GSE25724 was obtained from the Gene Expression Omnibus, and a cluster heatmap was generated by using the R package ComplexHeatmap. Differential expression analysis for 13 m⁶ A RNA methylation regulators between nondiabetic controls and T2DM subjects was performed using an unpaired t test. A cross-sectional design, including 393 subjects (131 patients with newly diagnosed T2DM, 131 age- and sex-matched subjects with prediabetes, and 131 healthy controls), was carried out. The associations between serum IGF2BP3 concentrations and T2DM were modeled by restricted cubic spline and logistic regression models.

RESULTS

Two upregulated (IGF2BP2 and IGF2BP3) and 5 downregulated (methyltransferase-like 3 [METTL3], alkylation repair homolog protein 1 [ALKBH1], YTH domain family 2 [YTHDF2], YTHDF3, and heterogeneous nuclear ribonucleoprotein [HNRNPC]) m⁶ A-related genes were found in islet samples of T2DM patients. A U-shaped association existed between serum IGF2BP3 levels and odds of T2DM according to cubic natural spline analysis models, after adjustment for body mass index, waist circumference, diastolic blood pressure, total cholesterol, and triglyeride. Multivariate logistic regression showed that progressively higher odds of T2DM were observed when serum IGF2BP3 levels were below 0.62 ng/mL (odds ratio 3.03 [95% confidence interval 1.23-7.47]) in model 4.

CONCLUSION

Seven significantly altered m⁶ A RNA methylation genes were identified in T2DM. There was a U-shaped association between serum IGF2BP3 levels and odds of T2DM in the general Chinese adult population. This study provides important evidence for further examination of the role of m⁶ A RNA methylation, especially serum IGF2BP3 in T2DM risk assessment.

New evidence for regional pastoral practice and social complexity in the Eastern Tianshan Mountains in the first millennium BCE

Mobile pastoralism was a key lifeway in the Late Bronze and Iron Age of Northwest China and played a crucial role in the regional socio-cultural development, as well as the formation of transregional networks. In this paper we analyse the complete faunal assemblage from House F2 in Shirenzigou, on the Eastern Tianshan Mountains, in combination with radiocarbon dating and spatial analysis, to explore local animal resources exploitation strategies and related socio-economic implications. Our results show an intensive multipurpose caprine management, while the exploitation of other domestic taxa, cattle, horses and dogs, was limited. This pastoral economy was supplemented with some hunting. The differentiated use of space in F2 indicates that basic domestic tasks were carried out in the structure, however its position within the landscape and the predominance of bone tools related to warfare and socialization activities, suggests that it was not an ordinary dwelling, it may also have served as a watch post for the summer encampment within the gully. Our findings constitute an important contribution on the discussion on animal resources exploitation strategies and their relationship with evolving socio-economic complexity in the Eastern Tianshan region in the late first millennium BCE.

Effects of integrated action and sensory observation therapy based on mirror neuron and embodied cognition theory on upper limb sensorimotor function in chronic stroke: a study protocol for a randomised controlled trial

INTRODUCTION

This study protocol aims to explore the effectiveness and neural mechanism of the integration of action observation therapy (AOT) and sensory observation therapy (SOT) for post-stroke patients on upper limb sensorimotor function.

METHODS AND ANALYSIS

This is a single-centre, single-blind, randomised controlled trial. A total of 69 patients with upper extremity hemiparesis after stroke will be recruited and randomly divided into an AOT group, a combined action observation and somatosensory stimulation therapy (AOT+SST) group, and a combined AOT and SOT (AOT+SOT) group in a 1:1:1 ratio. Each group will receive 30 min of daily treatment, five times weekly for 4 weeks. The primary clinical outcome will be the Fugl-Meyer Assessment for Upper Extremity. Secondary clinical outcomes will include the Box and Blocks Test, modified Barthel Index and sensory assessment. All clinical assessments and resting-state functional MRI and diffusion tensor imaging data will be obtained at pre-intervention (T1), post-intervention (T2) and 8 weeks of follow-up (T3).

ETHICS AND DISSEMINATION

The trial was approved by the Ethics Committee of Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Chinese Traditional Medicine (Grant No. 2020-178). The results will be submitted to a peer-review journal or at a conference.

TRIAL REGISTRATION NUMBER

ChiCTR2000040568.

Fibroblast-Derived Extracellular Vesicle-Packaged Long Noncoding RNA Upregulated in Diabetic Skin Enhances Keratinocyte MMP-9 Expression and Delays Diabetic Wound Healing

Accurate communication between fibroblasts and keratinocytes is crucial for diabetic wound healing. Extracellular vesicles are being explored as essential mediators of intercellular communication in the skin. However, the mechanisms underlying wound healing mediated by fibroblast-derived extracellular vesicles (Fib-EVs) remain unclear. The present study evaluated the role of long noncoding RNA upregulated in diabetic skin (lnc-URIDS) packed in Fib-EVs in the wound healing of streptozotocin-induced diabetes and the potential mechanisms of the effects. We demonstrated that high glucose induced the enrichment of lnc-URIDS in Fib-EVs, facilitated the transfer of lnc-URIDS to primary rat epidermal keratinocytes, and increased the expression of matrix metalloproteinase-9. Mechanistically, the binding of lnc-URIDS to YTH domain family protein-2 enhanced the degradation of YTH domain family protein-2 in the lysosomes, which increased the translational activity of the messenger RNA of matrix metalloproteinase-9 and ultimately induced the degradation of collagen for wound healing. The results provided an insight into the crosstalk and cooperation between fibroblasts and keratinocytes in collagen homeostasis in diabetic wounds and clarified the mechanism by which lnc-URIDS degrades collagen for diabetic wound healing.

Psychiatric disorders and Type 2 diabetes mellitus: A bidirectional Mendelian randomization

BACKGROUND

Extensive observational evidence put forward the association between psychiatric disorders and type 2 diabetes mellitus (T2DM). However, causal relationships between these two diseases required further research. Thus, we evaluated the bidirection casual effect between five psychiatric disorders and T2DM using two-sample mendelian randomization (MR).

METHODS

By selecting single nucleotide polymorphisms associated with T2DM and five psychiatric disorders (attention-deficit hyperactivity disorder (ADHD), major depressive disorder (MDD), schizophrenia, anxiety disorder and panic disorder), a bidirectional two-sample MR was applied to evaluate causality between these diseases. The inverse-variance weighted (IVW) method was used as the primary analysing approach for estimating possible causal effects. MR-Egger and weighted median were also conducted to verify the results. The funnel plot, Cochran's Q test and MR-Egger intercept test were used for sensitivity analyses. In addition, potential mediators were investigated by risk factor analyses.

RESULTS

Genetic susceptibilities of ADHD and MDD would increase the risk of T2DM (ADHD: OR = 1.14, 95%CI 1.08-1.20; p = 5.7 × 10 - 6 ; MDD: OR = 1.22, 95%CI 1.09-1.36; p = 0.0004 ). In addition, genetic predisposition to T2DM was also associated with ADHD (OR = 1.09, 95%CI 1.04-1.14; p = 0.0004). Several risk factors of T2DM were implicated in the above causal associations, including smoking, high body mass index, waist-to-hip ratio and elevated serum triglycerides.

CONCLUSION

Our studies indicated a causal effect of ADHD and MDD on increasing the risk of T2DM, which was potentially mediated by smoking and obesity-related phenotypes. Meanwhile, we found a causal effect of T2DM on ADHD. Thus, prevention strategies for T2DM should also include mental health and vice versa.

The prognostic utility of preoperative neutrophil-to-lymphocyte ratio (NLR) in patients with colorectal liver metastasis: a systematic review and meta-analysis

The neutrophil-to-lymphocyte ratio is used to reflect body's inflammatory status with prognostic value in different cancers. We aimed to investigate the influence of preoperative NLR in the prognosis of CRLM patients receiving surgery using meta-analysis. Data in Cochrane Library, PubMed, Embase, and Web of Science databases created before October 2022 were recruited. Meta-analysis was carried out with RevMan 5.3 and Stata16 software, and the primary outcome indicators included overall survival (OS), and secondary outcome indicators included disease-free survival (DFS) and relapse-free survival (RFS). The pooled risk ratio (HR) and 95% confidence interval (CI) for each outcome indicator were determined using random-effects models or fixed-effects models. The pooled odds ratio (OR) and corresponding 95% confidence intervals (CI) for NLR and clinicopathological characteristics were determined with a fixed-effects model. 18 papers published between 2008 and 2022 (3184 patients in total) were included. The pooled analysis found that high preoperative NLR was correlated with poor OS (multivariate HR = 1.83, 95% CI = 1.61-2.08, p < 0.01), DFS (multivariate HR = 1.78, 95% CI = 1.16-2.71, p < 0.01) and RFS (multivariate HR = 1.46, 95% CI = 1.15-1.85, p < 0.01), but NLR was not related to clinicopathological features of CRLM patients correlation. In conclusion, NLR is an independent risk factor for poor prognosis in patients with CRLM. More large-scale clinical researches are required in the future to demonstrate the inclusion of preoperative NLR as a prognostic indicator for CRLM patients to guide postoperative adjuvant chemotherapy.

Association between adiponectin and newly diagnosed type 2 diabetes in population with the clustering of obesity, dyslipidaemia and hypertension: a cross-sectional study

OBJECTIVES

Adiponectin is closely related to glucose metabolism and traditional diabetes risk factors (obesity, hypertension and dyslipidaemia). We aimed to explore the association between adiponectin levels and newly diagnosed type 2 diabetes mellitus (T2DM) and pre-diabetes in subgroups classified according to T2DM risk factors.

SETTING

Sun Yat-sen Memorial Hospital of Sun Yat-sen University.

PARTICIPANTS

3680 individuals (1753 men and 1927 women) aged 18-70 years from Guangzhou and Dongguan, China, were enrolled from December 2018 to October 2019.

PRIMARY AND SECONDARY OUTCOME MEASURES

T2DM was defined as fasting plasma glucose (FPG)≥7.0 mmol/L or HbA1c≥6.5%, and pre-diabetes was defined as 6.1 mmol/L≤FPG<7.0 mmol/L or 5.7≤HbA1c<6.5%.

RESULTS

With the increasing number of T2DM risk factors, the proportion of the population with high-quartile adiponectin levels gradually decreased (p<0.001). A low level of adiponectin was significantly associated with diabetes and pre-diabetes in a population with ≥1 T2DM risk factor, whereas its association was not consistently significant in the population with all three T2DM risk factors. For instance, participants were more likely to have diabetes or prediabetes with low levels of adiponectin when they had ≥ one T2DM risk factor (quartile 2 vs. 1: OR 0.71 [95%CI: 0.56-0.89]; P=0.003; quartile 3 vs. 1: OR 0.57 [95%CIs: 0.44-0.72]; P<0.001; and quartile 4 vs. 1: OR 0.52 [95%CIs: 0.40-0.67]; P<0.001).

CONCLUSION

Adiponectin was negatively associated with diabetes and pre-diabetes in a population with few T2DM risk factors, while their relationship gradually attenuated with the accumulation of T2DM risk factors, especially in a population with coexisting diseases such as obesity, hypertension and dyslipidaemia.

Silk fibroin fibers-based shape memory membrane with Janus wettability for multitiered wearable protection

Realizing breathable shape memory fiber-based material with antibacterial and waterproof performances is important for multitiered wearable protection to address the increasing concerns of air pollution. Herein, using an alternating electrospinning-electrospraying technology, we develop a fiber-based membrane with Janus wettability based on a silk fibroin nanofibers-substrate (SFNFs), a polyurethane nanospheres-top layer (PUNSs), and a middle layer of PU nanofibers-mat with in-situ grown silver nanoparticles (PUNFs-AgNPs), which serves separately for skin contact, a self-cleaning physical barrier to resist external aerosol/bacteria (PM2.5 filtration efficiency ~ 98.1%), and a bio-barrier that can sterilize harmful particles and inhibit bacteria proliferation (> 95%). This breathable Janus film (SFNFs/PUNFs-AgNPs/PUNSs, SPAP) with an antibacterial filter shows shape memory stretchability enabled by the thermoplastic PU component, which is mechanically adaptive to human body for wearable protection. This work presents a breathable wearable material for air-filtration and anti-bacteria, promising for applications such as wound dressings, medical masks, protection suits, and multifunctional filters.

GRAPHICAL ABSTRACT

An alternating electrospinning-electrospraying technology was proposed to achieve a silk fibroin-based antibacterial membrane with Janus wettability, as well as good skin affinity and breathability, which serves well as physical and bio-barriers for water resistance, PM2.5 filtration (~98.1%) and bacteria inhibition (efficiency of 95%). This shape memory Janus membrane can adapt mechanically to human body curvatures for functional wearable protections.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1557/s43578-022-00805-w.

NUF2 promotes tumorigenesis by interacting with HNRNPA2B1 via PI3K/AKT/mTOR pathway in ovarian cancer

BACKGROUND

Ovarian cancer (OC) is one of the commonest and deadliest diseases that threaten the health of women worldwide. It is essential to find out its pathogenic mechanisms and therapeutic targets for OC patients. Although NUF2 (Ndc80 kinetochore complex component) has been suggested to play an important role in the development of many cancers, but little is known about its function and the roles of proteins that regulate NUF2 in OC. This study aimed to investigate the effect of NUF2 on the tumorigenicity of OC and the activities of proteins that interact with NUF2.

METHODS

Oncomine database and immunohistochemical (IHC) staining were used to evaluate the expression of NUF2 in OC tissues and normal tissues respectively. Normal ovarian epithelial cell lines (HOSEpiC) and OC cell lines (OVCAR3、HEY、SKOV3) were cultured. Western blot was applied to analyze the expression of NUF2 in these cell lines. Small interfering RNA (siRNA) was used to silence the expression of NUF2 in OC cell lines, SKOV3 and HEY. Gene Set Variation Analysis (GSVA), Gene Set Enrichment Analysis (GSEA), the CCK-8 method, colony formation assay and flow cytometry were conducted to analyze the biological functions of NUF2 in vitro. OC subcutaneous xenograft tumor models were used for in vivo tests. Immunoprecipitation and mass spectrometry (IP/MS) were performed to verify the molecular mechanisms of NUF2 in OC. IP, immunofluorescence, IHC staining, and Gene Expression Profiling Interactive Analysis platform (GEPIA) were used to analyze the relationship between HNRNPA2B1 and NUF2 in OC cells. SiRNA was used to silence the expression of HNRNPA2B1 in SKOV3 cells, reverse transcription quantitative polymerase chain reaction (RT-qPCR) assay and western blot were used to detect the effect of HNRNPA2B1 on NUF2. GEPIA, The Cancer Genome Atlas (TCGA) database, GSEA and western blot were used to detect the potential signaling pathways related to the roles of HNRNPA2B1 and NUF2 in OC cells.

RESULTS

Our results showed high NUF2 expression in OC tissues and OC cell lines, which was associated with shorter overall survival and progression-free survival in patients. NUF2 depletion by siRNA suppressed the proliferation abilities and induced cell apoptosis of OC cells in vitro, and impeded OC growth in vivo. Mechanistically, NUF2 interacted with HNRNPA2B1 and activated the PI3K/AKT/mTOR signaling pathway in OC cells.

CONCLUSION

NUF2 could serve as a prognostic biomarker, and regulated the carcinogenesis and progression of OC. Moreover, NUF2 may interact with HNRNPA2B1 by activating the PI3K/AKT/mTOR signaling pathway to promote the development of OC cells. Our present study supported the key role of NUF2 in OC and suggested its potential as a novel therapeutic target.

Network Pharmacological Study of Compound Kushen Injection in Esophageal Cancer

AIM

To provide new methods and ideas for the clinical application of integrated traditional Chinese and Western medicine in the treatment of esophageal cancer.

BACKGROUND

Traditional Chinese medicine compound Kushen injection (CKI) has been widely used in the clinic with adjuvant radiotherapy and chemotherapy. However, the mechanism of action of CKI as adjuvant therapy for esophageal cancer has not yet been described.

METHOD

This study is based on network pharmacology, data mining, and molecular docking technology to explore the mechanism of action of CKI in the treatment of esophageal cancer. We obtained the effective ingredients and targets of CKI from the traditional Chinese medicine system pharmacology database and analysis platform (TCMSP) and esophageal cancer-related genes from the Online Mendelian Inheritance in Man (OMIM) and GeneCards databases.

RESULT

CKI mainly contains 58 active components. Among them, the top 5 active ingredients are quercetin, luteolin, naringenin, formononetin, and beta-sitostero. The target protein of the active ingredient was matched with the genes associated with esophageal cancer. The active ingredients targeted 187 esophageal cancer target proteins, including AKT1, MAPK1, MAPK3, TP53, HSP90AA1, and other proteins. Then, we enriched and analyzed the Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) and used AutoDockVina to dock the core targets and compounds. Finally, PyMOL and Ligplot were used for data visualization.

CONCLUSION

This study provides a new method and ideas for the clinical application of integrated traditional Chinese and Western medicine in the treatment of esophageal cancer.

Homeostatic Solid Solution in Layered Transition-Metal Oxide Cathodes of Sodium-Ion Batteries

Two-phase transformation reaction is ubiquitous in solid-state electrochemistry; however, it usually involves inferior structure rearrangement upon extraction and insertion of large-sized Na⁺, thus leading to severe local strain, cracks, and capacity decay in sodium-ion batteries (SIBs). Here, a homeostatic solid solution reaction is reported in the layered cathode material P'2-Na_0.653Ni_0.081Mn_0.799Ti_0.120O₂ during sodiation and desodiation. It is induced by the synergistic incorporation of Ni and Ti for the reinforced O(2p)-Mn(3d-e_g*) hybridization, which leads to mitigated Jahn-Teller distortion of MnO₆ octahedra, contracted transition-metal oxide slabs, and enlarged Na layer spacings. The thermodynamically favorable solid solution pathway rewards the SIBs with excellent cycling stability (87.2% capacity retention after 500 cycles) and rate performance (100.5 mA h g^-1 at 2500 mA g^-1). The demonstrated reaction pathway will open a new avenue for rational designing of cathode materials for SIBs and beyond.

Dual-Function Presodiation with Sodium Diphenyl Ketone towards Ultra-stable Hard Carbon Anodes for Sodium-Ion Batteries

Hard carbon (HC) is a promising anode material for sodium-ion batteries, yet still suffers from low initial Coulombic efficiency (ICE) and unstable solid electrolyte interphase (SEI). Herein, sodium diphenyl ketone (Na-DK) is applied to realize dual-function presodiation for HC anodes. It compensates the irreversible Na uptake at the oxygen-containing functional groups and reacts with carbon defects of five/seven-membered rings for quasi-metallic sodium in HC. The as-formed sodium induces robust NaF-rich SEI on HC in 1.0 M NaPF₆ in diglyme, favoring the interfacial reaction kinetics and stable Na⁺ insertion and extraction. This renders the presodiated HC (pHC) with high ICE of ≈100 % and capacity retention of 82.4 % after 6800 cycles. It is demonstrated to couple with Na₃ V₂ (PO₄ )₃ cathodes in full cells to show high capacity retention of ≈100 % after 700 cycles. This work provides in-depth understanding of chemical presodiation and a new strategy for highly stable sodium-ion batteries.

Thermal perception and lung function: a panel study in young adults with exercise under high outdoor temperature

It has been observed that high temperature exposure is associated with a reduction in lung function and some possible biological mechanisms have been suggested. However, it is unclear if thermal perception plays a role in the association. From September 3rd to 15th, 2018, in Guangzhou, China, we repeatedly measured daily thermal perception and lung function among 126 participants with outdoor military training. We performed a linear mixed model and stratified analyses by the origin of students, gender, and the training period to evaluate the effects of thermal perception on lung function. A total of 399 measurements were collected. Per vote increase in thermal sensation vote towards the "hot" direction was associated with a - 0.04 L (95% CI: - 0.08 to - 0.01) decrease in forced vital capacity (FVC), and - 0.04 L (95% CI: - 0.08 to - 0.01) decrease in forced expiratory volume in 1 s (FEV₁). Per grade increase towards the "very uncomfortable" direction for thermal comfort vote was associated with an increased percentage of forced expiratory volume in 1 s (FEV₁%) by 1.52% (95% CI: 0.18 to 2.86). For thermal preference, with preferred cooler vote increased by one level, FVC and FEV₁ decreased by - 0.05 L/s (95% CI: - 0.08 to - 0.02) and - 0.05L/s (95% CI: - 0.08 to - 0.02), respectively. The effects of thermal perception on lung function were stronger among non-local and in the first week of training. Our study suggests that in the same high-temperature environment, thermal perception is associated with lung function, even in healthy adults.

Thyroid autoimmunity and adverse pregnancy outcomes: A multiple center retrospective study

BACKGROUND

The relationship between thyroid autoimmunity (TAI) and adverse pregnancy outcomes is disputable, and their dose-dependent association have not been fully clarified.

OBJECTIVE

To investigate the association and dose-dependent effect of TAI with multiple maternal and fetal-neonatal complications.

METHODS

This study is a multi-center retrospective cohort study based on singleton pregnancies of three medical college hospitals from July 2013 to October 2021. The evolution of thyroid function parameters in TAI and not TAI women were described, throughout pregnancy. The prevalences of maternal and fetal-neonatal complications were compared between the TAI and control group. Logistic regression was performed to study the risk effects and dose-dependent effects of thyroid autoantibodies on pregnancy complications, with adjustment of maternal age, BMI, gravidity, TSH concentrations, FT4 concentrations and history of infertility.

RESULTS

A total of 27408 participants were included in final analysis, with 5342 (19.49%) in the TAI group and 22066 (80.51%) in control group. TSH concentrations was higher in TAI women in baseline and remain higher before the third trimester. Positive thyroid autoantibodies were independently associated with higher risk of pregnancy-induced hypertension (OR: 1.215, 95%CI: 1.026-1.439), gestational diabetes mellitus (OR: 1.088, 95%CI: 1.001-1.183), and neonatal admission to NICU (OR: 1.084, 95%CI: 1.004-1.171). Quantitative analysis showed that increasing TPOAb concentration was correlated with higher probability of pregnancy-induced hypertension, and increasing TGAb concentration was positively correlated with pregnancy-induced hypertension, small for gestational age and NICU admission. Both TPOAb and TGAb concentration were negatively associated with neonatal birthweight.

CONCLUSION

Thyroid autoimmunity is independently associated with pregnancy-induced hypertension, gestational diabetes mellitus, neonatal lower birthweight and admission to NICU. Dose-dependent association were found between TPOAb and pregnancy-induced hypertension, and between TGAb and pregnancy-induced hypertension, small for gestational age and NICU admission.

Lipid Parameters and the Development of Chronic Kidney Disease: A Prospective Cohort Study in Middle-Aged and Elderly Chinese Individuals

Epidemiological evidence suggests that lipid parameters are related to the progression of chronic kidney disease (CKD). Nevertheless, prospective studies that comprehensively assess the effect of routinely available lipid measures on the development of CKD are lacking. The aim of this study was to longitudinally assess the influence of lipid metabolism indicators on the presence of CKD in a large community-based population. We conducted a prospective cohort study at Sun Yat-sen Memorial Hospital, China, with 5345 patients of 40 years or older. Cox regression models were conducted, and hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated to assess lipid parameters and their relationship with the incidence of CKD. During the follow-up period, 340 (6.4%) subjects developed CKD. The incidence of CKD increased progressively with quartile values of triglyceride (TG), the ratio of non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol (non-HDL-C/HDL-C) and the ratio of TG to HDL-C, but decreased with HDL-C quartiles (p < 0.0001 for all trends). Pearson’s correlation analysis and multiple regression analyses indicated that these parameters were also associated with various indicators of kidney function. Moreover, we found that among all the lipid parameters, TG/HDL-C emerged as the most effective predictor of CKD. In conclusion, our findings suggest that TG/HDL-C better predicts the incidence of CKD in middle-aged and elderly Chinese individuals than other lipid parameters tested in the study.

Combined robot motor assistance with neural circuit-based virtual reality (NeuCir-VR) lower extremity rehabilitation training in patients after stroke: a study protocol for a single-centre randomised controlled trial

INTRODUCTION

Improving lower extremity motor function is the focus and difficulty of post-stroke rehabilitation treatment. More recently, robot-assisted and virtual reality (VR) training are commonly used in post-stroke rehabilitation and are considered feasible treatment methods. Here, we developed a rehabilitation system combining robot motor assistance with neural circuit-based VR (NeuCir-VR) rehabilitation programme involving procedural lower extremity rehabilitation with reward mechanisms, from muscle strength training, posture control and balance training to simple and complex ground walking training. The study aims to explore the effectiveness and neurological mechanisms of combining robot motor assistance and NeuCir-VR lower extremity rehabilitation training in patients after stroke.

METHODS AND ANALYSIS

This is a single-centre, observer-blinded, randomised controlled trial. 40 patients with lower extremity hemiparesis after stroke will be recruited and randomly divided into a control group (combined robot assistance and VR training) and an intervention group (combined robot assistance and NeuCir-VR training) by the ratio of 1:1. Each group will receive five 30 min sessions per week for 4 weeks. The primary outcome will be Fugl-Meyer assessment of the lower extremity. Secondary outcomes will include Berg Balance Scale, Modified Ashworth Scale and functional connectivity measured by resting-state functional MRI. Outcomes will be measured at baseline (T0), post-intervention (T1) and follow-ups (T2-T4).

ETHICS, REGISTRATION AND DISSEMINATION

The trial was approved by the Ethics Committee of Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Chinese Traditional Medicine (Grant No. 2019-014). The results will be submitted to a peer-reviewed journal or at a conference.

TRIAL REGISTRATION NUMBER

ChiCTR2100052133.

Interfacial Charge-Modulated Multifunctional MoS2/Ti3C2Tx Penetrating Electrode for High-Efficiency Freshwater Production

Freshwater production is critical in terms of solving the global water shortage. Aiming at improving freshwater production capability and ensuring its quality, an interfacial charge-modulated MoS₂/Ti₃C₂T_x-modified carbon fiber (CF/MoS₂/Ti₃C₂T_x) penetrating electrode is designed. To maximize the desalination and degradation efficiencies of CF/MoS₂/Ti₃C₂T_x, a photocatalytic component is introduced into the membrane capacitive deionization (PMCDI) device. High desalination capability is derived from the lamellar architecture structure of MoS₂/Ti₃C₂T_x. Meanwhile, excellent degradation performance is due to the formation of two photoelctrocatalytic activity centers, directionally generating singlet oxygen (¹O₂) and hydroxyl radical (^•OH). The intercalated Cl^- (desalination) as the electron transfer bridge optimizes the charge distribution of MoS₂/Ti₃C₂T_x, reinforcing the photoelectrocatalytic activity (degradation). The formation of the electron-deficient (desalination) and electron-rich (regeneration) regions at the terminated O atom of Ti₃C₂T_x accelerate the generations of ^•OH and ¹O₂, respectively. In perspective, a mutual promotion process of desalination and degradation is achieved for high-efficiency production of high-quality freshwater.