Muscle strength and prediabetes progression and regression in middle‐aged and older adults: a prospective cohort study

Background: Prediabetes progression is associated with increased mortality while its regression decreases it. It is unclear whether muscle strength is related to prediabetes progression or regression. This study investigated the associations of muscle strength, assessed by grip strength and chair‐rising time, with prediabetes progression and regression based on the China Health and Retirement Longitudinal Study (CHARLS) enrolling middle‐aged and older adults. Methods: We included 2623 participants with prediabetes from CHARLS, who were followed up 4 years later with blood samples collected for measuring fasting plasma glucose and haemoglobin A1c. Grip strength (normalized by body weight) and chair‐rising time were assessed at baseline and categorized into tertiles (low, middle, and high groups). Prediabetes at baseline and follow‐up was defined primarily using the American Diabetes Association (ADA) criteria and secondarily using the World Health Organization (WHO) and International Expert Committee (IEC) criteria. Multinomial logistic regression analysis was applied to obtain the odds ratios (ORs) and 95% confidence intervals (CIs). Results: The mean age of included participants was 59.0 ± 8.6 years, and 46.6% of them were males. During follow‐up, 1646 participants remained as prediabetes, 379 progressed to diabetes, and 598 regressed to normoglycaemia based on ADA criteria. Participants who progressed to diabetes had lower normalized grip strength than those who remained as prediabetes (0.49 ± 0.15 vs. 0.53 ± 0.15, P < 0.001), but participants who regressed to normoglycaemia showed the opposite (0.55 ± 0.16 vs. 0.53 ± 0.15, P = 0.003). However, chair‐rising time was comparable across different groups (P overall = 0.17). Compared with participants in low normalized grip strength or high chair‐rising time group, those in high normalized grip strength or low chair‐rising time group had decreased odds of progression to diabetes (OR 0.62, 95% CI 0.44 to 0.87; and OR 0.69, 95% CI 0.51 to 0.93, respectively) after multivariable adjustment. However, both were unrelated to the odds of regression to normoglycaemia (OR 0.94, 95% CI 0.71 to 1.25; and OR 0.84, 95% CI 0.65 to 1.07, respectively). These outcomes remained generally comparable when prediabetes was defined by WHO or IEC criteria. Higher normalized grip strength but not lower chair‐rising time was prospectively associated with lower blood pressure, better glycaemic condition, and lower inflammation (all P ≤ 0.04). Conclusions: High muscle strength is associated with reduced odds of progression to diabetes but does not predict regression to normoglycaemia in prediabetes. Future studies are warranted to assess whether increases in muscle strength promote prediabetes regression

Efficacy of calcium dobesilate in treating Chinese patients with mild-to-moderate non-proliferative diabetic retinopathy (CALM-DR): protocol for a single-blind, multicentre, 24-armed cluster-randomised, controlled trial.

INTRODUCTION Calcium dobesilate (CaD) has been used in the treatment of diabetic retinopathy (DR) due to its potential in protecting against retinal vascular damage. However, there is limited evidence exploring its efficacy in combating DR progression. This study is aimed at evaluating whether CaD could prevent DR progression into an advanced stage among Chinese patients with mild-to-moderate non-proliferative DR (NPDR). METHODS AND ANALYSIS This study is a single-blind, multicentre, cluster-randomised, controlled superiority trial. A total of 1272 patients with mild-to-moderate NPDR will be enrolled and randomly assigned at a 1:1 ratio into the control group (conventional treatment group) and the intervention group (conventional treatment plus CaD (500 mg three times per day) for 12 months). Patients will be followed at 1, 3, 6 and 12 months after randomisation and receiving treatments, with the severity of DR assessed by the Early Treatment Diabetic Retinopathy Study (ETDRS) scale. The primary endpoint is the progression of DR during follow-up, which is defined as an increase of two or more steps in the ETDRS scale. The secondary endpoints include the concomitant changes in visual acuity, presence, number, location and type of retinal lesions, and retinal blood vessel diameter as well as the arteriovenous ratio at different visits. ETHICS AND DISSEMINATION Each local ethics committee (first Vote: Ethical Review Committees of Zhongda Hospital of Southeast University (2019ZDSYLL132-P01)) has approved the study. The results will be published in high impact peer-reviewed scientific journals aimed at the general reader. TRIAL REGISTRATION NUMBERS NCT04283162

Efficacy of Co-administration of Liuwei Dihuang Pills and Ginkgo Biloba Tablets on Albuminuria in Type 2 Diabetes: A 24-Month, Multicenter, Double-Blind, Placebo-Controlled, Randomized Clinical Trial

Purpose: We investigated the effects of Traditional Chinese Medicine (TCM) on the occurrence and progression of albuminuria in patients with type 2 diabetes.Methods: In this randomized, double-blind, multicenter, controlled trial, we enrolled 600 type 2 diabetes without diabetic nephropathy (DN) or with early-stage DN. Patients were randomly assigned (1:1) to receive Liuwei Dihuang Pills (LWDH) (1.5 g daily) and Ginkgo biloba Tablets (24 mg daily) orally or matching placebos for 24 months. The primary endpoint was the change in urinary albumin/creatinine ratio (UACR) from baseline to 24 months.Results: There were 431 patients having UACR data at baseline and 24 months following-up in both groups. Changes of UACR from baseline to follow-up were not affected in both groups: −1.61(−10.24, 7.17) mg/g in the TCM group and −0.73(−7.47, 6.75) mg/g in the control group. For patients with UACR ≥30 mg/g at baseline, LWDH and Ginkgo biloba significantly reduced the UACR value at 24 months [46.21(34.96, 58.96) vs. 20.78(9.62, 38.85), P &lt; 0.05]. Moreover, the change of UACR from baseline to follow-up in the TCM group was significant higher than that in the control group [−25.50(−42.30, −9.56] vs. −20.61(−36.79, 4.31), P &lt; 0.05].Conclusion: LWDH and Ginkgo biloba may attenuate deterioration of albuminuria in type 2 diabetes patients. These results suggest that TCM is a promising option of renoprotective agents for early stage of DN.Trial registration: The study was registered in the Chinese Clinical Trial Registry. (no. ChiCTR-TRC-07000037, chictr.org

ScienceDirect Service innovation and smart analytics for Industry 4.0 and big data environment

Abstract Today, in an Industry 4.0 factory, machines are connected as a collaborative community. Such evolution requires the utilization of advanceprediction tools, so that data can be systematically processed into information to explain uncertainties, and thereby make more &quot;informed&quot; decisions. Cyber-Physical System-based manufacturing and service innovations are two inevitable trends and challenges for manufacturing industries. This paper addresses the trends of manufacturing service transformation in big data environment, as well as the readiness of smart predictive informatics tools to manage big data, thereby achieving transparency and productivity

Human-Guided Simulation for Lunar Rover in Virtual Environment

International audienceLunar rover development involves a large amount of validation works in realistic operational conditions, including its mechanical subsystem and on-board software. The traditional simulation step is to construct model, input parameters, execute a simulation, and visualize the results. However, a more insight and higher productivity can be achieved if these activities are guided by human simultaneously. In this paper, a human-guided simulation method for China lunar rover simulation environment (CLRSE) that affords real time capabilities with high fidelity has been presented. It studied the input of kinematics simulation, analyzed a quick steering method of complex dynamic interactions between wheel and soft moon ground, and presented a way of path choosing by human guided. And the application which runs on PC Cluster and Silicon Graphics is also developed in this environment

One-Stage Posterior Debridement and Transpedicular Screw Fixation for Treating Monosegmental Thoracic and Lumbar Spinal Tuberculosis in Adults

Spinal tuberculosis is still prevalent in some developing countries. The purpose of this study is to investigate the efficacy and safety of one-stage posterior debridement, autogenous bone grafting, and transpedicular screw fixation in treating monosegmental thoracic and lumbar tuberculosis in adults. 37 patients were retrospectively reviewed in this study. The data of images, operative time and blood loss volume, perioperative complications, time to achieve bony fusion, VAS score, and neurologic function preoperatively and postoperatively were collected. The mean follow-up period was 21.5±3.5 months. The tuberculosis was cured after surgery in all patients, and no recurrence was observed. Bony fusion was achieved in all patients with a mean time of 5.6±2.5 months. Neurological outcome did not change in one case with grade A, and increased by 1–3 grades in the other patients with nerve deficit. The average preoperative and postoperative VAS scores were 5.5±2.23 and 1.5±1.22, respectively; the difference was significant (P<0.05). There were three perioperative complications (8.1%, 3/37) observed in this study. In conclusion, the procedure of one-stage posterior debridement, interbody fusion with autogenous bone grafting, and posterior fixation with pedicle screw is effective and safe for treating monosegmental thoracic and lumbar spinal tuberculosis in adults

Quantifying multi-source uncertainties in multi-model predictions using the Bayesian model averaging scheme

This study focuses on a quantitative multi-source uncertainty analysis of multi-model predictions. Three widely used hydrological models, i.e., Xinanjiang (XAJ), hybrid rainfall–runoff (HYB), and HYMOD (HYM), were calibrated by two parameter optimization algorithms, namely, shuffled complex evolution (SCE-UA) method and shuffled complex evolution metropolis (SCEM-UA) method on the Mishui basin, south China. The input uncertainty was quantified by utilizing a normally distributed error multiplier. The ensemble simulation sets calculated from the three models were combined using the Bayesian model averaging (BMA) method. Results indicate the following. (1) Both SCE-UA and SCEM-UA resulted in good and comparable streamflow simulations. Specifically, the SCEM-UA implied parameter uncertainty and provided the posterior distribution of the parameters. (2) In terms of the precipitation input uncertainty, precision of streamflow simulations did not improve remarkably. (3) The BMA combination not only improved the precision of streamflow prediction, but also quantified the uncertainty bounds of the simulation. (4) The prediction interval calculated using the SCEM-UA-based BMA combination approach appears superior to that calculated using the SCE-UA-based BMA combination for both high flows and low flows. Results suggest that the comprehensive uncertainty analysis by using the SCEM-UA algorithm and BMA method is superior for streamflow predictions and flood forecasting

Efficacy of calcium dobesilate in treating Chinese patients with mild-to-moderate non-proliferative diabetic retinopathy (CALM-DR): protocol for a single-blind, multicentre, 24-armed cluster-randomised, controlled trial

Introduction Calcium dobesilate (CaD) has been used in the treatment of diabetic retinopathy (DR) due to its potential in protecting against retinal vascular damage. However, there is limited evidence exploring its efficacy in combating DR progression. This study is aimed at evaluating whether CaD could prevent DR progression into an advanced stage among Chinese patients with mild-to-moderate non-proliferative DR (NPDR).Methods and analysis This study is a single-blind, multicentre, cluster-randomised, controlled superiority trial. A total of 1272 patients with mild-to-moderate NPDR will be enrolled and randomly assigned at a 1:1 ratio into the control group (conventional treatment group) and the intervention group (conventional treatment plus CaD (500 mg three times per day) for 12 months). Patients will be followed at 1, 3, 6 and 12 months after randomisation and receiving treatments, with the severity of DR assessed by the Early Treatment Diabetic Retinopathy Study (ETDRS) scale. The primary endpoint is the progression of DR during follow-up, which is defined as an increase of two or more steps in the ETDRS scale. The secondary endpoints include the concomitant changes in visual acuity, presence, number, location and type of retinal lesions, and retinal blood vessel diameter as well as the arteriovenous ratio at different visits.Ethics and dissemination Each local ethics committee (first Vote: Ethical Review Committees of Zhongda Hospital of Southeast University (2019ZDSYLL132-P01)) has approved the study. The results will be published in high impact peer-reviewed scientific journals aimed at the general reader.Trial registration numbers NCT04283162

Evolution of Hydrological Drought in Human Disturbed Areas: A Case Study in the Laohahe Catchment, Northern China

A case study on the evolution of hydrological drought in nonstationary environments is conducted over the Laohahe catchment in northern China. Using hydrometeorological observations during 1964–2009, meteorological and hydrological droughts are firstly analyzed with the threshold level method. Then, a comprehensive analysis on the changes within the catchment is conducted on the basis of hydrological variables and socioeconomic indices, and the whole period is divided into two parts: the undisturbed period (1964–1979) and the disturbed period (1980–2009). A separating framework is further introduced to distinguish droughts induced by different causes, that is, the naturalized drought and human-induced drought. Results showed that human activities are more inclined to play a negative role in aggravating droughts. Drought duration and deficit volume in naturalized conditions are amplified two to four times and three to eight times, respectively, when human activities are involved. For the two dry decades 1980s and 2000s, human activities have caused several consecutive drought events with rather long durations (up to 29 months). These results reflect the considerable impacts of human activities on hydrological drought, which could provide some theoretical support for local drought mitigation and water resources management