Prevalence and Associated Factors of Behaviors of Monitoring to Prevent Chronic Diabetic Complications among Type 2 Diabetes Patients Involved in Community-based Management

BackgroundChronic diabetic complications are highly prevalent, which may be an underlying cause of diabetes-related disability and death. Regularly and continuously self-monitoring may contribute to early detection, diagnosis and treatment of various diabetic complications, which is essential to reducing the adverse consequences of diabetes, and is a key program in community-based management that should be highly valued.ObjectiveTo investigate the prevalence and associated factors (such as diabetes prevalence and monitoring and other factors) of behaviors of monitoring (self-observation and screening tests) to prevent chronic diabetic complications among type 2 diabetes patients receiving community-based management.MethodsThe convenience sampling was used to select 785 type 2 diabetes patients from Chengdu's central urban areas who received community-based type 2 diabetic management from May to November 2019. They were invited to attend a survey for understanding their socio-demographic information and monitoring behaviors to prevent chronic diabetic complications using a questionnaire developed by us.ResultsOnly 103 (13.1%) of the patients did not suffer from any chronic complications, and 435 (55.4%) suffered from both metabolic syndrome and chronic diabetic complications. The average total score for self-observation of chronic diabetic complications in the participants was (2.58±0.86) , but the average total score of regularly self-observation of pulsations of the dorsalis pedis artery was only (1.47±0.84) . The average total score of performing screening tests for chronic diabetic complications was (2.77±0.57) . The average score of diabetic retinopathy screening, peripheral neuropathy screening, and lower extremity vascular disease screening was (1.88±0.99) , (1.46±0.84) , and (1.47±0.84) , respectively. About 78.2% (614/785) of patients underwent screening tests following the doctors' advices. But only 9.9% (78/785) took the initiative to conduct regular tests. About 17.7% (139/785) and 49.0% (385/785) of the patients could not correctly manage the abnormal results of self-observation and the screening test results. Multiple linear regression analysis indicated that the duration of diabetes since diagnosis, prevalence of chronic diabetic complications, and management of self-observed abnormalities were associated with the score of self-observation of chronic diabetic complications (P<0.05) . The duration of diabetes since diagnosis, the most recently measured HbA1c value, prevalence of chronic diabetic complications, causes and results management of screening tests for chronic diabetic complications were associated with average total score of performing screening tests for chronic diabetic complications (P<0.05) .ConclusionThe prevalence of behaviors of monitoring to prevent chronic diabetic complications in community-dwelling type 2 diabetes patients was unsatisfactory, which was affected by the duration of diabetes since diagnosis, prevalence of chronic diabetic complications, the most recently measured HbA1c value, causes and results management of screening tests for chronic diabetic complications. In view of this, in the delivery of community-based management services, attentions should be paid to improving patients' initiative to actively and regularly observe their conditions and undergo relevant screening tests, thereby improving early diagnosis and treatment rates of chronic type 2 diabetic complications

A novel understanding of the normalized fatigue delamination model for composite multidirectional laminates

Normalized fatigue delamination models have been widely applied by researchers in the characterization of the fatigue delamination behavior of composite laminates. However, the inherent mechanism of this normalization method has not been explored. This study aims to present a physical understanding on the normalized fatigue delamination model from a viewpoint of energy. The fatigue delamination behavior is considered to be governed by the driving force and delamination resistance, and based on this principle the physical mechanism of the fatigue delamination is studied. A new physics-based normalized fatigue delamination model is proposed in this paper. In order to experimentally validate the proposed fatigue delamination model, mode I fatigue delamination tests are performed on double cantilever beam specimens to obtain the experimental data with different amounts of the fiber bridging. The results show that the normalized model is suitable to accurately characterize the fatigue delamination behavior of the composite laminates by using a single master curve. The master curve is finally employed as a standard approach to predict the fatigue results. Good agreement between the predicted and the experimental results is achieved, therefore it approves the applicability of the proposed fatigue delamination model in characterizing the fatigue delamination growth behavior

Inactivation of a Novel FGF23 Regulator, FAM20C, Leads to Hypophosphatemic Rickets in Mice

Family with sequence similarity 20,-member C (FAM20C) is highly expressed in the mineralized tissues of mammals. Genetic studies showed that the loss-of-function mutations in FAM20C were associated with human lethal osteosclerotic bone dysplasia (Raine Syndrome), implying an inhibitory role of this molecule in bone formation. However, in vitro gain- and loss-of-function studies suggested that FAM20C promotes the differentiation and mineralization of mouse mesenchymal cells and odontoblasts. Recently, we generated Fam20c conditional knockout (cKO) mice in which Fam20c was globally inactivated (by crossbreeding with Sox2-Cre mice) or inactivated specifically in the mineralized tissues (by crossbreeding with 3.6 kb Col 1a1-Cre mice). Fam20c transgenic mice were also generated and crossbred with Fam20c cKO mice to introduce the transgene in the knockout background. In vitro gain- and loss-of-function were examined by adding recombinant FAM20C to MC3T3-E1 cells and by lentiviral shRNA–mediated knockdown of FAM20C in human and mouse osteogenic cell lines. Surprisingly, both the global and mineralized tissue-specific cKO mice developed hypophosphatemic rickets (but not osteosclerosis), along with a significant downregulation of osteoblast differentiation markers and a dramatic elevation of fibroblast growth factor 23 (FGF23) in the serum and bone. The mice expressing the Fam20c transgene in the wild-type background showed no abnormalities, while the expression of the Fam20c transgene fully rescued the skeletal defects in the cKO mice. Recombinant FAM20C promoted the differentiation and mineralization of MC3T3-E1 cells. Knockdown of FAM20C led to a remarkable downregulation of DMP1, along with a significant upregulation of FGF23 in both human and mouse osteogenic cell lines. These results indicate that FAM20C is a bone formation “promoter” but not an “inhibitor” in mouse osteogenesis. We conclude that FAM20C may regulate osteogenesis through its direct role in facilitating osteoblast differentiation and its systemic regulation of phosphate homeostasis via the mediation of FGF23

Finishing the euchromatic sequence of the human genome

The sequence of the human genome encodes the genetic instructions for human physiology, as well as rich information about human evolution. In 2001, the International Human Genome Sequencing Consortium reported a draft sequence of the euchromatic portion of the human genome. Since then, the international collaboration has worked to convert this draft into a genome sequence with high accuracy and nearly complete coverage. Here, we report the result of this finishing process. The current genome sequence (Build 35) contains 2.85 billion nucleotides interrupted by only 341 gaps. It covers ∼99% of the euchromatic genome and is accurate to an error rate of ∼1 event per 100,000 bases. Many of the remaining euchromatic gaps are associated with segmental duplications and will require focused work with new methods. The near-complete sequence, the first for a vertebrate, greatly improves the precision of biological analyses of the human genome including studies of gene number, birth and death. Notably, the human enome seems to encode only 20,000-25,000 protein-coding genes. The genome sequence reported here should serve as a firm foundation for biomedical research in the decades ahead

SQR: a simple quantum representation of infrared images

A simple quantum representation (SQR) of infrared images is proposed based on the characteristic that infrared images reflect infrared radiation energy of objects. The proposed SQR model is inspired from the Qubit Lattice representation for color images. Instead of the angle parameter of a qubit to store a color as in Qubit Lattice representation, probability of projection measurement is used to store the radiation energy value of each pixel for the first time in this model. Since the relationship between radiation energy values and probability values can be quantified for the limited radiation energy values, it makes the proposed model more clear. In the process of image preparation, only simple quantum gates are used, and the performance comparison with the latest flexible representation of quantum images reveals that SQR can achieve a quadratic speedup in quantum image preparation. Meanwhile, quantum infrared image operations can be performed conveniently based on SQR, including both the global operations and local operations. This paper provides a basic way to express infrared images in quantum computer

Status and treatment of patients with uterine fibroids in hospitals in central China: a retrospective study from 2018 to 2021

Objective To evaluate the hospitalised patients with uterine fibroids (UFs) and describe treatment patterns in hospital-treated patients in central China from 2018 to 2021.Design A retrospective analysis.Setting The gynaecology departments of class A and class B secondary and tertiary hospitals in Hubei Province, China.Participants 101 008 patients diagnosed with UFs from 1 January 2018 to 31 December 2021.Results The hospitalised patients with UFs increased with age, reaching a peak at ages 45–49 years and then gradually decreasing. Among these patients, 19.05% had anaemia symptoms. Women aged 25–29 years were more likely to be treated with laparoscopic myomectomy (62.22%), while women aged 20–24 years tend to choose open myomectomy (34.58%). Women over age 45 years who had entered perimenopause tended to be treated with laparoscopic hysterectomy (64.85% for those aged 65–69 years). Patients with fibroid with moderate-to-severe anaemia mostly chose hysterectomy. As a whole, the proportion of patients who chose laparoscopic hysterectomy was similar to that of patients who chose laparoscopic myomectomy (31.38% vs 31.14%). Only 2.08% of UFs were treated with high-frequency MRI-guided focused ultrasound surgery (MRgFUS). The number of patients who choose laparoscopic surgery or MRgFUS treatment was increasing year by year. After stratifying by hospital grade, we found that women treated at class A tertiary hospitals were more likely to have laparoscopic than open surgery (66.12% vs 31.26%). At class B secondary hospitals, 61.9% of the patients underwent myomectomy. By contrast, hysterectomy was used to treat the majority of patients at class A secondary hospitals and class B tertiary hospitals (57.79% and 57.57%, respectively). Use of MRgFUS was mainly concentrated within class A tertiary hospitals.Conclusion UFs affect mainly women in childbearing period. Most patients chose to receive treatment at class A tertiary hospitals, among which laparoscopic myomectomy was the mainstream surgical method for patients in Hubei Province.Trial registration number NCT05840042