Discordance in the diagnosis of diabetes: Comparison between HbA1c and fasting plasma glucose

© 2017 Ho-Pham et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Objective HbA1c has been introduced as a complementary diagnostic test for diabetes, but its impact on disease prevalence is unknown. This study evaluated the concordance between HbA1c and fasting plasma glucose (FPG) in the diagnosis of diabetes in the general population. Materials and methods The study was designed as a population based investigation, with participants being sampled from the Ho Chi Minh City, Vietnam. Blood samples were collected after overnight fasting and analyzed within 4 hours after collection. HbA1c was measured with high pressure liquid chromatography (Arkray Adams, Japan). FPG was measured by the hexokinase method (Advia Autoanalyzer; Bayer Diagnostics, Germany). Diabetes was defined as HbA1c 6.5% or FPG 7.0 mmol/L. Prediabetes was classified as HbA1c between 5.7% and 6.4%. Results The study included 3523 individuals (2356 women) aged 30 years and above. Based on the HbA1c test, the prevalence of diabetes and prediabetes was 9.7% (95%CI, 8.7–10.7%; n = 342) and 34.6% (33.0–36.2; n = 1219), respectively. Based on the FPG test, the prevalence of diabetes and prediabetes was 6.3% (95%CI, 5.5–7.2%; n = 223) and 12.1% (11.1–13.2; n = 427). Among the 427 individuals identified by FPG as "pre-diabetes", 28.6% were classified as diabetes by HbA1c test. The weighted kappa statistic of concordance between HbA1c and FPG was 0.55, with most of the discordance being in the prediabetes group. Conclusion These data indicate that there is a significant discordance in the diagnosis of diabetes between FPG and HbA1c measurements, and the discordance could have significant impact on clinical practice. FPG appears to underestimate the burden of undiagnosed diabetes

Consequences of temperature and temperature variability on swimming activity, group structure, and predation of endangered delta smelt

The effects of water temperature on individual and group movement behaviour in prey fish can affect ecological interactions such as competition and predation, but how variability in temperature influence fish behaviour is less understood. Of particular concern is how increased warming in tidally fluctuating estuaries may impact the native and endangered delta smelt (Hypomesus transpacificus, Osmeridae). To help address this issue, we tested the effects of increased water temperature (fluctuating [17–21°C] and warm [21°C] acclimated treatments) on juvenile delta smelt individual and group behaviour, response to chemical alarm and predator cues, as well as capacity to evade predation. In addition, predation of delta smelt was tested in the presence of a dominant invasive competitor, Mississippi silversides (Menidia beryllina, Atherinopsidae), as well as comparative predation mortality on Mississippi silversides when isolated. After 7 days of increased temperature treatments, delta smelt in the warm treatment increased swimming velocity, decreased turning angle, and altered group structure with larger inter-individual distances compared to fish in the control (17°C) and fluctuating temperature treatments. Following conspecific and predator chemical alarm cues, delta smelt showed anti-predator responses. Control and fluctuating treatment fish responded to conspecific cues with increased swimming speeds, decreased inter-individual distances and near-neighbour distances, and, after 15 min, fish recovered back to baseline behaviours. In contrast, fish in the warm treatment had not recovered after 15 min, and swimming speeds were maintained at roughly 25 cm/s, close to maximum capabilities. Fish in control and fluctuating treatments showed minimal responses to predator cues, whereas delta smelt exposed to warm conditions significantly increased swimming speeds and decreased turning angle. Predation of delta smelt by largemouth bass (Micropterus salmoides, Centrarchidae) was greatest under the warm treatment, correlating with altered behaviours of delta smelt; however, predation of Mississippi silversides was greater than delta smelt, independent of temperature. This study provides novel insight into the group behaviour of delta smelt, their response to predation, and how prolonged exposure to elevated temperature may induce negative individual and group behaviours causing alterations in predator–prey dynamics. This work highlights the importance of testing ecologically realistic temperature fluctuations in experiments as delta smelt had significantly altered responses to elevated temperature, dependent on variability of warming

A Multidomain Intervention Program for Older People with Dementia: A Pilot Study

Background: Multidomain interventions have been shown to be effective in improving cognition, quality of life, reducing neuropsychiatric symptoms and delaying progression of functional impairment or disability in dementia patients. To investigate the multidomain intervention in other populations and diverse cultural and geographical settings, this pilot study will assess the feasibility of a multidomain intervention for older people with dementia in nursing homes in Vietnam. Methods: Participants will be randomized into two equal groups, to receive either a multidomain intervention (intervention group) or regular health advice (control group). The intervention will include physical, cognitive, and social interventions as well as management of metabolic and vascular risk factors. We will hypothesize that the multidomain intervention will be feasible in Vietnam, and participants who receive the intervention will show improvement in quality of life, behaviors, functional ability, cognitive function, sleep, and in reduction of falls, use of healthcare services, and death rate compared to those in the control group during the 6 months intervention period and after the 6 months extended follow-up. Discussion: This is the first study to evaluate the feasibility of a multidomain intervention program for older people with dementia in nursing homes in Vietnam. The results from the trial will inform clinicians and the public of the possibility of comprehensive treatment beyond simply drug treatments for dementia. This paves the way for further studies to evaluate the long-term effects of multidomain interventions in dementia patients. Furthermore, the research results will provide information on the effectiveness of multidomain interventions which will inform policy development on dementia. Trial Registration: The trial is registered with ClinicalTrials.gov identifier: NCT04948450 on 02/07/2021

Does Bitcoin hedge commodity uncertainty?

This paper examines the connectedness between Bitcoin and commodity volatilities, including oil, wheat, and corn, during the period Oct. 2013–Jun. 2018, using time- and frequency-domain frameworks. The time-domain framework’s results show that the connectedness is 23.49%, indicating a low level of connection between Bitcoin and the commodity volatilities. Bitcoin contributes only 2.55% to the connectedness, while the wheat volatility index accounts for 12.51% of the total connectedness. The frequency connectedness shows that Bitcoin’s contribution to the total connectedness increases from high-frequency to low-frequency bands, and the total connectedness reaches up to 22.47%. It also indicates that Bitcoin is the spillover transmitter to the wheat volatility, while being the spillover receiver from the oil and corn volatilities. The findings suggest that Bitcoin could be a hedger for commodity volatilities

Eco-friendly facile synthesis of Co3O4-Pt nanorods for ethylene detection towards fruit quality monitoring

Ethylene, a biomarker widely employed for evaluating fruit ripening during storage, exists at extremely low concentrations. Therefore a gas sensor with high sensitivity and a sub-ppm detection limit is needed. In this work, porous Co3O4 nanorods were synthesized through a hydrothermal method involving Co(NO3)2, Na2C2O4, H2O and ethylene glycol (EG), followed by annealing at 400 degrees C in air. The surface of the porous Co3O4 nanorods was functionalized with Pt nanoparticles to enhance the ethylene sensing performance. The effect of Co3O4 surface functionalisation with Pt nanoparticles was investigated by adding different amounts of nanoparticles. The sensor's outstanding performance at the optimum working temperature of 250 degrees C is attributed to the synergy between the high catalytic activity of Pt nanoparticles and the extensive surface area of the porous Co3O4 nanorods. Compared to pure Co3O4, the 0.031 wt% Pt sensor showed better ethylene sensing performance with a response 3.4 times that of pristine Co3O4. The device also demonstrated high selectivity, repeatability, long-term stability and a detection limit of 0.13 ppm for ethylene, which is adequate for fruit quality monitoring. The gas sensing mechanism of porous Co3O4 nanorods and the influence of Pt decoration on sensor performance are discussed

Machine Learning-Enabled Joint Antenna Selection and Precoding Design: From Offline Complexity to Online Performance

We investigate the performance of multi-user multiple-antenna downlink systems in which a base station (BS) serves multiple users via a shared wireless medium. In order to fully exploit the spatial diversity while minimizing the passive energy consumed by radio frequency (RF) components, the BS is equipped with M RF chains and N antennas, where M <; N. Upon receiving pilot sequences to obtain the channel state information (CSI), the BS determines the best subset of M antennas for serving the users. We propose a joint antenna selection and precoding design (JASPD) algorithm to maximize the system sum rate subject to a transmit power constraint and quality of service (QoS) requirements. The JASPD algorithm overcomes the non-convexity of the formulated problem via a doubly iterative algorithm, in which an inner loop successively optimizes the precoding vectors, followed by an outer loop that tests all valid antenna subsets. Although approaching (near) global optimality, the JASPD suffers from a combinatorial complexity, which may limit its application in real-time network operations. To overcome this limitation, we propose a learning-based antenna selection and precoding design algorithm (L-ASPA), which employs a deep neural network (DNN) to establish underlaying relations between key system parameters and the selected antennas. The proposed L-ASPD algorithm is robust against the number of users and their locations, the transmit power of the BS, as well as the small-scale channel fading. With a well-trained learning model, it is shown that the L-ASPD algorithm significantly outperforms baseline schemes based on the block diagonalization and a learning-assisted solution for broadcasting systems and achieves a better effective sum rate than that of the JASPA under limited processing time. In addition, we observed that the proposed L-ASPD algorithm can reduce the computation complexity by 95% while retaining more than 95% of the optimal performance

Generic Mechanism of Emergence of Amyloid Protofilaments from Disordered Oligomeric aggregates

The presence of oligomeric aggregates, which is often observed during the process of amyloid formation, has recently attracted much attention since it has been associated with neurodegenerative conditions such as Alzheimer's and Parkinson's diseases. We provide a description of a sequence-indepedent mechanism by which polypeptide chains aggregate by forming metastable oligomeric intermediate states prior to converting into fibrillar structures. Our results illustrate how the formation of ordered arrays of hydrogen bonds drives the formation of beta-sheets within the disordered oligomeric aggregates that form early under the effect of hydrophobic forces. Initially individual beta-sheets form with random orientations, which subsequently tend to align into protofilaments as their lengths increases. Our results suggest that amyloid aggregation represents an example of the Ostwald step rule of first order phase transitions by showing that ordered cross-beta structures emerge preferentially from disordered compact dynamical intermediate assemblies.Comment: 14 pages, 4 figure

Salmonella typhimurium Suppresses Tumor Growth via the Pro-Inflammatory Cytokine Interleukin-1 beta

Although strains of attenuated Salmonella typhimurium and wild-type Escherichia coli show similar tumor-targeting capacities, only S. typhimurium significantly suppresses tumor growth in mice. The aim of the present study was to examine bacteria-mediated immune responses by conducting comparative analyses of the cytokine profiles and immune cell populations within tumor tissues colonized by E. coli or attenuated Salmonellae. CT26 tumor-bearing mice were treated with two different bacterial strains: S. typhimurium defective in ppGpp synthesis (Delta ppGpp Salmonellae) or wild-type E. coli MG1655. Cytokine profiles and immune cell populations in tumor tissue colonized by these two bacterial strains were examined at two time points based on the pattern of tumor growth after Delta ppGpp Salmonellae treatment: 1) when tumor growth was suppressed (&apos;suppression stage&apos;) and 2) when they began to re-grow (&apos;re-growing stage&apos;). The levels of IL-1 beta and TNF-alpha were markedly increased in tumors colonized by Delta ppGpp Salmonellae. This increase was associated with tumor regression; the levels of both IL-1 beta and TNF-alpha returned to normal level when the tumors started to re-grow. To identify the immune cells primarily responsible for Salmonellae-mediated tumor suppression, we examined the major cell types that produce IL-1 beta and TNF-alpha. We found that macrophages and dendritic cells were the main producers of TNF-alpha and IL-1 beta. Inhibiting IL-1 beta production in Salmonellae-treated mice restored tumor growth, whereas tumor growth was suppressed for longer by local administration of recombinant IL-1 beta or TNF-alpha in conjunction with Salmonella therapy. These findings suggested that IL-1 beta and TNF-alpha play important roles in Salmonella-mediated cancer therapy. A better understanding of host immune responses in Salmonella therapy may increase the success of a given drug, particularly when various strategies are combined with bacteriotherapy.111715Ysciescopu