Glycemic variability evaluated by HbA1c rather than fasting plasma glucose is associated with adverse cardiovascular events

BackgroundAlthough studies have shown that glycemic variability is positively associated with an increased risk of cardiovascular disease, few studies have compared hemoglobin A1c (HbA1c) and fasting plasma glucose (FPG) variability with adverse cardiovascular events in patients with type 2 diabetes mellitus (T2DM).MethodsThis was a post hoc analysis of the Action to Control Cardiovascular Risk in Diabetes (ACCORD) study. Cox proportional hazards models were used to explore the relationship between HbA1c or FPG variability and the incidence of major adverse cardiovascular events (MACEs).ResultsIn total, 9,547 patients with T2DM were enrolled in this study. During the median 4.6 ± 1.5 years follow-up period, 907 patients developed MACEs. The risk of MACEs increased in the HbA1c variability group in each higher quartile of HbA1c variability (P < 0.01). Compared with those in the first quartile of HbA1c variability, patients in the fourth quartile had a hazard ratio of 1.37 (Model 2, 95% confidence interval: 1.13–1.67) for MACEs. Higher FPG variability was not associated with a higher risk of MACEs in patients with T2DM (P for trend=0.28). A U-shaped relationship was observed between HbA1c and FPG variability, and MACEs. Glucose control therapy modified the relationship between HbA1c and MACEs; participants with higher HbA1c variability receiving intensive glucose control were more likely to develop MACEs (P for interaction <0.01).ConclusionIn adults with T2DM, the relationship between glycemic variability evaluated using HbA1c and FPG was U-shaped, and an increase in HbA1c variability rather than FPG variability was significantly associated with MACEs. The relationship between HbA1c variability and MACEs was affected by the glucose control strategy, and a higher HbA1c variability was more strongly associated with MACEs in patients receiving an intensive glucose control strategy

UAV-enabled integrated sensing, computing, and communication for Internet of Things : joint resource allocation and trajectory design

As an aerial service platform for Internet of Things (IoT), unmanned aerial vehicle (UAV) can provide integrated sensing, computing and communication (ISCAC) services for the IoT nodes. In this article, a UAV-enabled ISCAC system is proposed for IoT to meet the evolving requirements of emerging services in 6G networks. This system has three functions: 1) sensing user equipments (UEs) for acquiring radar sensing information; 2) executing computing tasks; and 3) offloading incomplete tasks to the access point (AP) for further processing. Through jointly optimizing UAV CPU frequency, UAV radar sensing power, transmit power of UEs, and UAV trajectory, the weighted total energy consumption of both the UAV and the UEs can be minimized. We present a three-layer iterative optimization algorithm to tackle the original nonconvex optimization problem. Finally, the effectiveness of the algorithm and its superiority in energy consumption compared to other benchmark schemes are verified through simulation results

Topological structures of energy flow: Poynting vector skyrmions

Topological properties of energy flow of light are fundamentally interesting and have rich practical applications in optical manipulations. Here, skyrmion-like structures formed by Poynting vectors are unveiled in the focal region of a pair of counter-propagating cylindrical vector vortex beams in free space. A N\'eel-Bloch-N\'eel skyrmion type transformation of Poynting vectors is observed along the light propagating direction within a volume with subwavelength feature sizes. The corresponding skyrmion type can be determined by the phase singularities of the individual components of the coherently superposed electromagnetic field in the focal region. This work reveals a new family member of optical skyrmions and may introduce novel physical phenomena associated with light scattering and optical force

Efficacy and safety of zanubrutinib plus R-CHOP in treatment of non-GCB DLBCL with extranodal involvement

IntroductionTreatment with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) shows poor response rates in non–germinal center B cell–like (non-GCB) diffuse large B-cell lymphoma (DLBCL) patients with multiple extranodal involvement. This study aims to evaluate anti-tumor activity and safety of zanubrutinib with R-CHOP (ZR-CHOP) in treatment naïve non-GCB DLBCL with extranodal involvement.MethodsIn this single-arm, phase 2, prospective, single-center study, patients with newly diagnosed non-GCB DLBCL with extranodal involvement enrolled between October 2020 to March 2022 received ZR-CHOP for 6 cycles followed by 2 cycles of maintenance treatment with rituximab and zanubrutinib. The primary endpoint included progression-free survival (PFS) in the intent-to-treat (ITT) population whereas the secondary endpoints included overall response rate (ORR), complete response (CR), and duration of response. Further, next-generation sequencing (NGS) was used for detection of different oncogenic mutations closely related to DLBCL pathogenesis.ResultsFrom October 2020 to March 2022, 26 patients were enrolled, and 23 of them were evaluated for efficacy after receiving 3 cycles of ZR-CHOP treatment. 1-year PFS and OS were 80.8% and 88.5% respectively while expected PFS and OS for 2-years are 74.0% and 88.5% respectively with median follow-up of 16.7 months and ORR was 91.3% (CR: 82.61%; PR: 8.70%). Oncogenic mutations closely related to DLBCL pathogenesis were assessed in 20 patients using NGS. B-cell receptor and NF-κB pathway gene mutations were detected in 10 patients, which occurred in MYD88 (7/19), CD79B (4/19), CARD11 (5/19), and TNFAIP3 (2/19). Hematological adverse events (AEs) ≥ grade 3 included neutropenia (50%), thrombocytopenia (23.1%), and anemia (7.7%) whereas non-hematological AEs ≥ grade 3 included pulmonary infection (19.2%).ConclusionZR-CHOP is safe and effective for treating treatment naïve non-GCB DLBCL patients with extranodal involvement.Clinical Trial RegistrationClinicaltrials.gov, NCT0483587

H7N9 and H5N1 avian influenza suitability models for China: accounting for new poultry and live-poultry markets distribution data

In the last two decades, two important avian influenza viruses infecting humans emerged in China, the highly pathogenic avian influenza (HPAI) H5N1 virus in the late nineties, and the low pathogenic avian influenza (LPAI) H7N9 virus in 2013. China is home to the largest population of chickens (4.83 billion) and ducks (0.694 billion), representing, respectively 23.1 and 58.6% of the 2013 world stock, with a significant part of poultry sold through live-poultry markets potentially contributing to the spread of avian influenza viruses. Previous models have looked at factors associated with HPAI H5N1 in poultry and LPAI H7N9 in markets. However, these have not been studied and compared with a consistent set of predictor variables. Significant progress was recently made in the collection of poultry census and live-poultry market data, which are key potential factors in the distribution of both diseases. Here we compiled and reprocessed a new set of poultry census data and used these to analyse HPAI H5N1 and LPAI H7N9 distributions with boosted regression trees models. We found a limited impact of the improved poultry layers compared to models based on previous poultry census data, and a positive and previously unreported association between HPAI H5N1 outbreaks and the density of live-poultry markets. In addition, the models fitted for the HPAI H5N1 and LPAI H7N9 viruses predict a high risk of disease presence for the area around Shanghai and Hong Kong. The main difference in prediction between the two viruses concerned the suitability of HPAI H5N1 in north-China around the Yellow sea (outlined with Tianjin, Beijing, and Shenyang city) where LPAI H7N9 has not spread intensely.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

H7N9 and H5N1 avian influenza suitability models for China: accounting for new poultry and live-poultry markets distribution data

Risk maps are one of several sources used to inform risk-based disease surveillance and control systems, but their production can be hampered by lack of access to suitable disease data. In such situations, knowledge-driven spatial modeling methods are an alternative to data-driven approaches. This study used multicriteria decision analysis (MCDA) to identify areas in Asia suitable for the occurrence of highly pathogenic avian influenza virus (HPAIV) H5N1 in domestic poultry. Areas most suitable for H5N1 occurrence included Bangladesh, the southern tip and eastern coast of Vietnam, parts of north-central Thailand and large parts of eastern China. The predictive accuracy of the final model, as determined by the area under the receiver operating characteristic curve (ROC AUC), was 0.670 (95% CI 0.667-0.673) suggesting that, in data-scarce environments, MCDA provides a reasonable alternative to the data-driven approaches usually used to inform risk-based disease surveillance and control strategies

Determination of 13 Free Fatty Acids in Pheretima Using Ultra-Performance LC-ESI-MS

Abstract: A simple and rapid ultra-performance liquid chromatography-electrospray ionization mass spectrometry method for the simultaneous determination of thirteen free fatty acids (FFAs) in Pheretima has been developed and validated. Measurements for each FFA were linear over a wide range (0.05-3.95 μg mL −1 ) with good correlation coefficients (>0.99). The limit of detection and limit of quantification for all the fatty acids were below 26 and 78 ng mL −1 , respectively. The intra-and inter-assay precision and accuracy for the thirteen FFAs fell well within the predefined limits of acceptability. Satisfactory recoveries were in the range of 96-103%. Article: INTROCUDTION Pheretima has been well known for its wide therapeutic properties such as anti-inflammatory, anti-oxidative [1], anti-asthmatic, thrombolytic, reducing symptoms of the central nervous system decline including memory loss in traditional Chinese medicine (TCM) for over 2,000 years Although fatty acids have measurable absorbance in the range of 190-215 nm, the interference of most solvents is a limiting factor for sensitive detection when analyzed directly by liqui