Development of a core outcome set for cardiovascular diabetology: a methodological framework

BackgroundCardiovascular diabetology is an emergent field focusing on all aspects of diabetes/cardiovascular interrelationship and metabolic syndrome. High-quality evidence needs to be provided to determine the efficacy and safety of interventions in cardiovascular diabetology. The heterogeneity of outcomes among trials limits the comparison of results, and some outcomes are not always meaningful to end-users. The cardiovascular diabetology core outcome set (COS) study aims to develop a COS of interventions for cardiovascular diabetology. In this paper, we introduce the methodological framework for developing the COS.MethodsThe COS development will include the following steps: (a) establish the COS groups of stakeholders, including international steering committee, Delphi survey group, and consensus meeting group; (b) systematic reviews of outcomes used in trials of cardiovascular diabetology; (c) semistructured interview of stakeholders for outcomes of cardiovascular diabetology; (d) generate a list of candidate outcomes and determine the original outcome pool; (e) Delphi survey with stakeholders of cardiovascular diabetology to select potential core outcomes; and (f) review and endorse the cardiovascular diabetology COS by expert consensus meeting.ConclusionsThis current study reports the methodological framework to develop a COS in cardiovascular diabetology and will provide evidence for the future development of COS in cardiovascular diabetology

Spatial distribution of the persistent organic pollutants across the Tibetan Plateau and its linkage with the climate systems: a 5-year air monitoring study

The Tibetan Plateau (TP) has been contaminated by persistent organic pollutants (POPs), including legacy organochlorine pesticides (OCPs) and polychlorinated biphenyls (PCBs) through atmospheric transport. The exact source regions, transport pathways and time trends of POPs to the TP are not well understood. Here polystyrene–divinylbenzene copolymer resin (XAD)-based passive air samplers (PASs) were deployed at 16 Tibetan background sites from 2007 to 2012 to gain further insight into spatial patterns and temporal trends of OCPs and PCBs. The southeastern TP was characterized by dichlorodiphenyltrichloroethane (DDT)-related chemicals delivered by Indian monsoon air masses. The northern and northwestern TP displayed the greatest absolute concentration and relative abundance of hexachlorobenzene (HCB) in the atmosphere, caused by the westerly-driven European air masses. The interactions between the DDT polluted Indian monsoon air and the clean westerly winds formed a transition zone in central Tibet, where both DDT and HCB were the dominant chemicals. Based on 5 years of continuous sampling, our data indicated declining concentrations of HCB and hexachlorocyclohexanes (HCHs) across the Tibetan region. Inter-annual trends of DDT class chemicals, however, showed less variation during this 5-year sampling period, which may be due to the ongoing usage of DDT in India. This paper demonstrates the possibility of using POP fingerprints to investigate the climate interactions and the validity of using PAS to derive inter-annual atmospheric POP time trends

Clinical study of Bian-shi therapy to mitigate insomnia symptoms in young and middle-aged patients with chronic insomnia by regulating neurotransmitters

Objective To investigate the therapeutic mechanism of Bian-shi therapy in improving sleep quality in young and middle-aged patients with chronic insomnia. Methods 40 young and middle-aged patients with chronic insomnia were randomly divided into the western medicine group （n = 20） and Bian-shi group （n = 20）. In the western medicine group， patients were orally treated with zopiclone （7.5 mg， oral administration before bedtime）， and those in the Bian-shi group were treated with placebo and Bian-shi therapy （once a week， 40 min a time， 4 times in total）. The changes of Pittsburgh Sleep Quality Index （PSQI）， and serum melatonin， acetylcholine and norepinephrine before and after 30 d treatment were analyzed and compared between two groups. Results After 30 d treatment， PSQI scores were significantly lower compared with those before treatment in two groups （both P < 0.05）. In the Bian-shi group， PSQI scores were more significantly decreased than those in the western medicine group （all P < 0.05）. After 30 d treatment， serum levels of melatonin and acetylcholine were significantly higher， whereas norepinephrine levels were significantly lower than those before treatment in two groups （all P < 0.05）. In the Bian-shi group， serum levels of melatonin and acetylcholine were significantly higher， whereas norepinephrine levels were significantly lower compared with those in the western medicine group （all P < 0.05）. Conclusions Bian-shi therapy can effectively improve the sleep quality of young and middle-aged patients with chronic insomnia， which yields higher clinical efficacy than that of zopiclone tablets. Multiple neurotransmitters may be involved in the mechanism of Bian-shi therapy to mitigate chronic insomnia symptoms

Effect of Ridge Width on the Lasing Characteristics of Triangular and Rectangular InAs/In0.53Ga0.47As Quantum Well Lasers

The lasing characteristics of InP-based InAs/In0.53Ga0.47As quantum well (QW) lasers with different ridge widths are investigated. Two groups of lasers are grown for comparison, one with active triangular QW regions and the other with rectangular QW regions. Their output powers, characteristic temperatures (T0), external differential quantum efficiencies (ηd) and junction temperatures (Tj) are analyzed and compared. The parameter of ridge width is found to play an important role in the performance of the lasers. In triangular QW lasers, by broadening the ridge width from 8 to 12\ua0μm, output power and ηd of the lasers are decreased for the temperature range of 100–320\ua0K due to heating effect. But by broadening the ridge width from 8 to 100\ua0μm in rectangular QW lasers, output power has about 3.5 time increase at 100\ua0K and ηd also has a little increase for temperatures from 100 to 180\ua0K due to much larger emission area and much faster heat dissipation. Tj, the real temperature of the active region, is also found to have accelerated increase at high injection current and heat sink temperature. Besides, compared to the rectangular QW laser of the same ridge width, the improved thermal performance of triangular QW laser is also demonstrated

High-throughput, combinatorial synthesis of multimetallic nanoclusters

Multimetallic nanoclusters (MMNCs) offer unique and tailorable surface chemistries that hold great potential for numerous catalytic applications. The efficient exploration of this vast chemical space necessitates an accelerated discovery pipeline that supersedes traditional “trial-and-error” experimentation while guaranteeing uniform microstructures despite compositional complexity. Herein, we report the high-throughput synthesis of an extensive series of ultrafine and homogeneous alloy MMNCs, achieved by 1) a flexible compositional design by formulation in the precursor solution phase and 2) the ultrafast synthesis of alloy MMNCs using thermal shock heating (i.e., ∼1,650 K, ∼500 ms). This approach is remarkably facile and easily accessible compared to conventional vapor-phase deposition, and the particle size and structural uniformity enable comparative studies across compositionally different MMNCs. Rapid electrochemical screening is demonstrated by using a scanning droplet cell, enabling us to discover two promising electrocatalysts, which we subsequently validated using a rotating disk setup. This demonstrated high-throughput material discovery pipeline presents a paradigm for facile and accelerated exploration of MMNCs for a broad range of applications

Effect and Repair Mechanism of Nano Ag Sponge Dressing Combined with Gelatin-Bletilla Striata Gum/Salvia Miltiorrhiza on Refractory Orthopedic Wounds

Objective. To explore the effect and mechanism of the sponge dressing on the healing of refractory orthopedic wound, and the gelatin-Bletilla striata gum/Salvia miltiorrhiza nano Ag (GBS-Ag) sponge dressing was prepared. Methods. GBS-Ag sponge dressing was prepared by the freeze-drying method. Twenty male SD rats were randomly divided into the control group (Ctrl group) and GBS-Ag group, with 10 rats in each group, and the rats in the two groups were established a model of back wound infection. The Ctrl group was treated with gauze, while the GBS-Ag group was treated with GBS-Ag sponge dressing. Wound healing rate, blood immune indexes, Ag content in each organ, morphological changes of wound, and expression of transforming growth factor-β1 (TGF-β1) in wound transformation were detected in the two groups of rats. Results. The mechanical properties of GBS-Ag sponge dressing were all in line with the standard, and it had good killing effect on the conventional strain after being incubated for 24 hours. Compared with the Ctrl group, the healing rate and lymphocyte percentage in the GBS-Ag group were significantly increased on day 4 and day 10 (P<0.05), while the total number of white blood cells and the percentage of neutrophils were significantly decreased (P<0.05). Compared with Ctrl group, the Ag content in liver, spleen, and kidney of rats in the GBS-Ag group was significantly increased (P<0.05). The histological results showed that the Ctrl group lacked collagen fibers in the dermis, and the angiogenesis was not rich, accompanied by a large number of inflammatory cell infiltration. The epidermal repair of rats in the GBS-Ag group was complete and partially keratinized, the dermis was rich in collagen fibers, with elastic fibers and new blood vessels, inflammatory cells were rare, and new hair follicles and thick-walled blood vessels were also observed. The expression of TGF-β1 protein in the wounds of rats in the GBS-Ag group was higher than that of the Ctrl group. Conclusion. GBS-Ag sponge dressing had multiple effects of sterilization and promoting wound healing, and its mechanism may be related to promoting the TGF-β1 protein expression

An Improved Optimal Capacity Ratio Design Method for WSB/HPS System Based on Complementary Characteristics of Wind and Solar

The reliability and economic value of wind and solar power generation system with energy storage are decided by the balance of capacity distribution. The improved capacity balance matching method is proposed in this paper, which not only utilizes the complementary characteristics of the wind and solar power generation system sufficiently but also reduces the charge and discharge times of the battery. Therefore, the generation reliability is improved and the working lifetime of the whole system is lengthened. Consequently, the investment of the battery energy storage is reduced as well as the whole cost is decreased. The experimental result was presented to verify the effectiveness of the improved optimal capacity ratio design method

Lactylation-related gene signature for prognostic prediction and immune infiltration analysis in breast cancer

Background: Lactylation is implicated in various aspects of tumor biology, but its relation to breast cancer remains poorly understood. This study aimed to explore the roles of the lactylation-related genes in breast cancer and its association with the tumor microenvironment. Methods: The expression and mutation patterns of lactylation-related genes were analyzed using the breast cancer data from The Cancer Genome Atlas (TCGA) database and GSE20685 datasets. Unsupervised clustering was used to identify two lactylation clusters. A lactylation-related gene signature was developed and validated using the training and validation cohorts. Immune cell infiltration and drug response were assessed. Results: We analyzed the mRNA expression, copy number variations, somatic mutations, and correlation networks of 22 lactylation-related genes in breast cancer tissues. We identified two distinct lactylation clusters with different survival outcomes and immune microenvironments. We further classified the patients into two gene subtypes based on lactylation clusters and identified a 7-gene signature for breast cancer survival prognosis. The prognostic score based on this signature demonstrated prognostic value and predicted the therapeutic response. Conclusion: Lactylation-related genes play a critical role in breast cancer by influencing tumor growth, immune microenvironment, and drug response. This lactylation-related gene signature may serve as a prognostic marker and a potential therapeutic target for breast cancer

Effect of Low Temperature on the Undrained Shear Strength of Deep-Sea Clay by Mini-Ball Penetration Tests

The technology for in situ testing of the undrained shear strength of deep-sea clay is underdeveloped. Indoor tests remain necessary, and there is a large temperature difference between in situ and laboratory tests. To analyse the effect of temperature on undrained shear strength, in this study the physical characteristics of marine clay samples from the South China Sea were determined, followed by penetration tests by the mini-ball method under low (4 °C) and room (20 °C) temperatures. The results indicated that the clay strength increased by 14.1–30.0% as the temperature decreased from 20 °C to 4 °C, and the strength of the bound water and the viscosity of the free water in the clay sample increased as the temperature decreased, which was the root cause of the increase in the clay strength. Based on the research, it is possible to correct the undrained shear strength values measured in laboratory tests and provide more reasonable parameters for ocean engineering