Worldwide cohort study of 46, XY differences/disorders of sex development genetic diagnoses: geographic and ethnic differences in variants

Differences/disorders of sex development (DSDs) in individuals with a 46, XY karyotype are a group of congenital disorders that manifest as male gonadal hypoplasia or abnormalities of the external genitalia. Approximately 50% of patients with 46, XY DSDs cannot obtain a molecular diagnosis. The aims of this paper were to review the most common causative genes and rare genes in patients with 46, XY DSDs, analyze global molecular diagnostic cohorts for the prevalence and geographic distribution of causative genes, and identify the factors affecting cohort detection results. Although the spectrum of genetic variants varies across regions and the severity of the clinical phenotype varies across patients, next-generation sequencing (NGS), the most commonly used detection method, can still reveal genetic variants and aid in diagnosis. A comparison of the detection rates of various sequencing modalities revealed that whole-exome sequencing (WES) facilitates a greater rate of molecular diagnosis of the disease than panel sequencing. Whole-genome sequencing (WGS), third-generation sequencing, and algorithm advancements will contribute to the improvement of detection efficiency. The most commonly mutated genes associated with androgen synthesis and action are AR, SR5A2, and HSD17B3, and the most commonly mutated genes involved in gonadal formation are NR5A1 and MAP3K1. Detection results are affected by differences in enrollment criteria and sequencing technologies

Meta-analysis on the association between the frequency of tooth brushing and diabetes mellitus risk

BACKGROUND AND OBJECTIVE: Epidemiological studies suggested that the frequency of tooth brushing might be associated with the risk of diabetes mellitus (DM), but the results were inconsistent and no systematic review was conducted to focus on this topic. In this meta-analysis, we synthesized available observational epidemiological evidences to identify the association between tooth brushing and DM risk and investigate the potential dose-response relationship of them. METHODS: We searched PubMed and Embase from their inception through December 2017 to identify observational studies examining the association between tooth brushing and the risk of DM. Reference lists from retrieved articles were also reviewed. We quantitatively combined results of the included studies using a random-effects model. Dose-response meta-analysis was conducted to further examine the effect of tooth brushing frequency on DM risk. RESULTS: We identified 20 relevant studies (one cohort study, 14 case-control studies, and five cross-sectional studies) involving161,189 participants and 10,884 patients with DM. Compared with the highest tooth brushing frequency, the lowest level was significantly associated with an increased risk of DM (OR 1.32, 95% CI: 1.19 to 1.47), and there was no significant heterogeneity across the included studies (P = 0.119, I2 = 28.1%). Exclusion of any single study did not materially alter the combined risk estimate. The dose-response analysis indicated that the summary odds of DM for an increment of one time of tooth brushing per day was 1.20 (95% CI: 1.16-1.24). CONCLUSIONS: Integrated epidemiological evidence supports the hypothesis that low frequency of tooth brushing may be a risk factor of DM, and lower frequencies of tooth brushing were significantly associated with higher risk of DM

Reporting quality and statistical analysis of published dose-response meta-analyses was suboptimal: A cross-sectional literature survey

Objective To investigate the characteristics, methodological quality, and reporting of statistical analyses of published dose-response meta-analyses (DRMAs). Study Design and Setting We searched PubMed to identify DRMAs published in 2017. The reporting characteristics and methodological qualities were assessed by the PRISMA (27 items) and AMSTAR (11 items) respectively. We also summarized the reporting of statistical analyses of included DRMAs. Results We identified 93 DRMAs, most of which (59/93) were conducted by Chinese researchers, the main outcome was the incidence of cancers. Of the PRISMA and AMSTAR items, twenty and five were well complied (80% or more) respectively. The compliance rates of several PRISMA checklist items, such as structured summary, objectives, protocol and registration, and funding, were less than 50%. There were no criteria to estimate the doses for the open-ended intervals of exposure or intervention doses. When the restricted cubic splines were used to fit nonlinear dose-response relationships, there were also no criteria to determine the fixed knots. Conclusion The adherence to the methodological items of reporting guidelines and statistical analysis of published DRMAs were suboptimal. Development of reporting guidelines to assist authors in writing and readers in critically appraising the reports of DRMAs is timely

Vasopressors in septic shock: a systematic review and network meta-analysis

Objective: Vasopressor agents are often prescribed in septic shock. However, their effects remain controversial. We conducted a systematic review and Bayesian network meta-analysis to compare the effects among different types of vasopressor agents. Data sources We searched for relevant studies in PubMed, Embase, and the Cochrane Library databases from database inception until December 2014. Study selection Randomized controlled trials in adults with septic shock that evaluated different vasopressor agents were selected. Data extraction Two authors independently selected studies and extracted data on study characteristics, methods, and outcomes. Data synthesis Twenty-one trials (n=3,819) met inclusion criteria, which compared eleven vasopressor agents or vasopressor combinations (norepinephrine [NE], dopamine [DA], vasopressin [VP], epinephrine [EN], terlipressin [TP], phenylephrine [PE], TP+NE, TP + dobutamine [DB], NE+DB, NE+EN, and NE + dopexamine [DX]). Except for the superiority of NE over DA, the mortality of patients treated with any vasopressor agent or vasopressor combination was not significantly different. Compared to DA, NE was found to be associated with decreased cardiac adverse events, heart rate (standardized mean difference [SMD]: −2.10; 95% confidence interval [CI]: −3.95, −0.25; P=0.03), and cardiac index (SMD: −0.73; 95% CI: −1.14, −0.03; P=0.004) and increased systemic vascular resistance index (SVRI) (SMD: 1.03; 95% CI: 0.61, 1.45; P<0.0001). This Bayesian meta-analysis revealed a possible rank of probability of mortality among the eleven vasopressor agents or vasopressor combinations; from lowest to highest, they are NE+DB, EN, TP, NE+EN, TP+NE, VP, TP+DB, NE, PE, NE+DX, and DA. Conclusion: In terms of survival, NE may be superior to DA. Otherwise, there is insufficient evidence to suggest that any other vasopressor agent or vasopressor combination is superior to another. When compared to DA, NE is associated with decreased heart rate, cardiac index, and cardiovascular adverse events, as well as increased SVRI. The effects of vasopressor agents or vasopressor combinations on mortality in patients with septic shock require further investigation

Using Two-Way Prestressed Semicircular Steel Plate for Construction of Reinforced Concrete Cylinder Column

A concrete column has a significant influence on constructions because the component withstands the major weight of the whole structure. However, the ordinary concrete column has limited capacity to resist to multiaxial loadings. Since steel plate is one of the most common materials used in construction, concrete reinforced with steel plates based on prestressing reinforcement technology would be a directly applicable solution to the enhancement of mechanical property. In this study, a new reinforcement method upon concrete cylinder column used a two-way prestressed semicircular steel plate, which has already been patented. The study firstly analyzed the stress-bearing situation of the short concrete column reinforced by a two-way prestressed semicircular steel plate. The considerable substitution effect of vertical prestressing force on the concrete column was explored. The multiple restriction effects of horizontal prestressing force, semicircular steel plate, and stirrup were examined. Thereby, the calculation model was derived for the prestressed structure. Secondly, the formula was verified by experiments with close agreements. The result indicated that a unified strength theory was applicable to the theoretical calculation for short concrete column reinforced with a prestressed semicircular steel plate under axial compression, providing the foundation for analytical computation of prestressed semicircular steel plate-reinforced concrete column structures

Research on Electrical Conductivity and Mechanical Properties of Ecological Concrete Prepared from Mine Solid Waste

Conductive concrete with nanographite–cupric nickel sulfate ore was prepared in this paper. As a new type of multifunctional multiphase conductive building material with conductive, electrothermal, electromagnetic shielding, piezoresistive properties, etc., nanographite–cupric nickel sulfate ore conductive concrete will have a wide range of applications in snow melting, electromagnetic shielding, cathodic protection and structural health monitoring, and other fields. In this paper, different dosage of nanographite and cupric nickel sulfate ore admixture that the mixture was excited by alkali excitation, ultrasonic vibration and combined alkali excitation and ultrasonic vibration, respectively were used to study the electrical conductivity and mechanical properties of conductive concrete, 36 groups of nanographite–cupric nickel sulfate ore conductive concrete specimens and seven groups of comparative specimens were cured for 28 days, and the unconfined compression test, three-point bending test, and electrical conductivity test were carried out. The results show that the electrical conductivity and mechanical properties of the specimens with 6% nanographite and 60% cupric nickel sulfate ore were the best, with the compressive strength, flexural strength and resistance reaching 40.83 MPa, 6.81 MPa, and 5,850 Ω·cm, respectively. Compared with the comparative specimens, the compressive strength and the flexural strength of the specimens are increased by 38.5% and 20.4%, respectively, and the resistivity is decreased by 55.7%. This shows that the alkali excitation-ultrasonic vibration activation method can not only improve the electrical conductivity of nanographite–cupric nickel sulfate ore conductive concrete pavement but also ensure the stability of its mechanical properties

Seawater Corrosion Resistance of Duplex Stainless Steel and the Axial Compressive Stiffness of Its Reinforced Concrete Columns

In order to explore the corrosion resistance of duplex stainless steel under seawater corrosion and the compressive stiffness of its reinforced concrete columns, this study first performed seawater corrosion resistance tests on HRB400 ordinary steel rebar and S32205 duplex stainless steel rebar. The effect of the corrosion product film on the corrosion behavior was investigated through polarization curve tests and electrochemical impedance spectroscopy tests. The results showed that the corrosion rate of S32205 duplex stainless steel in a seawater environment was approximately 1/15 that of the HRB400 ordinary steel rebar. The anodic polarization curve of duplex stainless steel rebars exhibited a greater slope than that of carbon steel rebars. In the simulated seawater environment, the corrosion rate of these two kinds of steel bars showed different trends. The corrosion rate of ordinary steel bar HRB400 first decreased and then increased, while that of duplex stainless steel S2205 increased steadily. Furthermore, 18 short concrete columns reinforced with ordinary and duplex stainless steel rebars were subjected to the axial compression test and stiffness analysis; the stiffness of the short columns was calculated from the test data. The theoretical values agreed with the test values, with a stiffness calculation error of less than 5%