Plasmonic hotspot arrays boost second harmonic generation in thin-film lithium niobate.

Focusing light down to subwavelength scales to enhance the light-matter interaction has been highly sought after, which has promoted significant researches and applications in nanophotonics. Plasmonic nanoantennae are a significant tool to achieve this goal since they can confine light into ultra-small volumes far below the diffraction limit. However, metallic materials have the property of central symmetry, resulting in weak second-order nonlinear effects. Here, we design plasmonic bowtie nanoantennae on thin-film lithium niobate (TFLN) for deep-subwavelength light confinement to boost the second-harmonic generation (SHG) in TFLN via the plasmonic hotspot enhancement. The SHG enhancement factor of about 20 times as compared to unpatterned TFLN is achieved in the experiment when resonantly excited by femtosecond laser. This work proposes a route for subwavelength nonlinear optics on the TFLN platform.

Prevalence and risk factors for bone loss in rheumatoid arthritis patients from South China: modeled by three methods.

BACKGROUND: To explore the prevalence of bone loss among patients with rheumatoid arthritis (RA) and healthy controls (HC) and further explored the risk factors for osteopenia and osteoporosis of RA patients. METHODS: A cross-sectional survey was undertaken in four hospitals in different districts in South China to reveal the prevalence of bone loss in patients. Case records, laboratory tests, and bone mineral density (BMD) results of patients were collected. Traditional multivariable logistic regression analysis and two machine learning methods, including least absolute shrinkage selection operator (LASSO) and random forest (RF) were for exploring the risk factors for osteopenia or osteoporosis in RA patients. RESULTS: Four hundred five patients with RA and 198 HC were included. RA patients had lower BMD in almost BMD measurement sites than healthy controls; the decline of lumbar spine BMD was earlier than HC. RA patients were more likely to comorbid with osteopenia and osteoporosis (p for trend < 0.001) in the lumbar spine than HC. Higher serum 25-hydroxyvitamin D3 level and using tumor necrosis factor inhibitor in the last year were protective factors; aging, lower body mass index, and increased serum uric acid might be risk factors for bone loss. CONCLUSIONS: RA patients were more prone and earlier to have bone loss than HC. More attention should be paid to measuring BMD in RA patients aging with lower BMI or hyperuricemia. Besides, serum vitamin D and all three measurement sites are recommended to check routinely. TNFi usage in the last year might benefit bone mass.

Prevalence and risk factors for bone loss in Southern Chinese with rheumatic diseases.

BACKGROUD: This study is to explore the prevalence of different stages of bone loss and the potential risk factors in rheumatic patients. METHOD: A cross-sectional study recruits 1398 rheumatic patients and 302 healthy subjects. Demographic data, blood, and bone mineral density (BMD) tests are collected. Risk factors for bone loss in rheumatic patients are analyzed by logistic regression. RESULTS: (1) Rheumatic patients are consisted of 40.0% rheumatoid arthritis (RA), 14.7% systemic lupus erythematosus (SLE), 14.2% osteoarthritis (OA), 9.2% ankylosing spondylosis (AS), 7.9% gout, 7.0% primary Sjogren syndrome (pSS), 3.8% systemic sclerosis (SSc), and 3.2% mixed connective tissue disease (MCTD). (2) In male patients aged under 50 and premenopausal female patients, the bone mineral density score of AS (53.9%, P < 0.001) and SLE (39.6%, P = 0.034) patients is lower than the healthy controls (18.2%). (3) Osteopenia and osteoporosis are more prevailing in male patients aged or older than 50 and postmenopausal female patients with RA (P < 0.001), OA (P = 0.02) and SLE (P = 0.011) than healthy counterparts. (4) Those with SLE, RA and AS gain the highest odd ratio of 'score below the expected range for age', osteopenia and osteoporosis, respectively. (5) Age, female, low BMI and hypovitaminosis D are found negatively associated with bone loss. Dyslipidemia and hyperuricemia could be protective factors. CONCLUSION: Young patients with AS and SLE have a significant higher occurrence of bone loss, and older patients with RA, OA and SLE had higher prevalence than healthy counterparts. SLE, RA, SSc and AS were founded significant higher risks to develop into bone loss after adjustment. Age, BMI and gender were commonly-associated with bone loss in all age-stratified rheumatic patients. These findings were not markedly different from those of previous studies.

The negative spillover impact of the COVID-19 pandemic on Hong Kong diabetes patients' mortality and cardiovascular disease.

BACKGROUND: The spillover impact from disrupted healthcare services for non-COVID-infected diabetes mellitus (DM) patients caused by the reshuffling of the manpower during the pandemic remains understudied, especially in Hong Kong where healthcare resources were already strained before the pandemic. AIM: To evaluate the spill-over effect of the Pandemic on Hong Kong diabetes patients, we examined the change in all-cause mortality and the incidence of cardiovascular disease (CVD) from 2012 to 2021. METHOD: This retrospective cohort study analyzed data from Hong Kong Hospital Authority healthcare records covering all publicly provided care. Adults diagnosed with DM on/before December 31, 2010, without CVD before January 2012 were included. The 2016-2019 average all-cause mortality and the incidence of CVD after age-standardization represented the pre-pandemic levels. Subjects would leave the cohort after being infected with COVID-19. RESULTS: A cohort of 159,693 patients with diabetes was identified and followed up for 10 years from January 2012 to December 2021. Compared to the pre-pandemic levels, 2020 saw a 12% increase in age-standardized mortality per 10,000 diabetic patients (incidence rate ratio [95% CI]: 1.12 [1.10 - 1.14]), but no significant change in age-standardized CVD incidence. However, in 2021, there were 11% (1.11[1.10 - 1.13]) and 13% (1.13 [1.11 - 1.15]) more new CVD cases and deaths, respectively, versus the pre-pandemic period. CONCLUSION: The COVID-19 outbreak in 2020 had negative spillover impacts on DM patients without COVID-19 in Hong Kong, with a higher mortality in 2020 and 2021 compared with the pre-pandemic level.

The potassium transporter TaNHX2 interacts with TaGAD1 to promote drought tolerance via modulating stomatal aperture in wheat.

Drought is a major global challenge in agriculture that decreases crop production. γ-Aminobutyric acid (GABA) interfaces with drought stress in plants; however, a mechanistic understanding of the interaction between GABA accumulation and drought response remains to be established. Here we showed the potassium/proton exchanger TaNHX2 functions as a positive regulator in drought resistance in wheat by mediating cross-talk between the stomatal aperture and GABA accumulation. TaNHX2 interacted with glutamate decarboxylase TaGAD1, a key enzyme that synthesizes GABA from glutamate. Furthermore, TaNHX2 targeted the C-terminal auto-inhibitory domain of TaGAD1, enhanced its activity, and promoted GABA accumulation under drought stress. Consistent with this, the tanhx2 and tagad1 mutants showed reduced drought tolerance, and transgenic wheat with enhanced TaNHX2 expression had a yield advantage under water deficit without growth penalty. These results shed light on the plant stomatal movement mechanism under drought stress and the TaNHX2-TaGAD1 module may be harnessed for amelioration of negative environmental effects in wheat as well as other crops.

The indirect impact of the COVID-19 pandemic on people with type 2 diabetes mellitus and without COVID-19 infection: Systematic review and meta-analysis.

BACKGROUND: The effect directly from the coronavirus disease 2019 (COVID-19) infection on health and fatality has received considerable attention, particularly among people with type 2 diabetes mellitus (T2DM). However, evidence on the indirect impact of disrupted healthcare services during the pandemic on people with T2DM is limited. This systematic review aims to assess the indirect impact of the pandemic on the metabolic management of T2DM people without a history of COVID-19 infection. METHODS: PubMed, Web of Science, and Scopus were systematically searched for studies that compared diabetes-related health outcomes between pre-pandemic and during-pandemic periods in people with T2DM and without the COVID-19 infection and published from January 1, 2020, to July 13, 2022. A meta-analysis was performed to estimate the overall effect on the diabetes indicators, including hemoglobin A1c (HbA1c), lipid profiles, and weight control, with different effect models according to the heterogeneity. RESULTS: Eleven observational studies were included in the final review. No significant changes in HbA1c levels [weighted mean difference (WMD), 0.06 (95% CI -0.12 to 0.24)] and body weight index (BMI) [0.15 (95% CI -0.24 to 0.53)] between the pre-pandemic and during-pandemic were found in the meta-analysis. Four studies reported lipid indicators; most reported insignificant changes in low-density lipoprotein (LDL, n = 2) and high-density lipoprotein (HDL, n = 3); two studies reported an increase in total cholesterol and triglyceride. CONCLUSIONS: This review did not find significant changes in HbA1c and BMI among people with T2DM after data pooling, but a possible worsening in lipids parameters during the COVID-19 pandemic. There were limited data on long-term outcomes and healthcare utilization, which warrants further research. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42022360433.

Multiple ALMT subunits combine to form functional anion channels: A case study for rice ALMT7.

The Aluminum Activated Malate Transporter (ALMT) family members are anion channels that play important roles in organic acid transport, stress resistance, growth, development, fertilization and GABA responses. The rice malate permeable OsALMT7 influences panicle development and grain yield. A truncated OsALMT7 mutant, panicle apical abortion1 (paab1) lacking at least 2 transmembrane helices, mediates reduced malate efflux resulting in yield reducing. Here, we further investigated the contribution of OsALMT7 transmembrane helices to channel activity, using heterologous expression in Xenopus laevis oocytes. We further found that OsALMT7 formed as a homomer by co-expressing OsALMT7 and paab1 proteins in oocytes and detecting the physical interaction between two OsALMT7, and between OsALMT7 and paab1 mutant protein. Further study proved that not just OsALMT7, mutants of TaALMT1 inhibit wild-type TaALMT1 channel, indicating that ALMTs might perform channel function as homomers. Our discovery brings a light for ion channel structure and homomultimer regulation understanding for ALMT anion channels and potential for crop grain yield and stress response improvement in the context of the essential role of ALMTs in these plant processes.

Prevalence and Associated Factors of Electrocardiogram Abnormalities in Patients With Systemic Lupus Erythematosus: A Machine Learning Study.

OBJECTIVE: Electrocardiogram (EKG) abnormalities are predictive of subsequent cardiovascular events. Cardiac involvement is common in systemic lupus erythematosus (SLE). We aimed to determine the prevalence of EKG abnormalities in SLE patients and to examine the factors associated with EKG abnormalities with machine learning approaches. METHODS: Consecutive SLE patients' records were retrieved from the database of the hospital for the cross-sectional study. Abnormal EKGs with clinical significance were grouped by the presence of tachyarrhythmias, atrioventricular block, nonspecific ST segment changes, T wave abnormalities, ventricular hypertrophy, axis deviation, bundle branch block, and QT interval prolongation. Associated factors of the most common EKG abnormalities were assessed by comparing logistic regression and 4 other machine learning approaches. RESULTS: In the present study, 299 patients were enrolled, with 128 showing clinically significant abnormalities on EKG. T wave changes (52.3%), nonspecific ST segment-T wave (ST-T) changes (26.6%), and prolonged QT interval (8.6%) were the most prevalent abnormalities among patients with abnormal findings on EKG. Random forests models had the best performance in the discovery of associated factors. Age, disease duration, antinuclear antibody titer, disease activity (as measured by the Systemic Lupus Erythematosus Disease Activity Index 2000) were associated with nonspecific ST-T changes, prolonged QT interval, and T wave changes. Hypertension, positivity for anti-SSA antibodies, and secondary Sjögren's syndrome were influential factors for nonspecific ST-T changes, prolonged QT interval, and T wave changes, specifically. CONCLUSION: ST-T and T wave changes were the most common abnormalities seen on EKGs of SLE patients. Our finding suggests that age, longer disease duration, higher disease activity, hypertension, anti-SSA antibody positivity, and secondary Sjögren's syndrome are important and influential factors in these EKG abnormalities.

The Trend of Targeted Therapies in Chinese Patients With Ankylosing Spondylitis: Results From a Real-Life Survey.

Introduction : Targeted medication, including mostly biologics and small-molecule chemical drugs, is an important therapy for ankylosing spondylitis (AS). There are still limited data on the preference of different targeted drugs in Chinese AS patients. Methods : A questionnaire-based cross-sectional study was performed on AS patients from six hospitals in three provinces in South China. Anti-rheumatic diseases' medication history includes the recent and previous usage of biologics or Janus kinase inhibitors (JAKi) in the last complete course of treatment, disease severity, and reasons for targeted-treatment change or preference. Results : 354 of 366 participants responded to the online survey. The participants' median age was 32 years, with a median of 7.3 years of disease duration; 79.7% were male. 63.6% of them were in the course of biologics or JAKi. Generic ETN is the most widely used and willing-to-use biologic though the proportion of its usage shrunk in the present compared with the past. The choice of original-branded ADA demonstrated an increase in usage. The preference of secukinumab and tofacitinib depicted a quick ascending trend. Conclusion : TNF-α inhibitors (TNFi) are still the most popular targeted medication for AS in China. Their price influences patients' preferences mostly. The doctor's recommendation is also part of the equation. Rheumatologists should pay more attention to patients' education to formulate targeted therapeutic plans.